UVa trial produces decrease in tremors in Parkinson’s patients
October 30, 2017
A small pilot study has shown promising results from the use of focused ultrasound on Parkinson’s patients with tremors that previously had resisted medical treatment.
After three months, the treatment, overseen by Dr. Jeff Elias of the University of Virginia, restored some fine motor skills and increased the quality of life of participants. Elias and other researchers at UVa’s School of Medicine believe the results show focused ultrasound can be a promising treatment to help manage Parkinson’s, which currently has no cure.
The trial was conducted on 27 participants. The research team randomly assigned 20 patients to be treated with focused ultrasound waves, which send sound waves through the skull to focus on a tiny spot and interrupt faulty brain circuits. The remaining seven patients received a fake procedure. The trial participants saw significant improvement in hand tremors three months later.
“Typically, a 62 percent median improvement is the type of score that allows people to write, drink or eat,” said Elias, a professor of neurological surgery at UVa. “Those are the three daily tasks that are typically most impaired with Parkinson’s tremor, and can have a significant impact on people’s quality of life.”
Participants who underwent the sham procedure also improved slightly, suggesting a placebo effect. Additional testing is needed to better establish the effectiveness of focused ultrasound for Parkinson’s tremor, the researchers concluded.
The most significant side effects reported were mild weakness on one side of the body in two patients, which later improved, and numbness of the face and finger, which were persistent. Side effects occur if the focused ultrasound affects adjacent brain circuits, Elias said.
The procedure is simple: The ultrasound transducer looks like an old-timey helmet hairdryer, Elias said, and it is turned on while patients are undergoing an MRI. Researchers can watch the effects of the ultrasound in real-time and target it to sub-millimeter precision.
However, the treatment does not affect the progression of Parkinson’s, and has only been tested by UVa on patients with tremor-dominant presentation of the disease.
“The idea is that the tremors are just one less problem,” Elias said. “We’re not altering the course of the disease, but it’s a quality-of-life improvement.”
Now that the pilot study has concluded, researchers hope to begin a large, multicenter study to define the role of focused ultrasound in managing Parkinson’s.
“I’m hopeful that this trial could be evaluated by the [Food and Drug Administration] and included in treatment like essential tremor,” Elias said. “It looks like it could provide some type of benefit for this symptom of Parkinson’s disease.”
In 2011, Elias pioneered the first-ever clinical trial to treat essential tremor, a common movement disorder, with focused ultrasound. The Clinical Research Forum named the UVa Health System’s pioneering use of focused sound waves to treat essential tremor as one of the top 10 clinical research achievements of 2016.
UVa has one of the only focused ultrasound centers in the country that is capable of treating the brain, and the center treats one or two people a week, many of whom travel to Charlottesville for the procedure. Elias now is looking to expand his research to other neurological disorders, including conditions that cause chronic pain, that may be helped with focused ultrasound.
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