Incisionless brain surgery to ease tremors comes to Michigan

Corewell Health in Grand Rapids now offering focused ultrasound treatment

GRAND RAPIDS, Mich. – Doing brain surgery without any incisions. It sounds like science fiction, but Corewell Health in Grand Rapids performed the first focused ultrasound procedure in Michigan last month.

It’s offering a new option for people who suffer from a condition called essential tremor and tremors due to Parkinson’s disease. Local 4 sat down with the first patient to receive the treatment and the surgeon who brought this innovation to Michigan.

Imagine not being able to pour a cup of coffee. To sign your name. To put toothpaste on your toothbrush.

For people dealing with a condition called essential tremor, those daily tasks are often impossible.

Don Stadt, 73, of Grand Rapids, first developed a tremor in his 40s.

“I’d be writing along, doing a spreadsheet or something, all of a sudden I couldn’t make the number three. Wasn’t a long time after that, I couldn’t make an ‘s,’” said Stadt. “I got jittery when I was trying to drink a cup of coffee or something, and it just progressed.”

It didn’t cause any physical pain, but the tremor has taken an emotional toll.

“You can call it embarrassment or frustration or whatever, just quality of life,” said Stadt. “You go to a restaurant and everyone else has a nice dinner, and I order a sandwich because I can’t navigate a knife and fork.”

Medication helped, but Stadt’s tremor kept progressing.

Jody Stadt, Don’s wife of nearly 50 years, said the tremor also robbed him of his hobbies.

“He loved to work with tools, and he’s done a lot of projects around our house, and to go from that and not be able to screw in a screw tight, use a screwdriver or hammer a nail, that was hard, because I knew that was his love,” said Jody Stadt.

Essential tremor can run in families. That’s the case for Stadt.

“My mother had the shimmy shakes. My grandfather had the tremor,” said Stadt.

When patients with essential tremor stop responding to medication, the only other available option has been Deep Brain Stimulation (DBS), which involves a surgery to implant a device in the brain.

Now, there’s an alternative available called focused ultrasound.

Dr. Luyuan Li learned the procedure in Oregon and recently brought it to Michigan.

“We are focusing one solid ultrasound wave into one spot in the brain to create a lesion in the brain,” said Li. “These patients, they suffer from tremor for years, 10 years, 20 years, and with this procedure, usually see their hand become steady, like immediately.”

Li explained it like this. When you take a magnifying glass and focus the individual rays of the sun into one spot, it generates heat. The focused ultrasound procedure takes about a thousand ultrasound waves and focuses them in one precise spot in the brain to heat up the tissue, causing the tremor. There’s no implant, no incision, no hospital stay.

There is one catch. In order for the procedure to work, patients have to shave their heads.

Using an MRI scanner, Li finds the precise spot in the brain causing the tremor. The patient is tested repeatedly on their ability to draw a spiral and a straight line.

Stadt said the procedure was painless for him.

“Push you in, pull you out several times as they’re finding the right exact little pinprick spot,” said Stadt. “You’re in there for 10 seconds, 12 seconds, it’s nothing. You come out, and they hand you an ink pen, and you’re totally conscious. You’re not sedated, and you’re shaking like crazy. And by the fourth or fifth time they’re doing this, it’s smooth.”

Immediately after the procedure --

“I could sign my name again, right? I could draw a straight line. I could do the spiral,” said Stadt. “Hour and a half later, we’re going home.”

Stadt couldn’t wait to test his newfound steadiness.

“First thing I did was put an egg in the fry pan to see if I could flip it,” laughed Stadt. “I could write a check. I could sign my name, I could put my return address on the envelope. I could put the stamp on the envelope where it’s supposed to be.”

Stadt experienced a few days of brain fog, but it faded quickly.

Li cautions that there can be side effects.

“It is brain surgery. The most common side effect I’ve seen is temporary balance problems right after the procedure,” said Li. “What I tell the patient is number one goal is to do no harm. Number two goal is to improve their quality of life.”

The procedure is not a cure, but Li said most patients should see their hands remain steady for many years.

“The latest studies right now show about on average 73 percent tremor improvement at five years follow-up,” said Li.

The focused ultrasound procedure is FDA-approved for essential tremor and tremor caused by Parkinson’s disease.

“The technology has been FDA-approved since 2016, actually, and it has been covered by Medicare since 2018. It’s new to Michigan, but it’s not new to the United States,” explained Li. “I’m happy that we can offer this treatment in Michigan.”

In order to minimize the risk of side effects, surgeons only perform the procedure on one side of the brain at a time. Stadt will go back in nine months to have the tremor in his left hand treated.

He’s constantly discovering new things he can once again do.

“I can do a puzzle with my granddaughter,” said Stadt. “Just little things.”

“This weekend, I even saw him working with his power tools,” said Jody Stadt. “It was like, ‘Ah, there it is. I got my old Don back.’”

To learn more about focused ultrasound at Corewell Health in Grand Rapids or to schedule an appointment, patients and caregivers can email fusinfo@corewellhealth.org or call 616.391.6990.

You can also visit the Insightec website.

These videos offer a step-by-step explanation of the procedure for patients: