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New technology brings tremor treatment into the future

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ChristianaCare is the first in Delaware to offer incisionless brain surgery for the treatement of essential tremors and Parkinson's Disease. l PHOTO COURTESY OF CHRISTIANACARE

ChristianaCare is the first in Delaware to offer incisionless brain surgery for the treatment of essential tremors and Parkinson’s Disease. l PHOTO COURTESY OF CHRISTIANACARE

WILMINGTON Doctors at ChristianaCare are blasting away bad cells with a new MR-guided focused ultrasound technology helping them relieve tremors in Delaware patients.

Dr. Justin Martello, the director of the Parkinson’s and Movement Disorders Programs and Focused Ultrasound Program at ChristianaCare, said the technology also works to bring the state’s most northern health care system into the forefront of future possibilities.

“In our region, the closest places [with MR-Guided Ultrasound technology] are the University of Pennsylvania, University of Maryland, John Hopkins just bought a machine but it’s not in place yet and New Jersey surprisingly has three locations,” he said, adding that the machines available in Philadelphia and Maryland are primarily for research use at this time.

“We have a pretty big catchment area with Baltimore, Philly and Maryland as a state,” he told Delaware Business Times. “Since those machines are mostly for research, we have that catchment area to treat those patients, as well.”

ChristianaCare is the first hospital in the state of Delaware to use the FDA-approved MR-guided focused ultrasound treatment for essential tremor and Parkinson’s disease, conditions that could be embarrassing or debilitating for Martello’s patients. The technology was a $2.2 million investment for the health system.

Central tremors are one of the most common movement disorders that can impact 1% of the United States population or about 5% of patients over the age of 60. It’s common with Parkinson’s disease patients and mostly impacts fine motor abilities, like holding a cup of coffee.

“Everyone has a tremor center of their brain. You even see it in people when they’re really angry, they start shaking and things like that,” Martello told DBT.

He said the more serious tremors are the ones he hopes to attack with the new, non-invasive outpatient procedure which takes place from inside an MRI machine. During the procedure, patients stay awake so they can talk back and forth with the physician who is working behind the scenes to heat up parts of the brain which affect the individual patient’s tremors.

“We want to make sure we’re in the right spot so we’re not going to create additional side effects,” Martello explained to DBT, emphasizing the need for constant communication with the patient. “Any side effects and results from the procedure will happen immediately so they’ll know during the procedure.”

The most common side effects, he noted, are balance issues since balance cannot be tested during the procedure.

“Today, there are basically three options for managing tremor,” Dr. Pulak Ray of Delaware Neurosurgical Group and associate director of the Focused Ultrasound program stated in a press release. “The first is medication, which is effective and affordable for many patients, but its effectiveness tends to diminish over time. The second is deep-brain stimulation, which is the most invasive and costly treatment option. The newest is MR-guided ultrasound which tends to be the preferable option for most patients who do not respond well to medication, because it is a simple, non-invasive outpatient procedure that is highly effective, safe and produces instant results.”

But Martello encouraged patients to have those conversations with their medical providers to discuss risks and benefits of each option.

“This procedure tends to be for people who are not great surgery candidates. These kinds of issues [tremors and Parkinson’s Disease] tend to happen in older populations. They might have trouble holding onto something or doing something with their hands like bringing a cup to their mouth without shaking all over the place. To be honest, it tends to be a quality-of-life issue with embarrassment, too,” he told DBT.

“Christiana invested in this technology because right now there’s 40 or 50 other indications that haven’t been researched. The exciting part is that “60 Minutes” had, last month or in April, a segment looking at the use of this for Alzheimer’s or addiction and other future indications that look really promising and we’re at the forefront of that,” he told DBT.

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