Elias Pharaon is 85 years old and can sign his name for the first time in five years thanks to a new way to do brain surgery. Performed by a team of University of Calgary physicians and researchers with the Hotchkiss Brain Institute, magnetic resonance guided focused ultrasound (MRgFUS) is a new technology that allows surgeons to access the brain without cutting the skin, or drilling into the skull.
"We are able to see the brain with real-time imaging and target a beam of high intensity ultrasound to the region responsible for tremor," says Dr. Zelma Kiss, neurosurgeon and professor in the Department of Clinical Neurosciences at the Cumming School of Medicine (CSM). "The patient is awake the whole time and the results are immediate." Pharaon, came from BC for the treatment at Foothills Medical Centre, and volunteered to undergo this treatment procedure and participate in the research project.
The CSM MRgFUS system is the only one in western Canada. "I couldn’t believe the tremor in my right hand was gone. I didn’t feel anything during the procedure," he says. "I was so happy. It’s changed my life, I feel like I can go out in public again." Essential tremor is the most common type of movement disorder; usually treated with medication.
For some, like Pharaon, the medication doesn’t work and the tremors become so severe people can no longer dress or feed themselves. This procedure gives doctors the ability to provide individualized treatment. "The condition occurs because different parts of the brain are not talking to other parts properly, and the abnormal network function causes the tremor to appear ," says Dr. Davide Martino, neurologist and associate professor, CSM. Martino will identify patients who qualify for treatment, and conduct all the follow up work for the research study which will include brain scans, clinical evaluations, cognitive and functional testing, and motor and sensory abilities over time.
"This is the beginning of a much larger research platform," says Bruce Pike, PhD, and professor CSM. "The idea of neurosurgery in an awake patient without breaking the skin is revolutionary. This technology may provide a new tool to study different treatment options for devastating brain diseases such as Parkinson’s disease, dementia, epilepsy and brain tumours."
The research study is being done in collaboration with Alberta Health Services and with funding from Canada Foundation for Innovation and private donors, including significant donations from the Rob McAlpine Legacy Initiative and the Cumming Medical Research Fund. At this point, only patients with severe medication resistant essential tremor are being treated with MRgFUS.