New non-invasive procedure to help with tremors

From their hands to their heads, millions of Americans suffer from tremors, involuntary muscle movements that can make everyday tasks almost impossible.

Some procedures to fix the problem involve cutting into the brain. Now there's a non-invasive breakthrough procedure that could help patients steady their lives.

It's uncontrollable, and can make life miserable. Billy Williams knows what these people are going through.

For the past 10 years, he's suffered from a hand tremor. No one knows why he shakes, but the tremor was so bad, Billy stopped going out to eat.

Billy Williams, Tremor Patient, explains how bad it was, "I had trouble writing my name, really, I couldn't sign anything."

Now, neurosurgeons are using a new procedure called MRI Guided Focused Ultrasound to stop certain types of tremors.

Jeff Elias, MD, Neurosurgeon, University of Virginia Medical Center, explains what the new procedure involves, "It involves high resolution MRI scanning as well as ultrasound technology."

The new scalpel-free surgery is the first to use ultrasound in the brain to treat tremors.

Dr. Elias, MD, describes how important it is to know where to do the procedure, "We really have to be precise to within a millimeter to stop the tremor."

Doctors can get that precise by using the MRI scanner. It aims pulses of harmless ultrasound waves through a patient's skull to a targeted region in the brain.

The waves converge, heat up, and kill tremor-causing cells.

Dr. Elias, MD, describes how they can check to make sure the procedure worked, "It allows us the opportunity to test the patient during the treatment."

Billy and his doctors watched his tremor get better and better.

Williams explains how much better his tremors where after the procedure, “Almost immediately after the procedure my hand was as it is right now."

A quick fix with no cuts, that helped Billy’s hands go from shaky to steady.

The world's first clinical trials using MRI Guided Focused Ultrasound to treat essential tremors recently wrapped up at the University of Virginia Health System.

Officials say patients are experiencing immediate improvements that have been sustained through the study's three month follow-up period.

Future trials are planned to investigate the technology in treating functional brain disorders like Parkinson’s disease, epilepsy and stroke.


REPORT MB # 3417

BACKGROUND: A tremor is the most common of all involuntary movements that affect that hands, arm, head, face, vocal cords, and legs. A tremor consists of a somewhat rhythmic muscle movement of one or more parts of the body; most often occurring in the hands. Tremors most frequently affect middle-aged and older men and women. A tremor may indicate other neurological disorders in some people but can occur in otherwise healthy individuals. A tremor is not life-threatening but can make performing daily tasks difficult. (Source:

ABOUT THE NERVOUS SYSTEM: The brain is "hardwired" with connections, which are made by billions of neurons that make electricity whenever they are stimulated. The electrical patterns are called brain waves. Neurons act like the wires and gates in a computer, gathering and transmitting electrochemical signals over distances as far as several feet. The brain encodes information not by relying on single neurons, but by spreading the information across large populations of neurons, and by rapidly adapting to new circumstances. Motor neurons carry signals from the central nervous system to the muscles, skin, and glands of the body, while sensory neurons carry signals from those outer parts of the body to the central nervous system. Receptors sense things like chemicals, light, and sound and encode this information into electrochemical signals transmitted by the sensory neurons. And interneurons tie everything together by connecting the various neurons within the brain and spinal cord. The part of the brain that controls motor skills is located at the rear of the frontal lobe.

CAUSES: Tremors can be caused by; genetics, drug use, injuries, and others by unknown reasons. Commonly tremors are caused by neurological disorders, or other conditions that can produce tremors such as multiple sclerosis, stroke, traumatic brain injury, and neurodegenerative diseases that damage or destroy parts of the brainstem or the cerebellum. Tremors may be triggered by or become exaggerated when the individual is physically exhausted, during times of stress or strong emotion, or during certain postures or movements.

NEW TREATMENT: Traditional therapies for tremor treatment involve invasive brain surgery, but with the use of MRI's and ultrasounds neurosurgeons are using a new, non-invasive procedure on patients to help stop certain types of tremors that interfere with their everyday lives. The technique uses a combination of an ultrasound to heat up and kill the problem cells, and an MRI to allow surgeons to visualize and precisely target the affected regions of the brain. Patients most prefer this new treatment over traditional therapies for tremor treatment because the new procedure provides a scalpel-free approach to reduce and eliminate tremors. (Source:

HOW ULTRASOUND WORKS: Ultrasound is a medical imaging technique that uses high-frequency sound waves and their echoes. It is similar to the echolocation that bats use to navigate in the dark and the SONAR that submarines use to navigate underwater.. An ultrasound machine transmits high-frequency sound pulses into the body through a probe. The sound waves travel until they hit a boundary between two kinds of tissue-for example, the boundary between soft tissue and bone. When this happens, some of the sound waves are reflected back to the probe, while others travel further through the body until they hit another boundary. All the reflected waves or "echoes" are recorded by the machine, which then calculates the distance each sound wave traveled based on how long it took the sound wave's echo to return. This data is used to form a two-dimensional image based on the distances and intensities of the echoes.

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