Patient Looks to MRI-Guided Ultrasound Treatment to Relieve Tremors
Alexandra Lebenthal has kept the condition that makes her hands uncontrollably shake a secret throughout her life. Living with essential tremor since she was 3, Lebenthal has struggled to pour drinks, eat food, shake hands, and swipe her subway MetroCard with ease. Despite her success as the president and CEO of a boutique investment bank, the tremors have made her feel self-conscious at the many professional and social events she attends.
Since undergoing MRI-guided ultrasound ablation, a new non-invasive treatment for tremors being offered at Weill Cornell Medicine, on Aug. 22, Lebenthal is enjoying new confidence in her dominant left hand. The technique relies on MRI technology to pinpoint the exact location in the brain where the tremors originate, then administers high-intensity focused ultrasound to destroy the problematic tissue. The U.S. Food and Drug Administration recently approved the procedure, also known by its acronym HIFU and which has been previously and successfully used to treat breast and prostate cancer, for use on essential tremors in the brain.
Dr. Kaplitt became the first physician in New York to use HIFU treatment in the brain as part of the clinical trial in July. During that procedure, he watched as another trial participant's tremors disappeared in a matter of minutes.
This new technology provides a 21st century solution to a problem that's been around for a long time and continues the trend in neurosurgery toward offering less invasive therapies for a variety of brain disorders.
Dr. Kaplitt, associate professor of neuroscience and neurological surgery in neurology and otolaryngology at Weill Cornell Medicine and a neurosurgeon at NewYork-Presbyterian/Weill Cornell Medical Center.
Currently, the main option for essential tremor patients who do not respond well to medical therapy is deep brain stimulation (DBS), which involves placement of an electrode into the same area of the brain targeted by HIFU and implantation of a battery under the skin in the chest to power the therapeutic electrical impulses. DBS, which has been offered by Dr. Kaplitt and his team at Weill Cornell Medicine for movement disorders for over 15 years, remains a viable option for patients who may not be candidates for HIFU therapy.
Eventually scientists could study the technique's application to a variety of neurological disorders ranging from Alzheimer's disease to addiction. His laboratory has also been investigating ways to use HIFU to non-invasively deliver gene therapies to specific brain regions. Dr. Kaplitt has previously researched delivery of the same gene therapies in human patients with invasive injections.