Researchers at the University of Virginia are conducting a research study to investigate a new way of controlling tremor. The research study is designed to investigate the safety and feasibility of ultrasound waves targeted at the thalamus, a brain region important for tremor control. Similar to the thalamotomy of the past, this technique causes a lesion or destruction of brain cells that affect tremor.
Unlike traditional thalamotomy, this technique does not require brain surgery that includes drilling a hole in the skull to gain access to the brain and damage the cells but instead relies on MR guidance of these focused wave forms to precisely reach their target. In some ways it is similar to gamma knife thalamotomy, a technique that is sometimes used to treat tremor through focused gamma waves that when converging on a brain region can damage tissue (gamma knife is a common radiosurgery technique used for treating brain tumors and a condition called trigeminal neuralgia). These new techniques are promising and offer a less invasive approach to tremor control. It is important to note that research is just beginning and this current study is being conducted to investigate safety. If proven safe, larger studies will need to be done to test the benefit. Other considerations for this experimental procedure include
- Lesioning techniques (damaged cells) are not reversible since tissue is destroyed. If the wrong area of brain tissue is damaged it can not be restored.
- Focused ultrasound and gamma knife surgery does not have the same risk and recovery period associated with traditional neurosurgery offering a potential treatment for people in which standard surgery carries too much risk.
- Only unilateral thalamotomy at present is recommended for tremor on one side of the body due to concern of side effects with bilateral thalamotomy such as speech and walking problems.
- Research is for tremor predominant Parkinson’s disease, a condition in which other non-tremor movement symptoms are minimal compared with tremor. Non-tremor symptoms of Parkinson’s such as rigidity and bradykinesia are not treated with thalamotomy.
- There is limited experience about the combined effect of thalamotomy and other surgical techniques such as deep brain stimulation (DBS) if this were to be needed in the future.
- Like gamma knife thalamotomy, cells that are to be destroyed are located with MR imaging. Unlike thalamic DBS where a brain electrode is used to locate this precise area in the operating room by recording and stimulating actual brain cells involved in tremor, there is no ability to record the neuronal activity to further ensure that the area of tissue destruction is accurate for the individual.
Given these issues, researchers at the U of VA have designed a careful sham (placebo) controlled study to help effectively address these concerns. These new techniques show promise and offer hope for additional therapies in the future.
Wondering what others are reading about?
We analyzed 17,000 views from 106 countries to determine the top 5 posts of 2012. See the NWPF Wellness Center for more information and additional links to these topics.
The 5 most popular blog postings in the year 2012.
#5. Should I take CoQ10 for my Parkinson’s?
#4. Is Parkinson’s hereditary?
#3. Top 10 foods for PD
#2. Does stress cause Parkinson’s?
#1. Does Azilect slow disease progression?
Let others know which post was your favorite for 2012 by commenting below.
Turns out light can stimulate cells to behave differently. Researchers at the University of Virginia School of Medicine studied the effect of a low-level, near-infrared laser on nerve cells taken from people with Parkinson’s disease. The research was done in cells taken from people with Parkinson’s and compared to non-Parkinsons cells. A single, brief treatment with a 810 nm low-level, near-infrared laser increased the velocity of mitochondrial cells for 2 hours approaching the rate of mitochondria in non-PD cells. Mitochondria are the energy producing components of the cell and their activity is reduced in PD. Energy is needed for cell growth and maintaining cell health. Enhancing the functioning of mitochondria in cells taken from patients with PD may reduced the cell death seen with PD.
Light therapy is not new to brain disease. For instance full spectrum light is helpful for people suffering from seasonal depression. While promising, this research was tested in cells outside the body and much work needs to be done to develop light treatment inside the body of live individuals with PD.
Research was published in Molecular Neurodegeneration on June 17, 2009.
Tom Isaacs age 44 carries the olympic through Welwyn Garden City today. With each step he will raise awareness about Parkinson’s and inspire others with his positive message, humour, inspiration and courage for people living with Parkinson’s disease and other chronic conditions.
I am reminded of so many people with Parkinson’s that I have met along the way as I reflect on the Olympics and the stories of amazing athlete’s pushing their bodies and minds to the limit of human performance. People with Parkinson’s that meet challenge with strength and courage.
Marathoners, photographers, mountain climbers, journalists, poets, artists, dancers, quilters, motivational speakers, support group leaders to name a few- people with Parkinson’s that choose to make a difference in their lives and the lives of others.
Neupro (Rotigotine) is a dopaminergic agonist available in a skin patch. Many people benefited from Neupro in the past but it was taken off the market by the FDA when it was noted that some of the medicine crystalized on the patch and therefore did not get absorbed well through the skin.
A patch delivery of medicine allows more continuously absorption of medicine throughout the day. A small percentage of people cannot tolerate the patch experience skin irritation or rash. Side effects of dopaminergic agonists are still a concern for this patch especially impulsivity control problems, sedation, hallucinations, nausea, and low blood pressure.
Learn more about dopamine agonists…