A Canadian first, Sunnybrook brain scientists have pioneered the use of MRI-guided focused ultrasound to successfully treat a handful of patients who suffer from debilitating tremors in their arms and hands.
"This new non-invasive procedure is revolutionizing medicine," says Dr. Michael Schwartz, principal investigator of an early-stage clinical trial of the therapy and head of the Division of Neurosurgery at Sunnybrook. "Our goal was to evaluate the safety and initial effectiveness of MRI-guided focused ultrasound in treating patients with disabling tremor, and we are optimistic about the results we are seeing thus far. This technology could have far-reaching implications for many brain conditions including brain tumours and other movement disorders."
This outpatient procedure is described as "scalpel-free surgery" due to the lack of an incision. There is no general anesthetic required and the patient remains awake and alert during treatment and can go home the next day. Although only five patients have been treated so far in Canada, the procedure appears to be safe, and associated with limited side-effects.
In this trial, the technology allows investigators to focus ultrasound waves under MRI guidance through a patient's skull to reach an area located deep in the brain. Focused ultrasound is then used to lesion the cells that are responsible for the tremor.
During the treatment, real-time feedback from the MRI functions as a thermal "map" for the surgeon. It is used first to identify the target, for treatment planning, and is then used to guide the ultrasound as it is applied. Finally, it is used to immediately determine if the treatment worked.
Trials are currently planned or underway at Sunnybrook to apply MR-guided focused ultrasound to treat cancers and tumours of the brain, breast, bone, neck, and rectum, as well as benign uterine fibroids.
Update - March 2013: The study's findings have been published in the April 2013 issue of The Lancet Neurology. Watch CTV National's follow-up story with a patient three months after he had the focused ultrasound procedure.
- Michael Schwartz MD, FRCSC