Focused Ultrasound Therapy
Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with Holmes tremor. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue) enabling treatment of Holmes tremor without surgery.
The primary options for treatment of Holmes tremor include medications or unilateral thalamotomy.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as nerve damage, bleeding, surgical wound healing, or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary. This approach also does not require the use of general anesthesia.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of Holmes tremor.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for Holmes tremor is not yet approved by regulatory bodies or covered by medical insurance companies.
Yamamoto K, Ito H, Fukutake S, Odo T, Kamei T, Yamaguchi T, Taira T. Factors Associated with Heating Efficiency in Transcranial Focused Ultrasound Therapy. Neurol Med Chir (Tokyo). 2020 Dec 15;60(12):594-599. doi: 10.2176/nmc.oa.2020-0225. Epub 2020 Nov 6.
Fasano A, Llinas M, Munhoz RP, Hlasny E, Kucharczyk W, Lozano AM. MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes. Neurology. 2017 Aug 22;89(8):771-775. doi: 10.1212/WNL.0000000000004268. Epub 2017 Jul 26.
Gabriela B. Raina, MD, Maria G. Cersosimo, MD, Silvia S. Folgar, MD, Juan C. Giugni, MD, Cristian Calandra, MD, Juan P. Paviolo, MD, Veronica A. Tkachuk, MD, Carlos Zuñiga Ramirez, MD, Andrea L. Tschopp, MD, Daniela S. Calvo, MD, Luis A. Pellene, MD, Marcela C. Uribe Roca, MD, Miriam Velez, MD, Rolando J. Giannaula, MD, Manuel M. Fernandez Pardal, MD, and Federico E. Micheli, MD, PhD. Holmes tremor: Clinical description, lesion localization, and treatment in a series of 29 cases. Neurology. 2016 Mar 8; 86(10): 931–938.
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