MR-Guided Focused Ultrasound (MRgFUS) for Essential Tremor

1Welcome to Precision Brain Spine and Pain, where we provide innovative solutions for managing Essential Tremor.

This leaflet aims to provide relevant information about MR-guided focused ultrasound (MRgFUS) as a treatment option for essential tremor, including scientific details regarding risks, clinical outcomes, and specific statistics related to the procedure. Please read this information carefully before discussing it with your healthcare provider.

What is Essential Tremor?

Essential tremor is a neurological disorder characterized by involuntary and rhythmic shaking of certain parts of the body, most commonly the hands and arms. This condition can significantly impact a person’s quality of life, making everyday tasks like eating, drinking, and writing challenging.

What is MR-Guided Focused Ultrasound (MRgFUS)?

MR-guided focused ultrasound is a non-invasive procedure that uses focused ultrasound waves to target and treat specific areas of the brain responsible for essential tremor. This innovative technique combines magnetic resonance imaging (MRI) and ultrasound technology to precisely deliver focused energy to the affected brain tissue, without the need for surgery or incisions.

How Does MRgFUS Work?

Planning: Before the procedure, your healthcare team will conduct a thorough evaluation and use MRI scans to create a personalised treatment plan. This plan determines the exact location in your brain that needs to be treated.

Treatment: During the MRgFUS procedure, you will be placed inside an MRI scanner. High-intensity ultrasound waves are then focused on the targeted brain tissue to create a small lesion. This lesion disrupts the abnormal brain circuits causing essential tremor.

Monitoring: The MRI scanner continuously monitors the procedure, allowing real-time adjustments to ensure precision and safety.

Advantages of MRgFUS for Essential Tremor

Non-invasive: MRgFUS does not involve surgery or incisions, reducing the risks associated with traditional surgical treatments.

Precise: The technology allows for accurate targeting of affected brain regions while sparing healthy tissue.

Quick Recovery: Most patients can return to their normal activities within a few days to a week after the procedure.

No Radiation: MRgFUS uses MRI for guidance, eliminating exposure to ionising radiation.

Clinical Outcomes of MRgFUS for Essential Tremor

Most patients who undergo MRgFUS experience significant tremor improvement during the treatment process. Published outcomes indicate the following improvements in tremor compared to baseline (pre-treatment):

1 year after treatment: 69%

2 years after treatment: 75%

3 years after treatment: 76.5%

Like any surgical procedure, MRgFUS may have potential side effects and complications, although they are generally mild and temporary. Common side effects include:

  1. Nausea
  2. Headache during the procedure
  3. Numbness and tingling in the lips or fingertips
  4. Unsteadiness and balance problems
  5. Speech or swallowing problems

Most side effects start within days or weeks after treatment and resolve in many cases. Long-term safety data show that approximately 74% of adverse events are mild, with almost 50% resolving within 30 days of the procedure.

In larger pooled studies, the immediate proportion of ataxia (loss of coordination) was 50%, while it was 20% for sensory complications. These rates declined to 31% and 13%, respectively, on long-term follow-up.

How Long Does the Tremor Reduction Last?

Studies provide up to 3-4 years of outcome data, with the majority of patients maintaining a good and sustained benefit during this period.

Around 5% of patients experience recurrent tremor in the first 12 months after their procedure. If this occurs, the treatment options are a further MRgFUS procedure, or deep brain stimulation, either of which are likely to offer a significant benefit.

Choosing the Right Clinic:

When considering MRgFUS thalamotomy for Essential Tremor, it is crucial to receive advice and treatment from an experienced clinic with a strong track record in both deep brain stimulation and MRgFUS.

Expertise Matters, and is required across a broad range of specialties:

  1. Fellowship-Trained Functional and Stereotactic Neurosurgeons: An experienced team of fellowship-trained functional and stereotactic neurosurgeons specialising in MRgFUS ensures precise targeting and safe procedures.
  2. Neurologists: Expert neurologists can provide comprehensive pre- and post-operative care, optimising treatment outcomes.
  3. Neuroradiologists: These specialists play a vital role in guiding the procedure with real-time imaging, enhancing accuracy.
  4. MR Technicians: Well-trained and skilled MR technicians are essential for obtaining high-quality imaging during MRgFUS. This contributes to the procedure’s safety and effectiveness.
  5. Nursing Team: Nurses are a crucial part of the care team, providing attentive and compassionate care throughout your treatment journey.

Benefits of Choosing an Experienced Clinic:

Safety: A clinic with years of experience in both MRgFUS and Deep Brain Stimulation should be better equipped to minimise risks and manage potential complications.

Precision: Expertise ensures accurate targeting of the thalamus, maximising the effectiveness of the treatment.

Personalised Care: Experienced teams tailor treatment plans to each patient’s unique needs, enhancing the overall patient experience.

MRgFUS at Precision Brain Spine and Pain:

At Precision Brain Spine and Pain, we pride ourselves on our extensive experience and expertise in MRgFUS and deep brain stimulation. Our multidisciplinary team includes expert fellowship-trained functional and stereotactic neurosurgeons, neurologists, neuroradiologists, highly skilled MR technicians, and a dedicated nursing team. We are committed to providing the highest level of care for patients with Parkinson’s Disease.

Please remember that this page provides general information and does not replace personalised advice from your healthcare provider. Always consult with your healthcare team to make informed decisions about your treatment options.