From dependence to independence: Focused ultrasound may help improve life with essential tremor

(BPT) - Living with essential tremor can be exhausting. Each day starts with challenges — from brushing teeth, to shaving to tying shoelaces. These daily activities highlight the common symptom of uncontrollable shaking in the hands or arms, and sometimes head, legs and even voice. These symptoms lead to other, less visible impacts on daily life including anxiety, loss of independence and embarrassment in social settings.

For Rich Schaefer of Blue Springs, Missouri, signing his name, buttoning his shirt and eating with a fork were difficult because of his essential tremor, or ET. His wife noticed he seemed self-conscious in restaurants and other social gatherings. As the Schaefers started researching treatment options, they found a wide range of therapies from medication to deep brain stimulation. But they also uncovered an exciting, less invasive option: Focused Ultrasound.

Ultrasound can be used to treat movement disorders such as ET and tremor-dominant Parkinson’s disease (PD) that don’t respond to prescribed medications. The procedure uses ultrasound energy to precisely target and treat a small spot in the brain considered to be responsible for tremor, the Vim of the thalamus. The treatment is less invasive than some other treatment options and is performed as an outpatient procedure.

Rich wasn’t immediately sure he wanted to undergo the treatment. Like many procedures, it comes with a risk of potential side effects that could be temporary or permanent, such as trouble with balance or tingling in the lips or fingers. He knew that his ET would progress and that meant becoming more dependent on others. After he weighed his options, discussed with his physician and thought about his future, it didn’t take long for him to get on board.

Rich was treated in February of 2021 by Dr. Michael Kinsman, a neurosurgeon at The University of Kansas Health System. Along with his neurosurgery colleague, Dr. Jennifer Cheng, Dr. Kinsman was instrumental in bringing Focused Ultrasound treatment to the University of Kansas. During the procedure, Dr. Kinsman was able to view MRI images of Rich’s brain in real time, and use the click of a computer mouse to deliver the ultrasound waves to the precise target in the brain. Lying on the treatment bed, Rich was moved in and out of the MRI machine as the ultrasound was applied, with Dr. Kinsman continuing to check the tremor’s response to treatment and if there were any side effects. The treatment lasted about 2.5 hours.

On the morning of his procedure, Rich struggled to sign his name legibly. Immediately following the procedure, Rich was able to sign his name in almost perfect form. The results were clear and obvious, offering Rich the chance to focus on his future without the burden and stress of his hand shaking.

“The Focused Ultrasound program at the University of Kansas is at the forefront, which allows us to offer new and innovative treatment options to patients dealing with chronic conditions like ET,” says Dr. Kinsman. “I’m energized whenever I get to help a patient like Rich improve their outlook on life.”

Since FDA approval in 2016 for the unilateral treatment of ET that does not respond to medication, adoption of this technology is growing. The number of Focused Ultrasound programs has increased from 20 in 2019 to 34 centers today in the U.S., including The University of Kansas Health System — the only provider in the region that offers the treatment for patients with ET or tremor-dominant PD. Medical device company Insightec is the pioneer and innovator of the Focused Ultrasound technology.

Not every patient is a candidate for Focused Ultrasound treatment. Since the treatment is done under MRI guidance, the patient must be able to have an MRI scan. Someone who has metal implants that are not MRI-compatible may not be suitable. Additionally, a patient’s skull density must be evaluated with a CT scan before their suitability for treatment can be determined. Candidates must be older than 22 years of age. Safety information associated with the procedure can be found at https://usa.essential-tremor.com/safety-information.

Learn more about Focused Ultrasound treatment and start your journey to tremor relief by seeing if you could be a candidate at https://usa.essential-tremor.com/candidate/ or call an Insightec Educator at 1-800-704-6797.