Alternative to invasive deep brain stimulation (DBS) new technology in Indian market MRgFUS intervention offers medical intervention for tremors
Dressed in a hospital gown 55-year-old Rohit Kumar (name changed) remembers the ice-cold, sterile, brightly lit Magnetic Resonance Imaging (MRI) room that he walked into early this year at Sir Ganga Ram Hospital, West Delhi, seeking treatment for his essential tremors that he has been struggling with for nearly half a decade now.
Essential tremor (ET) is one of the most common neurological disorders affecting around 1% of the general population worldwide. The prevalence increases with age, with approximately 5% of individuals over the age of 60 experiencing it. Essential tremor can present several challenges, primarily due to the rhythmic shaking it causes, which can significantly impact daily life activities.
While not life-threatening, the tremors can make simple tasks like writing, eating, and dressing difficult, leading to embarrassment, frustration and social isolation. In advanced stages, it can affect speech and swallowing. Mr. Kumar is among the three patients to have successfully undergone the relatively new Magnetic Resonance-guided Focused Ultrasound (MRgFUS) procedure for his essential tremors at Sir Ganga Ram Hospital, the first private hospital in North India offering the treatment.
The relatively new technology for the Indian market is currently available in select centres across the country including – Royal Care Super Speciality Hospital in Coimbatore (first to offer the technology), KIMS Hospitals (Telangana), and All India Institute of Medical Sciences, Delhi (first government hospital).
An alternative to more invasive surgical procedures like deep brain stimulation (DBS) MRgFUS intervention is a non-surgical procedure that uses focused ultrasound waves guided by MRI to target brain tissue responsible for tremors in patients with Parkinson's disease or essential tremor. Currently approved for Essential Tremor (ET) and Tremor-Dominant Parkinson's Disease (TD-PD), this technique offers new hope for patients whose symptoms significantly disrupt daily life.
This one-time medical intervention costing Rs. 19-23 lakh has on-table procedure duration of 1 to 3 hours, according to doctors at Sir Ganga Ram which started offering the treatment early this year.
The procedure allows physicians to monitor the treatment in real-time and adjust parameters for optimal safety and efficacy. In simple terms we can see the tremors subsiding as the ultrasound disrupts the abnormal communication that the brain has been sending to the body affected body organs,'' said Anshu Rohatgi, vice-chairperson, Neurology, Sir Ganga Ram who has been doing these procedure at the health facility here.
Speaking about this technique that has been available in America for over half-a-decade now he added that besides the real-time monitoring, the other benefits include -- no incisions, minimal to no anaesthesia to patients, rapid symptom relief, minimal recovery time (1–2 days) and, one-time treatment with no implants or batteries.
MRgFUS treatment targets the thalamus, a key relay centre in the brain. Focused ultrasound energy is used to thermally ablate this specific area, leading to a marked reduction—and in many cases, near-complete resolution—of tremors, often within the same session.
Explaining how the system works Dr. Rohatgi said that the treatment creates a small, targeted lesion in the brain tissue to interrupt abnormal signals causing the tremors, without the need for any incisions or implants. This translates to significantly fewer side effects and a faster recovery time compared to traditional surgical methods.
Speaking about her experience with procedure Mrs. Radha (name changed), a retired schoolteacher, said that the debilitating hand tremors for several years had transformed her from an independent, confidence woman who loved socialising to being withdrawn and embarrassed by her inability to perform simple tasks such as drinking water, eating a sandwich, or writing her name.
The suggestion of undergoing Deep Brain Stimulation left me in distress and fear and when I got to know about MRgFUS I did initially consider getting treatment at UK but was disappointed because of the long waiting time. That was when I heard about the technology being available in Delhi,'' she said.
Mrs. Radha underwent MRgFUS Thalamotomy at Sir Ganga Ram Hospital and experienced immediate results. 'Her right hand became tremor-free during the procedure itself. The next morning, she joyfully drank water without spilling, ate a sandwich on her own, and wrote her name with a steady hand — big victories that marked a huge leap in reclaiming her life,'' said Dr. Rohatgi.
Satnam Chhabra, chairman, Department of Neurosurgery adds, 'This is a highly precise procedure performed by a team of neurologists, neurosurgeons, and neuroradiologists. As this is completely non-invasive, all risks associated with open surgery are effectively avoided.'
Insightec is a medical technology company that specialises in MR-guided Focused Ultrasound (MRgFUS) and in a written response to The Hindu, Maurice R. Ferré, M.D., CEO and chairman of the board of Company noted that they are committed to expanding access to focused ultrasound technology in India, where the demand for innovative, incisionless treatment options continues to grow.
Our efforts are centered not only on advancing care for patients with essential tremor and Parkinson's disease, but also on exploring new clinical indications for our Exablate technology in the treatment of other neurological conditions.
With more than 25,000 patients treated globally, and over 200 in India across three leading centers, we are proud of the excellent clinical outcomes and the growing enthusiasm from both physicians and patients. This is just the beginning, as we remain focused on working closely with our distributor partner to bring this transformative technology to even more patients across India,'' he added.
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