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  1. #1
    Thailand Expat misskit's Avatar
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    Tremors disappear with use of machine that sends heat waves to the brain

    Delray Medical Center cut the ribbon on its newest high-tech machine last week that targets brain areas to treat movement disorders such as essential tremor and tremor-dominant Parkinson’s disease.


    The machine can stop the involuntary trembling of the heat and hands experienced by people with neurological disorders in one treatment using focused ultrasound guided by MRI.


    Neurosurgeons at Delray Medical Center already have been treating patients with uncontrollable tremors or stiffness with the earlier version of the machine developed by Insightec. During treatment, ultrasound waves enter a patient’s skull to precisely heat and destroy specific regions deep inside the brain that generate tremors.

    Typically, the tremor is gone immediately and the patients go home the same day with minimal complications, said Dr. Lloyd Zucker, chief of neurosurgery at Delray Medical Center. Neurosurgeons at Delray began using the original machine 10 years ago as an alternative to surgery.


    A video shown at the Thursday ribbon-cutting for the new, modernized machine highlighted a patient with Parkinson’s Disease whose hand went from shaking to still in a matter of minutes. As the patient readied to go home, he teared up seeing the difference.


    Zucker said the next generation of the Insightec machine, called the Exablate Prime, will get even better results. It uses algorithms, data management, and a higher resolution monitor. “The amount of imaging and style of imaging has improved … There are things we couldn’t do with the original machine that they have given us the ability to do now,” Zucker said.


    With improvements, this new version can treat more patients in a day than the previous one. Rather than surgery, the Exablate Prime system sends 1024 beams of ultrasound to pass through the skull and focus on a point in the brain, Zucker explained. At first, low-energy ultrasound is applied to the targeted area, allowing the patient to provide feedback so the neurosurgeon can adjust the treatment before applying high-energy ultrasound to destroy a lesion causing the tremor.

    “What you are seeing is the next step, and the next step ensures patient safety, improves patient outcomes, and gives us the opportunity to treat diseases we only dreamed about treating … not just Alzheimer’s, not just movement disorders,” he said. “I am talking about chronic pain, addiction, neurooncology, and things we all know reside in the brain.”


    Zucker said the hospital has a wait list of about a year for patients with essential tremor or tremor-dominant Parkinson’s to be treated with focused ultrasound. The new machine allows his team to complete a few more patients daily, requiring less downtime in between.


    Delray Medical Center also has been treating Alzheimer’s patients using focused ultrasound technology as part of a study done in collaboration with Florida Atlantic University’s Institute for Human Health and Disease Intervention.


    Dr. Arif Dalvi, physician chief of the movement disorder program at Delray Medical Center, says for Azheimer’s patients, the ultrasound shakes up the blood-brain barrier enough to allow the amyloid plaque that builds up in the brain to leak out. He gives the patients three treatments with the machine and plans to monitor them over five years.

    “I think this, in some ways, is the most exciting time for Alzheimer’s,” Dalvi said. “I think we have some infusion drugs, we have focused ultrasound, and we have drugs that address non-amyloid pathways. Once you put the three together, you will have a cocktail that really helps. I think we are right at the beginning of that now.”


    Dr. Augusto Grinspan, chief medical officer for Insightec, said the need for his machines is increasing.


    “About 500,000 people have tried medication and found it ineffective. They are desperate to find a solution,” he said.


    Nationally, 79 treatment centers use Insightec’s focused ultrasound machines, including nine Florida locations. Each machine costs about $2 million and must be integrated with an MRI.

    Medicare covers focused ultrasound in Florida for essential tremor patients. Some private insurers will cover it, too.


    At the ribbon-cutting Thursday, Heather Havericak, CEO of Delray Medical Center, said the administration saw a benefit in the investment. “We’ve already been able to touch so many lives, and we’re going to be able to touch so many more with this new technology.”

    Parkinson’s tremors disappear with use of machine that sends heat waves to the brain

  2. #2
    Thailand Expat harrybarracuda's Avatar
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    You can clean jewellry with ultrasound.

