Cutting-Edge Brain Surgery That Needs No Scalpels

Essential Tremor, ET, or kinetic tremor, are all names for an extremely common and challenging disease for over 200,000 people in the U.S. yearly. One in 20 people over the age 45 and one in 5 over the age of 65 are affected by this disease, which causes uncontrollable tremors when trying to voluntarily move or hold something up. The average onset age is 40, but it can affect the elderly and chlidren. Until recently, the disorder was treated with medication that was unreponsive to almost 40% of the affected population. Recently, however, doctors have used INSIGHTEC's Exablate Neuro device to send focused UV waves into the problematic part of the brain and turn off the tremor.

How does ET work?

Usually, tremors are caused by small issues in the section of the brain that controls motor movement, which is anywhere in the cerebellum, which is a relatively large portion of the brain. These issues could be any number of things that cannot be removed or fixed by surgery, such as metabolic problems or toxins that inhibit the nervous system. Also, it can happen when certain parts of the brain do not communicate well. There is not an exact, pinpointed cause for kinetic tremor, but it is widely assumed that it is a genetic disease that can happen to people with family history of it. However, there are milllions of cases of people without family history getting ET. The two types of tremors caused by Essential Tremor: Action Tremor and Postural Tremor. Action tremor is a tremor caused when an affected person is trying to lift or move something voluntarily, such as putting glasses on. Postural tremor is caused when trying to hold something up, such as holding a cup in the air.

What kinds of treatments were there for ET?

Usually, patients are prescribed with medication such as any beta blockers (Acebutolol, Atenolol, Bisoprolol) or in some cases, epilepsy medication or anticonvulsants. 40% of patients, however, do not respond to these medications and have to resort to a complicated surgical procedure called deep-brain stimulation, in which permanent electrodes are inserted into the brain, which are wired to a device in the chest. However, this procedure is slightly invasive and comes with many risks, as it is brain surgery. The recovery period is also lightly long with a procedure such as this one. However, the new treatment from INSIGHTEC does not have any of these risks of complications and recovery time.

How INSIGHTEC revolutionized ET treatment

INSIGHTEC is a medical device company founded in 1999, based in Haifa, Israel, whose purpose is to try and remove the need for incisions in certain procedures. While looking into treatments for ET, INSIGHTEC came up with a treatment where ultrasound waves are focused into the problematic part of the brain, which effectively turns off the tremors. This treatment has been approved by the U.S. Food and Drugs Administration (FDA) and has been accepted as a course of treatment in 25 states, and this treatment has cured over 1,200 patients in 2019. The magical thing about this treatment is that it is not very risky to try, because it is not an invasive procedure and will not affect the brain if it does not work. INSIGHTEC is working to use this focused ultrasound technology to fix other disorders as well. Patients that are treated using INSIGHTEC's exablate neuro device are instantly cured and can leave the hospital as soon as the treatment is over.

Bibliography

https://news.kochind.com/news/2019/cutting-edge-brain-surgery-no-incision-required

https://www.medtronic.com/au-en/your-health/conditions/essential-

tremor.html#:~:text=As%20many%20as%20one%20in,65%20may%20have%20essential%20tremor.&text=Although%20the%20average%20age%20of,between%20childhood%20and%20old%20age.

https://www.mayoclinic.org/tests-procedures/deep-brain-stimulation/about/pac-20384562