Stanford doctors use heat to steady shaking hands

Thursday, December 8, 2016
PALO ALTO, Calif. (KGO) -- A newly approved treatment, tested in the Bay Area, could soon be making the lives of thousands of people a lot steadier. It's able to smooth out severe shaking, right in front of a patient's eyes.

NOTE: Stanford Health Care is receiving a significant amount of inquiries about the new procedure. Please be advised that the program is just beginning. There may be some delay in scheduling.

Living in Carmel, golf was a passion for Joe Cusenza once he was actually able to tee off.
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"Because literally I could not hold the ball steady enough to keep it on the tee," explains Cusenza.

Joe suffered from a condition called essential tremor, which effects an estimated 10-million Americans. His right hand shook so badly, he could barely write a legible sentence. Stanford neurologist Veronica Santini, M.D.,M.A., says the normal treatments range from drugs, which can lose effectiveness over time, all the way up to major surgery.

"For instance the other therapies we have require a big brain operation, where we open the skull and we enter the brain tissue," says Dr. Santini.



Instead the Stanford team turned to a newly approved procedure. It combines the imaging power of MRI with heat generated by a special ultrasound. With a halo-like device attached to his skull, Joe is placed in the MRI. Over the course of the treatment, doctors beam sound waves into a precise area inside Joe's brain. That resulting heat destroys the nerve cells causing the tremors.

"And the tissue at the target is disrupted," says Dr. Pejman Ghanouni, M.D., Ph.D., assistant professor of radiology at Stanford Medical Center.
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Dr. Ghanouni says the targeting system is incredibly precise. But key feedback also comes from patients themselves, who are awake during the procedure.

"And so we're able to do this heating and then in real time go in and ask the patient to do various tasks. We're able to assess their tremor and see that the tremor is diminishing," says Dr. Ghanouni

And the evidence is clearly visible. A short time after his procedure, Joe Cusenza's handwriting improved from almost illegible, to smooth and fluid.

"We're talking about somebody who was utterly disabled by this disease to an almost 100-percent recovery," says Dr. Santini.



Doctors say they're still gathering data to learn how long the effects last. And millions more patients could ultimately benefit. Stanford has just joined a second nationwide trial, aimed at Parkinson's disease.
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Joe is already thrilled with the results.

"I started to notice it an hour after the operation. And basically I could do anything with my right hand," he says.

Including, setting up the tee for 18 holes.

And millions more patients could ultimately benefit. Stanford has just joined a second nationwide trial, aimed at Parkinson's disease, and hope to use the same ultrasound technique to treat those tremors as well.

Written and produced by Tim Didion.
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