image: Patient, John Lukens', writing samples before and after receiving MR-guided Focused Ultrasound Treatment (MRgFUS) for Essential Tremor (ET). view more
Credit: Penn Medicine
PHILADELPHIA - John Lukens recently became the first patient in Pennsylvania to receive MR-guided Focused Ultrasound Treatment (MRgFUS) for Essential Tremor (ET). At age 61, Lukens has suffered with bilateral Essential Tremor for roughly 10 years -- a condition which left him with such significant shaking in his hands and arms that eating, shaving, and even writing with his dominant hand was very difficult. Now two weeks after the procedure, Lukens, who lives in Plymouth Meeting, Pa., says he's tremor-free in his right hand.
Essential tremor (ET) is a movement disorder characterized by uncontrollable shaking mostly in the hands or legs. ET is eight times more common than Parkinson's disease, affecting an estimated 10 million Americans and 42 million worldwide.
Gordon Baltuch, MD, PhD, director of the Center for Functional and Restorative Neurosurgery and a professor of Neurosurgery, Andres F. Deik, MD, assistant professor of Clinical Neurology, and Robert W. Hurst, MD, professor of Radiology, worked alongside a multidisciplinary team to perform Lukens' procedure at Pennsylvania Hospital on April 27, 2017.
During the procedure, high intensity focused ultrasound waves are used to target a focal point in the Vim nucleus of the thalamus, the tiny part of the brain that is thought to be responsible for causing tremors, with no surgical incisions or implants. After magnetic resonance imaging (MRI) pinpoints the exact location in the brain where the tremors originate, MRI guidance is used to focus the many ultrasound waves on that location.
"There are millions of people in this country who are affected by essential tremor and whose lives could benefit from this non-invasive therapy," Baltuch said. "Seeing Mr. Lukens' tremor disappear before our eyes without making an incision or drilling a hole in his skull was nothing short of spectacular."
Pennsylvania Hospital is the first in the area to offer the MRgFUS treatment, Exablate Neuro, as a non-invasive treatment for Essential Tremor. This year, Exablate Neuro was approved by the U.S. Food and Drug Administration (FDA) for use with 1.5T and 3.0T MRI systems. In clinical studies of patients receiving MRgFUS for this purpose, patients saw a 75 percent improvement in their symptoms in the treated hand at 12 months after receiving the therapy. In Lukens' case, his right hand is currently completely tremor-free and he's hoping to have a future procedure that will also eliminate tremor in his left hand.
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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine. Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.