Focused Ultrasound Device Helps Treat Essential Tremor

An innovative device uses magnetic resonance imaging (MRI) guidance to deliver focused ultrasound into the thalamus, the area of the brain thought to be responsible for tremor.

The ExAblate Neuro device is designed to deliver precise high-intensity focused ultrasound (HIFU) waves to target a focal point in the Vim nucleus of the thalamus, a part of the brain thought to be responsible for causing tremors. The proprietary ultrasound transducer consists of 1,024 beams that generate heat at a focal point of up to 85○C to ablate targeted tissue the frequencies used for therapeutic ultrasound are in the range of 220-680 MHz. The result is an immediate and significant reduction of tremor for patients.

During planning and treatment for essential tremor, the patient is fully conscious and lying on the treatment bed in a proprietary MR guided focused ultrasound (MRgFUS) system. The MRI provides high-resolution visualization, patient-specific treatment planning, and continuous monitoring of the procedure. Real-time thermal feedback allows the physician to control and adjust the treatment, ensuring that the targeted tissue is completely ablated without impacting adjacent healthy tissue. The ExAblate Neuro device is a product of InSightec (Dallas, TX, USA), and has been approved by the U.S. Food and Drug Administration (FDA).

“I am confident that we have arrived at a tipping point for non-invasive medical treatment,” said Maurice Ferré, MD, CEO and chairman of the board of InSightec. “Focused ultrasound has the unique ability to precisely ablate target tissue deep within the body. With Exablate Neuro, InSightec expands its Exablate product line with a system that signifies a new era for functional neurosurgery.”

“Patients with essential tremor who have not seen improvement with medication now have a new treatment option that could help them to avoid more invasive surgical treatments,” said Carlos Peña, PhD, director of the division of neurological and physical medicine devices at the FDA Center for Devices and Radiological Health (CDRH). “As with other treatments for essential tremor, this new device is not a cure but could help patients enjoy a better quality of life.”

HIFU technology is based on nonlinear acoustic mathematical optimization methods to analyze and simulate the propagation of sound in material. The information is then used to enhance the shape of an acoustic lens in such a way that that ultrasound pressure is focused precisely on the location of the tissue to be ablated, while the surrounding tissue retains as little damage as possible.

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