A new approach to addressing neurological conditions is yielding tremendous results for patients. We spoke with Meaghan Caliste, MA, RMA, Parkview Neurosciences about the nuances of focused ultrasound and who makes a great candidate.
What would be some symptoms or diagnoses that might benefit from focused ultrasound?
There are two main conditions we see benefit from this approach: Parkinson's disease and essential tremors.
Essential tremor is a movement disorder that results in shaking that you can't control. It may start in the hand or fingers. The shaking may increase or spread to other parts of the body over time. Your voice may shake when you speak. Essential tremor doesn't cause other health problems, but it can make work or other activities more difficult. It is not related to a stroke or Parkinson's disease.
Parkinson's disease is a problem with certain nerve cells in the brain that control movement. The disease affects the way you move, and can include tremors, slow movement, stiffness and problems with balance. Parkinson's disease gets worse over time, but usually this happens slowly, over years.
How were these conditions treated before focused ultrasound became available?
Historically, these neurological conditions were addressed through medications and advanced therapies, such as Botox® and Cala Trio, a wearable electronic nerve stimulation device.
There are some medicines, such as beta-blockers or anticonvulsants, that may help reduce tremors. Treatment could also include physical therapy to help improve your strength and balance. This arm of the treatment plan could entail occupational therapy as well so that patients can learn to manage daily activities more easily. Surgery may be an option for some people.
Resting and reducing stress are key to caring for yourself when you have essential tremor. Regular exercise and massages may help. Avoid drinks or foods with caffeine if they make your tremors worse. Wearing a heavy bracelet or watch may reduce tremors. Take your medicines exactly as prescribed.
Some might not require treatment at all.
What are the benefits of the focused ultrasound approach?
The benefits and results really depend on the patient, but when individuals are asked if they would try the procedure if it could reduce their tremors by 50%, they say yes. We have done about 50 cases, with promising results.
Are there certain conditions that benefit more than others?
Not really. Again, outcomes truly vary by individual.
What's involved in focused ultrasound?
There is some testing patients will go through, such as a neuropsychology, CT scan and MRI of the brain. Patients also must shave their head.
Watch Beverly’s experience in this video.
Like with any surgery, there is always a slight risk of side effects.
What are some other causes of tremors?
Some things can affect how much you shake. For example, caffeine and anxiety may make tremors worse. Some medicines, including antidepressants and too much thyroid replacement, also can increase tremors. Talk to your doctor if you think one of your medicines makes your tremors worse.
What are some other changes that can benefit those with an essential tremor?
Changes to your activities and your home may help. For example, simplify your daily activities and change the location of furniture so that you can hold on to something as you move around the house, which can help prevent falls.
- Eat healthy foods. This includes plenty of fruits, vegetables, grains, cereals, legumes, poultry, fish, lean meats and low-fat dairy products.
- Exercise and do physical therapy. They have benefits in both early and advanced stages of the disease. Exercise also may slow the worsening/progression of Parkinson's disease.
Improving your motor skills
- Work on your tremor. This may include things like putting a little weight on your hand to help reduce tremors and restore control.
- Improve speech quality by working with a speech therapist (also called a speech-language pathologist).
- Reduce problems with eating and drooling by changing how and what you eat. For example, avoid foods that crumble easily.
- Practice overcoming "freezing" with various techniques, such as stepping toward a specific target on the ground. A physical therapist may be able to help you with this.
Improving your mood and memory
- Talk to someone about depression. If you are feeling sad, ask a friend or family member for help. If these feelings don't go away, or if they get worse, talk to your doctor. They may be able to suggest someone for you to talk to or give you medicine that can help.
- Know the signs of dementia. Dementia is common late in Parkinson's disease. Symptoms may include confusion, getting lost and memory loss. If you (or a family member) notice that you are confused a lot or have trouble thinking clearly, talk to your doctor. There are medicines that can help.
If you are experiencing symptoms consistent with essential tremors or Parkinson’s disease, talk to your doctor or neurologist about a referral to a movement disorder specialist.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.
