I was worried a while ago.  While one of my friend was talking with us (we were sitting around a table at St. Elmo’s for our morning discussion), I noticed his hands were trembling.  I thought he had more than enough coffee- or, worse, he was developing Parkinson’s Disease.

After everyone began petering out, I approached him.  He promised it was not too much coffee- and that he would visit his doctor.  Not really because I brought it to his attention, but because he felt it too- and was worried.

It turns out, DS has what is called “essential tumor”.  No, It’s not essential. Physicians call things essential because that sounds a lot better than saying we don’t have a darned clue what causes it.  About 7 million American citizens are so afflicted.  Those afflicted have shaking of their hands and arms- and that shaking exhibits a fairly large amplitude and very slow rhythm.

The problem is that drug therapy provides only a short-term effect.  (Hmm. Kind of like L-Dopa and how it “helps” those with Parkinson’s.)  Both propranolol (normally used for circulatory issues like blood pressure and heart problems) and primidone (a barbiturate used to treat those afflicted with seizures) don’t really reduce the amplitude of the tremors by more than 60%- plus they afford the taker plenty of side effects.

Brain surgery can help- but most folks with this less-than-threatening life illness are not (nor should they be) willing to accept the consequences of a “hole in the head”- plus the protruding electrodes after that surgery tend to be somewhat unsightly.  You see, a wire is inserted (as part of this therapy) into the brain and then threaded to the thalamus  (this is the brain’s relay center, thought to control tremors) .  This lets the patient (and the physician)  turn on signals to the brain via a remote controller.  The deep brain stimulation stops the tremor.  When the signals are turned off, the tremor returns.  The operation and inserted wires create no irreversible changes to the brain.)

(I have mentioned my grandfather did have an irreversible change to his brain..  But, he had Parkinson’s.  And, Dr. Cooper’s technique to freeze part of his brain worked for several years, before my grandfather’s disease progressed beyond therapy.)

But, it looks like there is a much less invasive therapy for this malady.  One based upon a variation of technique we developed for brain surgery years ago.  The technique is called focused ultrasound; this means that instead of “seeing things”, the energy alters them.   (Actually, the target area of the brain; in this case, the Vim nucleus of the thalamus,   is destroyed.)

(This therapy is what is normally used to eradicate fibroids in women’s uteri, a far safer practice than the now outlawed macerating process.)

Dr. Jeffrey Elias (UVa Neuroscience) and 26 of his colleagues were effecting this research under the auspices of Insightec (a firm headed by Dr. Jacob Vortman and Mr. Oded Tamir) , the Focused Ultrasound Foundation, and the BIRD (Binational [US and Israel] Industrial Research and Development) Foundation.  The 76 elderly (average age, 71) patients with moderate to severe tremors were drawn from their institutions including UVa, Toronto Western, Sunnybrook Health Science Center, Methodist Neurological, Stanford, Yonsei College of Medicine, Swedish Neuroscience Institute, Maryland, Miami, Brigham and Women’s Hospital, Tokyo Women’s Hospital  and Shin-yurigaoka Hospital.  20 patients underwent a placebo operation (the other 56 had parts of their thalamus destroyed).  Since the therapy worked, after the trial, the controls, too, underwent the true procedure.

Those who received the therapy had their tremors reduced by almost 50%; the control group had no change (until they were added to the treatment group).  The activities of eating, drinking, washing, dressing, working- and handwriting all improved by 60%.  However, after a year, the treatment’s efficiency dropped somewhat (hence the 50%).

Long-term follow-up is being effected, to ensure that further decay in the observed improvements does not ensue.  Because if it does, the only therapy that provides the long-term results desired will the deep-brain stimulation (the invasive surgery).

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