The Neurosurgery Department at Taipei Veterans General Hospital has introduced the transcranial Magnetic Resonance guided Focused Ultrasound (tcMRgFUS) (Figure 1), using magnetic resonance-guided focused ultrasound to disrupt tremor-related neural circuits. This non-invasive procedure, which doesn't require craniotomy or anesthesia, has successfully treated patients with "essential tremor" and "Parkinson's disease." It holds promise for future applications in treating conditions such as epilepsy, muscle tension disorders, and obsessive-compulsive disorder, providing a significant breakthrough for patients with neurological diseases.
Some individuals, despite having functional extremities, struggle with daily activities due to conditions like essential tremor or Parkinson's disease, making simple tasks like grasping utensils, pouring water, squeezing toothpaste, or brushing teeth challenging. This not only hampers their ability to sustain a livelihood but also impacts social activities and mental health. The news highlights a case of a 94-year-old man who, after undergoing the non-invasive tcMRgFUS surgery, regained the ability to write and grasp objects without tremors, bringing a new lease on his life.
Dr. Cheng-chia Li from the Neurosurgery Department at Taipei Veterans General Hospital stated that in Taiwan, around 400,000 people suffer from essential tremor, more prevalent than Parkinson's disease. Essential tremor caused by neural degeneration leads to continuous shivering in different parts of the body. The condition most commonly seen in the elderly but might occur at any age. Over half of essential tremor patients have a family history of the condition. Statistically, about 100,000 individuals in Taiwan suffer with severe symptoms which significantly affect their daily lives and challenges such as smooth handwriting, holding a cup stably, dressing, and signing.
Dr. Li explained that conventional treatments for essential tremor and Parkinson's disease involve medication; Once the symptoms are unmanageable, surgical interventions like Thalamotomy or Deep Brain Stimulation (DBS) may be considered. Both procedures involve invasive surgeries with potential risks that deter patients from the treatments.
On the contrary, Dr. Li stated, tcMRgFUS provides a non-invasive and precise results for the patients. It doesn't require the implantation of electrodes or batteries in the patient's brain. The procedure is performed without anesthesia or craniotomy, which minimizes the risk of complications such as infections or cerebral hemorrhage. With real-time MRI navigation, the treatment is accurate and generates immediate therapeutic effects. The significant results can not only cure essential tremor but also offer more options for patients in neurological disorders.
【Case Studies】
Ms. Ma, a 67-year-old woman diagnosed with Parkinson's disease since 2019, has been regularly monitored at the Taipei Veterans General Hospital Neurology Department. Although her symptoms showed some improvement with medication, she experienced tremors in her right hand and legs. Stiff facial expressions resulted in slowed speech, and tremors or stiffness in her right hand and legs made tasks like writing and using the restroom difficult. She underwent tcMRgFUS treatment in May of 2023. One month after the procedure, there were no tremor reported. Four months later, there was slight stiffness in the legs, and occasional amnesia without any abnormal sensations. She has remained in stable condition until the end of 2023.
Mr. Liu, an 80-year-old man, experienced tremors in his right hand in his 40s, which gradually worsened over time. The tremors alleviated occasionally but worsened in attempt of performing writing for example. After a delicate pre-operative evaluation, Mr. Liu underwent tcMRgFUS treatment in April of 2023. The tremors significantly decreased, leading to a substantial enhancement in his quality of life. Follow-ups at 1 month, 3 months, and 5 months post-surgery indicated that his condition remained stable and satisfactory.