The High Authority for Health has given its agreement for a reimbursement for high intensity focused ultrasound therapy for people suffering from essential tremor, a common neurological condition that results in uncontrollable tremors. Professor Marc Vérin, neurologist and founder of the Brain Clinical and Experimental Neuroplasticity research unit at the University of Orléans and vice-president of the Orléans University Hospital, explains to Figaro Health that approximately 1,000 patients are resistant or have contraindications to traditional treatments currently available on the market.
This non-invasive therapy allows, without opening the skull and without incision of the skin, to create small, so-called therapeutic lesions in a strategic location of the brain. An MRI also helps guide the doctor and provides images of this central organ.
High-frequency sound waves cause tissue vibrations that generate the heat and cause necrosis or tissue death without damaging neighboring cells.
The treatment is carried out in two stages. “The ultrasound target is initially localized by slightly increasing intracerebral temperature in order to check that we actually obtain the desired therapeutic effect: a transient reduction in tremor in the absence of undesirable effects”, specifies the National Center for Scientific Research (CNRS) in a press release. When the therapeutic effect is satisfying, the temperature is increased to approximately 56°C. The ultrasound then causes a thermal injury of approximately 2 to 6 mm and interrupts the abnormal brain circuits causing the tremors.
The latest clinical trials carried out on around fifteen patients made it possible to observe a reduction in tremors in the arms and handsmaking everyday activities easier such as writing or pouring a glass of water. Some of the participants were also able to practice a more complex exercise like play a musical instrument.
A common disease that affects 1 in 200 people
The reimbursement of this technique therefore appears to be good news for people who suffer from this disabling pathology. According to the Brain Institute, after age 40, it is estimated that 4% of the population suffers from essential tremor. “This disease still remains poorly known to the general public but also to the medical community outside of neurologists. Unfortunately, the diagnosis is too often late.“, specifies, on the website of the association of people affected by essential tremor, Doctor David Grabli, neurologist at Pitié-Salpêtrière.
The diagnosis is clinicali.e. based on symptoms. It is often guided by the presence of other cases in the family and makes it possible to differentiate from other neurological pathologies such as Parkinson’s disease. “My hands shake as soon as I perform everyday movements. It’s not due to my age, I am not an alcoholicI’m not hyper-emotional, I’m not drugged… I suffer from essential tremor“, testifies a patient on the association’s website.
A new therapeutic target for other neurological pathologies
This promising technique could also show benefits in other brain pathologiesnotably the Parkinson’s disease. “Low-power ultrasound could also, in the longer term, be used to treat patients suffering from deep depression resistant to drugs, or to treat l’addiction or disorders of consciousness”, underlines the CNRS in a press release.
Researchers from the Physical Institute for Medicine have created la start-up “Sonomind” to develop a compact instrument dedicated to focusing low-power transcranial ultrasound, intended for doctors to find new therapeutic avenues and improve the lives of patients who suffer from neurological disorders.
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