    I wonder what the long term effects will be.

  3. #3
    Member Molle's Avatar
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    Quote Originally Posted by harrybarracuda View Post
    You can clean jewellry with ultrasound.

    I wonder what the long term effects will be.
    Oxidation will eventually make it soiled again..

  4. #4
    Excommunicated baldrick's Avatar
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    Can it be used for the people with the jumpy legs and the tapping fingers?

  5. #5
    I am not a cat
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    Quote Originally Posted by harrybarracuda View Post

    I wonder what the long term effects will be.
    Therapeutic use of ultrasound is well established for certain conditions. That is therapeutic use, not solely imaging.

    As someone who has essential tremor I would go under the machine tomorrow.

    Essential tremor is very different to the Parkinsonian tremor. Parkinsonian tremor happens all the time. Essential tremor occurs when you try to do something. For me, the effect is mostly in my hands, and to a lesser extent my legs. I can go up stairs no problem, but have to be very, very cautious going down stairs. I never carry anything going down stairs unless it can be slung over my shoulder.

    In general, it is just a f*cking pain in the arse. The first time I *really* noticed it was one handed pouring a glass of wine for someone across the table. My arm and hand were twitching like crazy. Then my handwriting got progressively worse. My signature went into a deep spiral - when you work in Thailand you can spend half your working day just signing shit. I had to get a note from my specialist to give to the bank so they would get off my arse about my signature. Typing is a nightmare now. Probably one word in three has an extra/wrong letter in it, requiring quite careful double checking. Anyone who comments on mistakes in my posts with regards to misspelling etc can simply go fuck themselves.

    I know I am blessed that it is not Parkinson's, and unlike their horror, essential tremor is an inconvenience that requires accommodation, and to be fair, I have good days and bad days. Today was pretty bad.

    The biggest joke in the world is that one of the things that is known to dampen the tremors is alcohol.

    Meh. Beats being dead I suppose.

  6. #6
    Thailand Expat misskit's Avatar
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    ^I have essential tremor also, nid.

  7. #7
    CCBW Stumpy's Avatar
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    This process has been around and in use for awhile. My Pops is going to have the process at Stanford in a few weeks.

    We went through the overview and process with the neurologist while I was back in California a few months ago. There are a lot of results from hospitals that have completed this process and the results are amazing and there been virtually no negative side effects, in fact all are positive. The main issue patients noted were headaches for a few days but they subside in a few days. Being i can't be there, my youngest daughter will be with him.

  8. #8
    I am not a cat
    nidhogg's Avatar
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    Quote Originally Posted by misskit View Post
    ^I have essential tremor also, nid.
    Kinda sucks right?

  9. #9
    Thailand Expat misskit's Avatar
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    Yes. Particularly going down stairs.

  10. #10
    Thailand Expat david44's Avatar
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    Quote Originally Posted by Molle View Post
    make it soiled again

  11. #11
    CCBW Stumpy's Avatar
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    Quote Originally Posted by nidhogg View Post
    Kinda sucks right?
    They do. My Pops tremors are in his right hand/arm making it very difficult to write and eat. Of course after a few what we call Anti-shaker cocktails (usually a Vodka drink or 2) they almost completely go away which the neurologist said is extremely common. He told us a few funny stories about patients.

  12. #12
    Thailand Expat misskit's Avatar
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    Mine aren’t that bad. Other people notice it more than I do. It’s certainly not difficult for me to eat though my signature doesn’t look the same as in the past. I must hold a rail when going down stairs which I find rather embarrassing but falling would be worse.

    If it were available to me, I would get treated by ultrasound. I will research it in Thailand. Maybe even go to the US for it.

  13. #13
    Thailand Expat harrybarracuda's Avatar
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    There is a caveat according to one poster:

    FUS is irreversible so if it doesn’t work then you can’t try dbs!

  14. #14
    Thailand Expat misskit's Avatar
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    ^Wires in the brain doesn’t sound too good either!

