PROVIDENCE, R.I. (WPRI) — An estimated 10 million Americans are living with a condition most commonly misdiagnosed as Parkinson’s Disease called essential tremor (ET), and doctors in Rhode Island are able to help treat it with neurosurgical technology.
Rhode Island Hospital is only the second facility in New England to obtain the technology, with the first being at Brigham and Women’s Hospital.
Essential tremors are described as the uncontrollable trembling of the hands, head, voice, legs or body.
While the condition isn’t life-threatening, Dr. Wael Asaad tells 12 News it can severely impact a person’s quality of life.
“It can impact every aspect of daily living,” Asaad explained. “It can impact your daily ability to eat and drink, it can impact your ability to get dressed.”
Asaad, a neurosurgeon with expertise in movement disorders, psychiatric disease and traumatic brain injury, said the treatment involves a Focused Ultrasound (FUS), a non-invasive treatment in which ultrasonic energy targets tissues deep within the body and treats the brain circuit responsible for the patient’s tremors.
“It’s a big helmet that fits around your head,” Asaad said. “You go into an MRI scanner, and we can deliver the energy from over a thousand sources in this helmet to focus it very precisely at a single spot, just a millimeter or two across.”
The first device was approved by the U.S. Food & Drug Administration in 2016.
While the treatment is fairly new, Asaad expects that most people who receive it will not need to return for additional appointments.
“But the disease can get worse over time, and tremors can continue to get worse,” Asaad said. “So, a treatment that you give at one time may not be enough to treat the tremor later on if the tremor is getting worse.”
“As a field, we’re getting better and better at knowing how to maximize a procedure to minimize the chance that they’ll have to come back for another treatment later,” he continued. “But our hope is that for most people, this is a permanent benefit.”
In addition to treating essential tremors, the Focused Ultrasound can also be used to reduce the signs and symptoms of Tremor-Dominant Parkinson’s Disease.
At least five patients have received the treatment at Rhode Island Hospital’s Norman Prince Neurosciences Institute since late last year, according to Asaad.
“Each one of them has had a very dramatic improvement in tremors, and nobody has had any concerning side effects,” Asaad said.
Alfred Pagliarini, 80, of Hope Valley, received the treatment for an essential tremor in his left hand.
“So, I’ve got to shift everything to my right hand, which sounds like a simple thing, until you try doing it,” Pagliarini said on the day of his treatment.
Asaad said the procedure is performed while the patient is awake, so their response to treatment can be assessed in real time.
Before the treatment, Pagliarini was asked to trace a spiral shape and draw a straight line on a sheet of paper with both hands.
Mid-treatment, he was assessed and asked to repeat the task to see if his tremor was improving. He then performed the drawings a final time to once the treatment was complete.
The results in Pagliarini’s case showed an improvement.
“When we do deep brain stimulation for tremors and there’s that moment when you turn the stimulator on and the tremor stops, it’s a breathtaking moment,” Asaad said. “Now we see that same benefit without even having to use a scalpel, a totally noninvasive procedure. It feels like magic, and the patients are kind of blown away.”