TONIGHT.
NICOLE ESTAPHAN REPORT NICOLE: MANY OF US ENJOY A MORNING CUP OF JOE, BUT FEW ENJOY IT MORE THAN DUANE SCHMIDT.
A MOMENT OF STILLNESS, A PLEASURE HE THOUGHT WAS GONE FOREVER.
>> IT IMPEDED ON EVERYTHING, BUTTONING SHIRTS, JACKETS, SHAVING.
I WOULD NICK MYSELF WITH THE BLADE.
USING THE COMPUTER, MY FINGERS WOULD SHAKE.
NICOLE: SCHMIDT IS ONE OF AN ESTIMATED 10 MILLION PEOPLE IN THE U.S. WHO LIVE WITH AND ESSENTIAL TREMOR, THE MOST COMMON MOVEMENT DISORDER IN THE WORLD.
>> THIS IS AN ESSENTIAL TREMOR.
THE HANDSHAKES IN AN UP-AND-DOWN MOTION.
IT IS SOMETHING HEREDITARY, AS I UNDERSTAND IT.
MY GRANDFATHER HAD IT.
NICOLE: FOR THE 79-YEAR-OLD FROM RHODE ISLAND, THIS WAS MORE THAN AN INCONVENIENCE.
HE STILL WORKS AS AN ACCOUNTANT AND NUMBERS WHEN OUR PROBLEM.
>> I COULD NO LONGER WRITE NUMBERS, GOT SLOPPY, THEN I WAS PRINTING WITH TWO HANDS, USING THE LEFT HAND TO STEADY IT.
LAST YEAR I WAS WRITING DOWN NUMBERS AND WOULD MISS READ THEM THE FOLLOWING DAY.
NICOLE: AFTER SEVERAL FAILED ATTEMPTS TO CONTROL HIS BODY WITH MEDICATION, HIS DOCTOR RECOMMENDED A FAIRLY NEW TREATMENT SHOWING REMARKABLE RESULTS.
>> THEY ARE LOOKING AT THEIR HAND AND SAYING, WAIT A SECOND, IT IS NOT MOVING.
THEN THEY GET A BIG SMILE ON THEIR FACE.
IT IS REMARKABLE.
NICOLE BRIGHAM AND WOMEN’S HOSPITAL IS THE ONLY HOSPITAL IN NEW ENGLAND WITH FOCUSED ULTRASOUND THERAPY, LED BY DR.
REESE COSGROVE, A NEUROSURGEON WHO SPECIALIZES IN THE SURGICAL TREATMENT OF EPILEPSY.
FOR 40 YEARS HE HAS BEEN HELPING PEOPLE CONTROL THEIR INVOLUNTARY BODY MOVEMENTS.
THE ONLY OPTION HAD BEEN INVASIVE SURGERY.
>> THE ORIGINAL PROCEDURE WAS WHAT WE CALL RADIOFREQUENCY -- YOU HAVE TO MAKE AN INCISION IN THE HEAD, DRILL A HOLE IN THE SKULL, AND THEN WE TRANSITIONED IN THE MID-1990’S TO DEEP BRAIN
STIMULATION, A TWO GENERAL ANESTHESIA.
IT IS REALLY PRETTY INVOLVED.
NICOLE: EVERY TUESDAY YOU CAN FIND DR. COSGROVE HERE PERFORMING A TWO HOUR DAY SURGERY WITHOUT EVER CREATING AN INCISION.
>> IT IS JUST SO REMARKABLE WE CAN DO THIS OPERATION WITHOUT EVER OPENING UP THE PERSON’S HEAD.
WHILE WE ARE DOING IT, THEY ARE IN THE M.R.I. SCAN ARE.
WE ARE ALSO IMAGING THEIR BRAIN WHILE THEY ARE DOING IT SO WE CAN SEE THE LESION BEING MADE AS WE MAKE IT.
THAT HAS NEVER HAPPENED BEFORE.
