About one million Americans have Parkinson’s disease. It’s a disorder that affects brain cells in a specific area of the brain and can lead to Dyskinesia — involuntary, erratic bodily movements such as shaking and tremors.
Historically, medications were used to treat the disease. When medications didn’t work, or stopped working well, deep brain stimulation was often used.
But some work being done by researchers in Maryland is helping more people suffering with Parkinson’s.
“That is really the placement of pacemaker-like wire into a brain target to really jam the effects of groups of overactive nerve brain cells,” said Dr. Paul Fishman, a professor at the University of Maryland School of Medicine and a neurologist at the University of Maryland Medical Center.
But that procedure came with risks.
“Deep-brain stimulation still required drilling a hole in the skull and placing a wire deep within the brain,” said Fishman said. “During that procedure, there’s always the possibility that there would be bleeding into the brain, or infection.”
But this newer treatment — MRI-guided focused ultrasound — doesn’t involve surgery.
So how does it work?
“A patient wears an array of sound speakers, tiny little sound speakers, over 1,000 of them,” he said. “And they can actually penetrate the skull and target, with accuracy, a deep-brain area.”
Just like focusing the sun’s rays with a magnifying glass, he said the sound energy can target and heat the area that needs to be destroyed to improve the patient’s symptoms.
“The thing that was really a concern is that our intent was to kill a small piece of brain and just making sure that we could control the process, so that we didn’t cause any serious injury to the neighboring areas of brain, for me as a neurologist was one of the most gratifying results of the study,” he said.
The one time treatment is not a cure, but for many people he believes it will reduce the impact of Parkinson’s on their daily lives.
Currently, the treatment is only used on one side of the brain. But for many patients, that’s enough, as Parkinson’s often impacts one side more than the other.
Soon, they hope to offer treatment for those with more severe cases, where both sides are impacted. They are currently recruiting people who have been treated on one side to take part in a trial to treat both sides of the brain. But he said they are taking it slow, as they want to make sure those people are not developing any complications in the years following their initial treatment.
“The most troublesome part of Parkinson’s is that it worsens over the years,” Dr. Fishman said, “In this study, so far, we’ve only been able to follow people for the first year. And so the real question is how will people do (in) 2-5 or more years.”
He also said this treatment doesn’t address some of the most serious symptoms of more advanced Parkinson’s disease. Patients with more advanced Parkinson’s disease develop serious problems with balance. They also have problems with intellectual functioning, which can resemble Alzheimer’s disease.
He hopes future therapies can have an impact on those symptoms.
MRI-guided focused ultrasound may also become a more common treatment for other ailments.
Research is underway in Boston to use this therapy to treat psychiatric conditions, in particular, severe obsessive compulsive disorder.
Fishman also has a colleague researching using forced ultrasound to treat brain tumors.