Study Makes Waves in Treating Essential Tremor

August 23, 2013

The treatment of neurologic disease took a major step forward this past week with the publication of a clinical trial that used ultrasound waves to treat Essential Tremor.  Essential tremor affects about 10 million people in the USA and can be extremely disabling. For patients that fail medical therapy invasive surgical options are considered, including deep brain stimulation (DBS). DBS surgeries involve drilling a hole in the skull and implanting an electrode into structures deep in the brain to turn off the unwanted signals that cause the tremor.

A study of 15 patients lead by Dr. Jeff Elias (University of Virginia) was published in the New England Journal of Medicine this week and describes how researchers used ultrasound waves to effectively treat Essential Tremor non-invasively – no cutting or drilling.  Briefly, a helmet like device sends over one thousand ultrasound waves through the skull and focuses the ultrasound energy onto a tiny point deep in the brain. The principle is similar to using a magnifying glass to focus the sun’s rays to burn a hole in a leaf. Each beam has no effect on healthy tissue but there is a dramatic effect at the point of beam convergence. Using an MRI machine, researchers were able to visualize a small target area and create a lesion in the brain at a precise target with extreme accuracy.  Patients are awake and interactive throughout the procedure, and feedback from the patient helps guide treatment.
At one year follow-up all patients had significant improvements in their quality of life and tremors.  Four patients had tremor so severe they were unable to feed themselves, however they can now feed themselves independently after the procedure.

MR guided Focused Ultrasound technology offers the potential to non-invasively treat many other neurological conditions including Parkinson’s Disease, brain tumors, epilepsy, stroke, OCD, trigeminal neuralgia, and difficult to treat chronic pain from cancer and other causes.  Clinical trials for Essential tremor, Parkinson’s disease, and brain tumors have already begun.

Swedish Neuroscience Institute continues to be a leader in the adoption of minimally invasive therapies to treat neurological disease. The Institute has partnered with InSightec, the manufacturer of the ExAblate Transcranial Neuro device, and with the Focused Ultrasound Foundation, which provides support for clinical trials as well as facilitating collaborative research. Clinical trials using focused ultrasound for essential tremor at Swedish have recently opened for patient enrollment. I was part of the essential tremor treatment team at the University of Virginia and recently joined the Swedish Neuroscience Institute to partner with Dr. Ryder Gwinn (Principal Investigator) for the essential tremor trial.

Topics: Neuroscience


Does this treatment cause some damage to the brain because of the lesion it creates. If it doesn't work what is the person left with? I need more information about this procedure.
If you have tremors in both hands, must they be threaded at separate times? One year?
Is this the same as the "Gamma Knife" I read about seems similar in the way they focus the beams on a spot and zap it. I understand that process had bad effects on about 4% of the procedures.I have the Tremor and its getting worse so I am looking for some thing that will work
I am 76 yrs old with hereditary tremors in my dominant left hand and would like more information and possible consideration for your trials.
I have been diagnosed with Essential Tremor that affects my head and both hands. Could you please give me more information about the Clinical Trial on the Ultrasound technique and also cost information about the Gammaknife Procedure.I would also like to know the risks involved.Thank you very much.
Hi Cathy,Thank you for your inquiry about the Gamma Knife treatment for essential tremor. If you would like more information about this treatment option, we would be happy to speak with you about it. Our number is 206-320-7187.
Could you send information on choices for treatments for ET and if they don't work, what could be the worst thing that could happen that would leave you with more disability??
My husband has familial Essential Tremors and for his parents become severe. At what stage of difficulty are treatment options considered, especially now that they are less invasive. We would like to stay ahead of the tremors progressing to worse stages.
I have had ET for 30 years, now. It is so severe that I spill food, find writing very difficult, and my voice quivers. It is definitely progressing but I am afraid to have deep brain stimulation surgery. I live in Florida and wondering if there is an ultra-sound treatment facility anywhere in the state? Would like more information in general. Thank You
Hi Cynthia, a good resource might be
I am inquiring about more information about the ET treatments you have wrote about on the website. My father has this and found your information, he in turn forwarded the information to me.
Hi Ericka,Thank you for your inquiry about the Gamma Knife treatment for essential tremor. If you would like more information about this treatment option, we would be happy to speak with you about it. Our number is 206-320-7187.
I was diagnosed with ET about 10 years ago. None of the usual medications helped. I'm interested in the comparative merits of the gamma knife treatment vs recently reported focused ultrasound. Thank you Loren Rickard