UVA study testing ultrasound surgery treatment on Parkinson’s patients

UVA neurosurgeon Neal Kassell has given up the OR in favor of working to advance a surgical technology he says could be the most important medical device development since the invention of the scalpel—and he’s building a new research funding model in the process. Photo courtesy of UVA Medical Center. UVA neurosurgeon Neal Kassell has given up the OR in favor of working to advance a surgical technology he says could be the most important medical device development since the invention of the scalpel—and he’s building a new research funding model in the process. Photo courtesy of UVA Medical Center.

Researchers at UVA have embarked on a new study to determine whether an advanced, noninvasive surgical procedure could help alleviate some of the debilitating symptoms of Parkinson’s disease.

Dr. W. Jeffrey Elias, a UVA neurosurgeon, is overseeing the placebo-controlled, FDA-approved study, which is treating patients with focused ultrasound waves. Treatments involve pinpointing a trouble spot in the body with concentrated sound waves that can superheat a tiny area only a centimeter across and burn away tissue. Tissue removal techniques have been successfully used to treat Parkinson’s in the past, but the process is much more invasive. With focused ultrasound, patients go through something similar to a long, involved MRI procedure—no cuts, no anesthetic, no long recovery.

Exploration of and advancements in the technology has been spurred in recent years by the work of another UVA neurosurgeon, Dr. Neal Kassell, who founded the Focused Ultrasound Surgery Foundation in 2006, and has since steered $20 million in investment dollars toward studies like the one underway at UVA, exploring various applications for what he believes will be a technology that will change surgery forever.

The current study follows an exploratory clinical trial Elias conducted earlier this year that treated 15 people with essential tremor—shaking of the hands and body associated with Parkinson’s and other neurodegenerative diseases.

The trial was promising: All 15 patients saw a reduction in their tremor symptoms. But the placebo effect is known to be strong with many Parkinson’s treatments. While it’s not well understood, researchers have noted that in some studies, patients saw improvement even when they didn’t get a treatment dose—though those improvements usually aren’t as strong or as long-lasting as those seen in patients who got actual treatment.

That makes determining the effectiveness of a particular Parkinson’s treatment more difficult. The best way to get past the placebo is through a carefully run double-blinded study, which is exactly what Elias is overseeing now. It involves 30 patients who will be randomly divided into either a treatment group or a control group, and neither patients nor those in charge will know which participants are receiving the real treatment.

“The essential tremor trial was our first experience with MR-guided focused ultrasound, and we were very encouraged by the results,” said Elias in a press release. “We’re eager to extend our investigation and evaluate the technology’s use in alleviating symptoms of Parkinson’s disease. A treatment without incisions could offer new options and new hope to patients worldwide.”

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