    Here it is in Thailand. MRI-guided Focused Ultrasound (MRgFUS) the Advancement in Radiology that Faculty of Medicine Siriraj Hospital - SIRIRAJ

    Go for it nidhog! Then tell me if it’s worth it or not.

  15. #15
    I am not a cat
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    ^ Not sure mine is severe enough at the moment, but will talk to my neurologist next time I see him.

  16. #16
    CCBW Stumpy's Avatar
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    The wire to the brain requires a pacemaker style controller. That's a big no and old technology.

    The Focused Ultrasound using the MRI is the best option when meds have no impact. But... a few drinks and the essential tremors stop completely. It's a pick your option. My Pops and I did a bunch of tests per the neurologist.

  17. #17
    Thailand Expat DrWilly's Avatar
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    Self medicating sounds good to me!

  18. #18
    CCBW Stumpy's Avatar
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    Quote Originally Posted by DrWilly View Post
    Self medicating sounds good to me!
    Hey. We laugh. So at mid 80s one has to think about it..right. so the Stanford Neurologist told us a 86 year old lady was going to attempt the surgery after the awful meds she was taking didn't work. She came back and told the Neurologist, I find if I have a few Vodka cocktails they go away and at my age, I enjoy that. So she passed. My dad is similar. When he has few his tremors are completely gone and he enjoys the pleasantly anesthesized feeling. At mid 80s. Why go through it all and take a boat load of meds. Enjoy Life.
    Last edited by Stumpy; 16-01-2025 at 12:40 PM.

  19. #19
    Member Salsa dancer's Avatar
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    Nerve stimulation devices

    A wearable electronic peripheral nerve stimulation device (Cala Trio) is a newer treatment option for people with essential tremor. The device, which can be worn as a wristband for 40 minutes twice a day, works by stimulating peripheral nerves and muscles to create a muscle response that reduces tremors. Studies have found that the device can bring some improvement for tremors.

  20. #20
    CCBW Stumpy's Avatar
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    We reviewed a host of new processes but they overall have had limited to no success with people that have what would be called mild to excessive essential tremors. They work for some that have extremely low early tremors conditions.

    The only 2 very effective methods are the wire to the brain using an installed controller or the High Frequency focused ultrasound.

    There are medications available that will work for folks with very mild tremors. They are the same medications used for epilepsy. The issue is the side
    effects and drug interactions. Those meds cannot be used if you use blood thinners or meds for high BP.

  21. #21
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    ^True, meds have so many side effects.

    This new technology sounds amazing and I hope it can help many people both with Parkinsons and Alzheimers. It sounds expensive though.

  22. #22
    I am not a cat
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    Quote Originally Posted by MarilynMonroe View Post
    ^True, meds have so many side effects.

    This new technology sounds amazing and I hope it can help many people both with Parkinsons and Alzheimers. It sounds expensive though.
    The Parkinson tremor is very, very different from essential tremor, and I do not think Alzheimer's is associated with tremors.

  23. #23
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    Interesting thread. Mrs blds hands constantly shake and I've tried to get her to see a doc but she refuses saying it's always been there. She simply won't discuss it. To hard headed I guess I would like to know if it's something serious? or treatable ?

  24. #24
    CCBW Stumpy's Avatar
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    Nid above is right. Essential tremors and very different from Parkinson and Alzheimers does not have a shake factor in its ailment. The process being discussed is for Essential Tremors. The process isn't applicable to Parkinson as they are different.

    @BLD, your wife should go and at least have the tremors assessed to determine what it could be. Hopefully it's not serious.

  25. #25
    Thailand Expat harrybarracuda's Avatar
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    Quote Originally Posted by BLD View Post
    Interesting thread. Mrs blds hands constantly shake and I've tried to get her to see a doc but she refuses saying it's always been there. She simply won't discuss it. To hard headed I guess I would like to know if it's something serious? or treatable ?
    Essential Tremor is far more common than people think but the symptoms can vary from almost imperceptible to very Parkinson's like. There are a variety of treatments. You could try some of things listed here, starting with the non-medicinal ones.

    Just a moment....

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