In February 2022, the Germans Trias Hospital became the first Catalan public center to non-invasively treat diseases such as essential tremor or tremoric Parkinson's disease, pathologies that make it difficult or even impossible to perform such basic tasks as writing, shaving, washing. , dressing or using eating utensils. Now medical advances have managed to reduce the tremors caused by the disease by up to 90%.
Then, the center launched equipment to treat patients non-invasively, establishing a therapeutic program consisting of applying high-intensity focused ultrasound (HIFU) guided by magnetic resonance imaging in the brain, a pioneering technology in a public hospital in Catalonia.
The first five patients treated that year with this technique already showed very satisfactory results, even with the tremor disappearing in the same procedure. Now, two years later, with more than 200 interventions carried out, the clinical assessment scales confirm "extremely positive" degrees of improvement, according to Ramiro Álvarez, head of the section of the Movement Disorders Unit of the Neurosciences area of the Germans Hospital. Trias.
Specifically, in the majority of patients the disabling tremor that they had before undergoing the procedure has improved significantly, between 70% and 90%, even with some cases of complete disappearance. “There are patients who tell us that their lives have changed, being able to eat and drink again, write, use their cell phone or shave normally. Suffering from this affectation is much more dramatic, on a day-to-day basis, than it seems,” emphasizes Álvarez.
The 218 people operated on so far (in almost equal proportions between women and men) are mostly over 60 years old, although the oldest is 89. They are mainly from all over Catalonia and represent approximately a third of the total number of people who have been treated. have been evaluated so far, which shows the high interest in this program.
The procedure is performed by the Functional Surgery Unit for Movement Disorders, recognized by the Servei Català de la Salut as a reference in the treatment of these disorders. It is made up of a team of neurologists and neurosurgeons who are experts in these pathologies. Its manager, Jorge Muñoz, highlights among the advantages of the program that it is “a non-invasive technique that does not require prior admission of the patient and that the patient can be discharged a few hours after the procedure.”
The specific equipment for the treatment is located in one of the MRI rooms of the Diagnostic Imaging Institute (IDI). It is a technology with a solid foundation, proven effectiveness and with an upward indication. In fact, in September bilateral treatment of essential tremor was approved with a minimum interval of 9 months between both procedures; Furthermore, shortly afterwards the indication of two procedures - subthalamotomy and unilateral pallidotomy - was accepted in the treatment of Parkinson's disease.
In this sense, the Neurosciences area of the Hospital has already carried out the first 16 bilateral treatments and activity will soon begin in the rest of the approved indications.
Apart from making functional and everyday aspects of the daily life of the affected people difficult, they also suffer work repercussions, since a significant part of patients with tremor - up to 60% - present a reduction in their work expectations and up to 15-20 % leave their work activity prematurely.
Until the existence of this program, patients with tremoric Parkinson's disease and essential tremor who do not respond to pharmacological treatment had to undergo surgeries for the implantation of intracerebral electrodes; However, this procedure has limitations of age and concomitant pathologies, and can exclude a significant group of patients who do not have other therapeutic alternatives. In addition, using this technology represents savings compared to the cost of surgical techniques, hospital admission expenses and devices and medication that are permanently dispensed to patients.
