Focused ultrasound for essential tremor

FUS harnesses the power of ultrasound waves to reach deep brain regions without the need for scalpels or cutting.

On the morning of a FUS procedure, a special head frame is fitted to the patient’s head with local anaesthetic. This will attach to a focused ultrasound helmet that helps to hold the patient’s head still during the procedure. The helmet contains transducer elements that deliver ultrasound to a specific region of the brain. Patients lie down in the MRI scanner and are awake throughout the entire procedure, and carefully monitored by the medical team.

Following the procedure, patients are transferred to the neurosurgical ward for recovery and are discharged home a few hours later. Patients return to the hospital the next day for a follow-up MRI scan. The surgical and medical teams closely monitor each patient’s post-treatment recovery and longer term outcome.

For many people with essential tremor the disability is relatively mild, while for others it can be quite severe. For many patients, medication is effective but in those for whom medications do not work, surgery becomes an option. MRI-guided focused ultrasound treatment is suitable for people with severe tremor that interferes with activities of daily living like writing, eating and drinking from a cup, who do not respond to medication.

Eligible patients must be:

• At least 18 years of age
• A Canadian resident
• Have a tremor dominant movement disorder that has failed medical treatment

Focused ultrasound for essential tremor can be offered as part of clinical care for Canadian residents. Patients interested in this treatment option can have their doctor send a referral to Sunnybrook neurosurgeons Dr. Michael Schwartz or Dr. Nir Lipsman. Please contact harquailcentre@sunnybrook.ca for more information. Please use subject line: FUS Essential Tremor.

Contact us using one of the three options:

• Fill out our online form
• Email: harquailcentre@sunnybrook.ca Note: Please use subject line: FUS Essential Tremor
• Phone: 416-480-6100 ext. 63773 (please leave your contact information)

For more information about this treatment or focused ultrasound at Sunnybrook Health Sciences Centre: sunnybrook.ca/focusedultrasound

Sunnybrook researchers are investigating the safety of a bilateral essential tremor treatment with focused ultrasound in a new clinical trial.

Some patients experience tremor in both hands. This is called bilateral tremor.

In the trial, patients with severe essential tremor who have previously and successfully been treated with focused ultrasound to address tremors in one hand will receive a second focused ultrasound procedure targeting the other side of the body.

Patients are eligible for the trial if they have a confirmed diagnosis of essential tremor and at least one year has passed since their first FUS procedure.

The goal of this clinical trial is to investigate the safety of a second focused ultrasound procedure on patients with severe essential tremor, to better understand the affects of a second treatment, and evaluate the ways in which a second treatment might further improve a patient’s quality of life.

Eligible research participants must be at least 18 years of age, a Canadian resident, have a confirmed diagnosis of essential tremor and have had at least one year pass since their first FUS procedure.

This clinical trial will involve 12 patients.

Patients interested in participating in this research study can contact the Harquail Centre for Neuromodulation at Sunnybrook:

• Email: harquailcentre@sunnybrook.ca Note: Please use subject line: FUS Bilateral Essential Tremor Study
• Phone: 416-480-6100 ext. 63773 (please leave your contact information)

Patients will undergo baseline examinations, including imaging and videotaped neurological, speech and balance/gait assessments.

On the day of the procedure, the patient will be fitted with a specialized head frame with local anaesthesia. This will attach to a focused ultrasound helmet that helps to hold the patient’s head still during the procedure. The helmet contains transducer elements that deliver ultrasound to a specific region of the brain. Patients lie down in the MRI scanner and are awake throughout the entire procedure, and carefully monitored by the medical team.

Following the procedure, the patient will be transferred to the neurosurgical ward for recovery and will be discharged home a few hours later. Patients return to the hospital the next day for a follow-up MRI scan. Patients will return for clinical imaging and assessment follow up one week after the procedure and again after three 3 months.

In this trial, focused ultrasound is being used to target the thalamus, which is a small structure in the centre of the brain that sends motor and sensory signals to other parts of the brain. It is the same structure targeted in the patient’s first focused ultrasound treatment for essential tremor. There is one thalamus on each side of the brain. This procedure will target the second one on the opposite side of the brain that was not treated the first time.

Contact us using one of the three options:

• Fill out our online form
• Email: harquailcentre@sunnybrook.ca Note: Please use subject line: FUS Bilateral Essential Tremor Study
• Phone: 416-480-6100 ext. 63773 (please leave your contact information)

For more information about this trial or focused ultrasound at Sunnybrook Health Sciences Centre: sunnybrook.ca/focusedultrasound