fda approves non-invasive, outpatient surgery to relieve parkinson’s symptoms

a new method for treating advanced parkinson’s disease that uses focused sound waves instead of invasive surgery has just been given the green light by the u.s. food and drug administration.the treatment, successfully tested at the university of virginia’s school of medicine, is now authorized to treat dyskinesias, the involuntary movements and mobility issues commonly associated with the disease. the device, known as the insightec exablate neuro, uses focused ultrasound — instead of drugs or invasive surgery — to interrupt the faulty brain circuits underlying such symptoms.medical experts are able to use magnetic resonance imaging during the procedure to view the brain in real time before any permanent changes are made by the device, which operates in a similar fashion to the way a magnifying glass can create heat by focusing light.“this fda approval of focused ultrasound pallidotomy allows for more treatment options if medications become ineffective or cause disabling side effects,” said jeff elias, a health surgeon and pioneer in the field of focused ultrasound who led the testing of the technology at uva.“while this procedure does not provide a cure for parkinson’s disease, there is now a less invasive option for patients suffering with medication-induced dyskinesia or severe motor deficits.”parkinson’s disease is a brain disorder that occurs when clusters of nerve cells (or neurons) controlling the body’s movement die or malfunction, resulting in a decrease in the production of dopamine. doctors are unsure exactly what causes these cells to die, but their destruction leads to motor control issues that can have a debilitating effect on patients.there are more than 100,000 canadians living with parkinson’s today and roughly 6,600 new diagnoses every year, most occurring around the age of 65 when symptoms become undeniable. it costs more than $1.2-billion annually in canada to manage the symptoms and associated costs of the disease, with some medications costing the typical patient more than $1,000 per month.the progressive disease also damages nerve endings that produce norepinephrine — a messenger in the nervous system — likely accounting for non-motor symptoms such as fatigue and digestive issues. parkinson’s has proven notoriously difficult to treat because by the time patients seek medical attention for their symptoms, the bulk of the damage has already been done.elias first used focused ultrasound technology a decade ago to treat a clinical volunteer who was suffering from essential tremor, a neurological disorder that causes involuntary shaking, typically in the hands. he has worked since then to help the procedure gain commercial and, now, fda approval. the federal authority, which authorized use of the treatment for essential tremor in 2018, now allows its use on other parkinson’s symptoms, such as rigidity and involuntary movements.elias and his colleagues are now exploring the potential of the procedure — currently only available in 37 medical centres in the u.s. — to treat a range of other conditions, including breast cancer and epilepsy. the ability of the treatment to briefly cross the blood-brain barrier may even hold the key to tackling glioblastoma, a deadly form of brain cancer. a trial exploring that possibility is currently underway at uva.“this ultrasound technology is obviously very popular with patients because it can be performed on an outpatient basis and without any incision,” elias said. “it is still very early stage for a new procedure, so experience and technological advances will increase the safety and effectiveness.”dave yasvinski is a writer with healthing.ca