NO HOLE IN THE HEAD, SO THERE IS NO RISKS OF BLEEDING, HEMORRHAGE OR INFECTION.
NICOLE: THE PROCESS BEGINS BY SHAVING THE HEAD, THEN THE PATIENT IS FITTED INSIDE A HELMET OF SORTS.
>> INSIDE THIS HELMET THERE ARE OVER 1000 ULTRASOUND TRANSMITTERS EMBEDDED IN THE SEVERE POINTED AT THE FOCAL POINT.
NICOLE: THEN INTO THE MRI.
COSGROVE IN ANOTHER ROOM CONTROLLING THE SURGERY FROM A COMPUTER SCREEN.
>> THE PROCEDURE CREATES A PERMANENT LESION IN A VERY SPECIFIC NUCLEAR’S IN THE THALAMUS.
THIS IS A TARGET IN THE THALAMUS WE HAVE KNOWN FOR MANY, MANY YEARS IS THE SOURCE OF THE TREMOR.
NICOLE: THE LESION IS CREATED IN SMALL INCREMENTS IN BETWEEN NEUROLOGICAL TESTS.
THESE ARE IMAGES OF SCHMIDT’S BRAIN AFTER THE PROCEDURE.
>> RIGHT HERE IN THE THALAMUS IS THE LESION WE CREATED.
NICOLE: A PEA-SIZED LESION THAT KILLED THE NEURONS RESPONSIBLE FOR THE TREMOR.
THIS IS BEFORE AND AFTER THE PROCEDURE.
THE RESULTS ARE IMMEDIATE AND SO FAR, LONG-LASTING.
>> AS SOON AS WE REMOVE THE LESION AND MAKE IT AN APPROPRIATE SIZE, LARGE ENOUGH, THE TREMOR STOPS.
NICOLE: ARE THERE ANY DRAWBACKS?
>> THERE ARE LIMITATIONS.
YOU DO NOT GET HANDS LIKE MINE.
WHEN THEY HAVE A REALLY BAD TREMOR AND CANNOT DRINK FROM A CUP, RIGHTS, -- THEY CANNOT WRITE, FEED THEMSELVES, THAT IS DISABLING.
NICOLE: SCHMIDT’S SURGERY WAS IN EARLY AUGUST OF 2020.
>> YOU CAN SEE THE LEFT HAND SHAKING, THE RIGHT HAND IS STEADY.
NICOLE: AND BOTH USED TO SHAKE.
>> THE SAME WAY.
NICOLE: DOCTORS ARE ONLY ABLE TO PERFORM THE PROCEDURE ON ONE SIDE OF THE BODY, GIVING PATIENTS BACK STABILITY IN THEIR DOMINANT SIDE, WHICH FOR MANY IS MORE THAN ENOUGH.
>> I WAS PAINTING TRIM ON THE HOUSE YESTERDAY AND WAS ABLE TO DO AN AWNING.
I CAN DO A CROSSWORD PUZZLE BECAUSE I CAN GET THE LETTERS INSIDE THE BOXES AND READ THEM.
NICOLE: A PEA-SIZED LESION CAN CHANGE SOMEBODY’S LIFE.
>> I HAVE NOT BEEN ABLE TO DRAW A SPIRAL IN YEARS.
SHAYNA: NOT ONLY ARE THE RESULTS FOR ESSENTIAL TREMOR REMARKABLE, RESEARCHERS ARE HOPEFUL THE SURGERY WILL BE SUCCESSFUL FOR SUCH CONDITIONS AS PARKINSON’S DISEASE.
THEY ARE ALSO STUDYING IF THIS TYPE OF PROCEDURE COULD BE AN EFFECTIVE WAY TO TREAT BRAIN TUMORS.
NEXT, SOMETIMES EVEN THE BEST IDEAS GET THIS REACTION.
>> I KNEW HE WAS CRAZY, THAT IS