For many people with Parkinson’s disease, tremors can become one of its most visible and disabling symptoms — and medication may no longer be enough to control them.
Doctors at UT Southwestern Medical Center are now using a newly approved treatment that requires no incision or implanted device. Instead, it uses precisely focused sound waves aimed at a specific point deep inside the brain.
For one Arlington patient, 72-year-old Air Force veteran Bud Leavell, the results came within minutes. Leavell had suffered from Parkinson’s for years, and his tremors had become so severe that he could no longer do many of the things he enjoyed, including repairing antique radios.
After undergoing the treatment, he could hold his hand steady again.
Dr. Bhavya Shah, an interventional neuroradiologist at UT Southwestern who helped perform the procedure, has spent much of the past decade working to develop the medical center’s brain-focused ultrasound program.
“We’ve been working on ways to map the brain and identify patient-specific targets so that we can treat them for essential tremor and Parkinson’s disease,” Shah told the Texas Standard.
How focused ultrasound works
Shah said therapeutic ultrasound works on a principle similar to the ultrasound technology commonly used for medical imaging. The difference is that instead of using sound waves to produce an image, doctors use them to deliver energy.
During the procedure, a helmet containing approximately 1,024 ultrasound transducers surrounds the patient’s skull. Each transducer produces its own beam.
“Each ultrasound transducer starts its own beam,” Shah said. “And these beams cross an intact skull onto a very specific point in the brain.”
Individually, the beams aren’t capable of affecting the tissue, Shah said. “It’s really where all of these beams combine onto a focal spot that we can achieve a heat deposition,” capable of reaching the targeted brain tissue he said.
But identifying exactly where to direct that energy is a crucial part of the process. Shah said every patient’s brain is slightly different, so UT Southwestern doctors map each patient’s brain to identify a target based on that individual’s symptoms.
Doctors initially expose the targeted area to low-energy ultrasound while the neurologists examine the patient, looking both for improvement in Parkinsonian symptoms and for possible side effects. If the treatment is working as planned, Shah said, doctors then increase the energy and treat the target.
Shah sees focused ultrasound as part of a potentially significant shift in treating disorders of the brain.
“I think this is opening the door to what I would call incisionless therapies of the brain,” he said.
Three elements make the approach possible, Shah said: precisely mapping and identifying a patient-specific target; testing that target in real time with a movement disorder neurologist; and then heating the targeted tissue so that the clinical change lasts.
And Shah believes focused ultrasound could eventually have applications that extend beyond the treatment being performed today.
“I think it’s opening the door for future therapies, things like gene therapy, cell therapy,” he said.
Focused ultrasound is a dynamic enough technology, Shah said, that researchers may ultimately be able to use it to enhance some cellular therapies. That could mean moving away from destroying targeted brain tissue and toward treatments designed to give cells material they need to produce the right proteins or overcome other problems.
The goal, Shah said, is reaching a point where doctors can accomplish that “without having to burn a hole in someone’s brain.”
If you found the reporting above valuable, please consider making a donation to support it here. Your gift helps pay for everything you find on texasstandard.org and KUT.org. Thanks for donating today.
