During the American Society for Stereotactic and Functional Neurosurgery meeting held this week in Chicago, a trio of international focused ultrasound experts shared the results from two ongoing clinical trials in essential tremor and participated in a special session on state-of-the-art lesioning techniques.

assfn16 banner 300More than 350 neurosurgeons attended the essential tremor (ET) abstract sessions presented by Drs. Daniel Jeanmonod (SoniModul AG, Solothurn, Switzerland) and Ryder Gwinn (Swedish Medical Center, Seattle, WA). The following day, various lesioning techniques were discussed, and Dr. W. Jeffrey Elias described his experience using focused ultrasound for ET. 

  • Dr. Daniel Jeanmonod presented “Incisionless Transcranial MR-guided Focused Ultrasound in Essential Tremor: Cerebellothalamic Tractotomy.” He described the areas of the brain that are hyperactive in patients with ET, how these areas release impulses that follow cell pathways (“tracts”), and how those impulses result in excessive movements. By creating lesions in the tracts, the impulses do not reach their target, resulting in dramatic improvements of the tremors.
  • Dr. Ryder Gwinn reported results from an international, multi-site study. In “MR Guided Focused Ultrasound Thalamotomy for the Treatment of Essential Tremor: Pivotal Study Results,” he described the trial and its intent to unilaterally block the VIM nucleus in the thalamus, which led to improved ET results.
  • Dr. W. Jeffery Elias contributed to the lesioning session with his presentation entitled, “High Frequency Focused Ultrasound.” He described the appropriate targeting processes and highlighted its non-invasive advantages (the skull is not opened, the dura remains closed, no hardware is placed, and no issues of infection). After the presentations, the audience asked multiple questions about the various applications of focused ultrasound.

 

 

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