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Focused Ultrasound Can Bring Relief for Parkinson's Patients

An incision-less ultrasonic brain surgery may reduce involuntary shaking

spinner image illustration of a focused ultrasound that targets cells that cause tremors.
IBRAHIM RAYINTAKATH

The news is full of ‘promising’ developments that may ‘one day’ lead to a brighter, healthier future. But for our annual AARP focuses on 'game-changing' medical breakthroughs in vision, heart health and more survey of the latest medical breakthroughs, we decided to focus on game changers that are improving lives today. Each of these astounding new technologies and treatments is available, or will be in the near future, to make your life, and the lives of millions of other Americans, better.

Mark Witman and his son, Aaron, celebrate baseball season every year by watching the movie Field of Dreams and playing catch in Witman’s backyard in Greencastle, Pennsylvania. Worsening symptoms of his Parkinson’s disease, however, were making the decades-old tradition “really difficult,” says Witman, 59. But after undergoing incision-less brain surgery called focused ultrasound in January 2022, he says throwing the ball was once again “real smooth.”

spinner image Mark Witman overcame his Parkinson’s symptoms and is back playing catch with his son.
Mark Witman overcame his Parkinson’s symptoms and is back playing catch with his son.
Rob Tringali

Like a magnifying glass concentrating sunlight, focused ultrasound aims beams of sound energy deep into the brain, heating up and destroying cells associated with the movement problems in both Parkinson’s disease and essential tremor, a nervous system disorder that also causes involuntary shaking. The procedure doesn’t cure the underlying causes of these conditions, which together affect at least 8 million Americans, but research shows this FDA-approved procedure can calm shaking, stiffness and other movement problems that interfere with everyday activities. In a recent study, focused ultrasound reduced tremors by 38 to 50 percent for people with essential tremor. 

Another study found it also eased tremors, muscle rigidity and uncontrolled movements caused by the Parkinson’s medication levodopa by about 76 percent. Lingering side effects in one study included numbness and tingling (9 percent of users), imbalance or unsteadiness (4 percent), and muscle weakness or walking disturbance (2 percent each).​​ Focused ultrasound is best for tremors that affect one side of the body, says Howard M. Eisenberg, M.D., a professor of neurosurgery at the University of Maryland School of Medicine, who performs the procedure using a focused ultrasound system called the Exablate Neuro. “Helping one side can have a major effect on quality of life.”

Another Parkinson’s treatment, deep brain stimulation, can relieve symptoms on both sides of the body, but it carries a higher risk of infection and involves threading electrodes into the brain through holes drilled in the skull. “Deep brain stimulation has distinct advantages,” Eisenberg says. “But the majority of people who choose focused ultrasound find deep brain stimulation too intrusive.” ​

Nancy Heavrin, 74, an artist from Freeland, Maryland, had the focused ultrasound procedure in June 2022 after three decades of uncontrollable arm movements due to essential tremor. The condition made everything from painting to eating a salad to styling her hair nearly impossible. When her medications grew less effective, she opted for focused ultrasound to calm tremors on her dominant right side. “Now I’m in my studio, painting alongside my granddaughter,” she says. “I don’t have to sit on my hands or hide them behind my back. I’m making plans to go out to lunch with friends again.”​​

Like Witman, Heavrin had the procedure at the University of Maryland Medical Center. Her head was shaved (hair can obstruct ultrasound waves) and fitted with a helmet, complete with a cooling system. Surgeons used magnetic resonance imaging to focus sound waves on the correct area of the brain (the thalamus for tremors, the globus pallidus for other symptoms). “You’re awake during the procedure, so they can monitor the progress,” Heavrin explains. “I drew a spiral and a line on a piece of paper and held a bottle of water up to my mouth. I could not believe it. The tremor was just gone from my right hand. I started crying.”​​

The therapy is currently FDA-approved for treating symptoms on one side of the body, but studies of bilateral procedures are underway. (Witman participated in an experimental bilateral procedure. After a second treatment later in 2022, he says, “Most days I no longer think about having Parkinson’s disease. I really feel like I have a second chance.”)​​

More brain health breakthroughs

AI-powered robots for stroke recovery​​

spinner image man using one of Bionik’s InMotion robots
The Bionik’s InMotion robot
Courtesy Bionik

A fleet of robots powered by artificial intelligence is helping survivors of stroke, spinal cord injury and other conditions regain control of their arm, shoulder and hand movements. Bionik’s InMotion robots look like computer workstations, with specialized equipment for retraining motions used in everyday activities. A review of 19 studies concluded that robot-assisted arm training improves functioning and the ability to perform routine activities after a stroke, although it did not improve arm muscle strength.

​​A web browser that compensates for hand tremors 

spinner image tablet screen showing a Staybl app page
Staybl, a free app for iPads, compensates for hand tremors.
Courtesy Havas Group/New York/Germany

​Hand tremors caused by Parkinson’s or other conditions can make typing on a computer, moving a mouse and clicking on the screen difficult to nearly impossible. Now a company called Havas Creative has launched Staybl, a web browser technology available as a free app for iPads that compensates for hand tremors. (An Android version is planned.) It uses iPad motion sensors to detect tremors, then compensates with slight movements in the opposite direction to keep words, graphics and pictures steady on the screen. ​​

Automated help for insomnia 

​​Cognitive behavioral therapy for insomnia is proven to help midlife and older adults fall asleep faster, wake up less often during the night and log more shut-eye. Now an FDA-authorized, prescription-only version (its use must be supervised by a health care provider) called Somryst delivers similar benefits via an app — convenient if you can’t make it to a practitioner’s office for in-person sessions. Researchers are now testing a version tailored for older adults.​​

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