Senior Physician Speaker Series
Curated and hosted by Sam Yared, MD
Topic: MR-Guided Focused Ultrasound for Essential Tremor Guest Speaker: Abigail Rao, MD
At the June meeting of the Senior Physicians Committee, Dr. Sam Yared, Chair, introduced Dr. Abigail Rao, a functional and stereotactic neurosurgeon at Norton Neuroscience Institute, who presented on the evolving role of MR-guided focused ultrasound( MRgFUS) in treating essential tremor( ET). Her lecture not only underscored a major therapeutic advancement, but also provided insights into the clinical application, patient selection and neurophysiological underpinnings of this novel approach.
Dr. Rao brings an impressive background to the conversation. A graduate of the University of Wisconsin with a degree in neurobiology, she earned her MD from the Alpert Medical School at Brown University and completed a fellowship in functional and stereotactic neurosurgery at UCLA. Since joining Norton Healthcare in 2018, she has pioneered Kentucky’ s first MRgFUS program and practices a broad spectrum of neurosurgical interventions, including deep brain stimulation( DBS), vagus nerve stimulation( VNS), epilepsy surgery and spinal cord stimulation.
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Her talk centered on MRgFUS as a non-invasive, incisionless procedure, FDA-approved for medication-refractory essential tremor. ET, a common movement disorder, can severely impact quality of life, particularly in aging populations. While pharmacologic therapies like propranolol or primidone may provide relief, many patients experience suboptimal control or intolerable side effects. DBS has long been the surgical standard, but not all patients are candidates or willing to undergo implantation.
MRgFUS offers a compelling alternative. Using real-time MRI for targeting and thermometry, high-intensity ultrasound beams are focused on the ventral intermediate nucleus( VIM) of the thalamus to create a precise, controlled lesion. The entire procedure is outpatient-based, eliminates the need for implants or anesthesia and allows for immediate intraoperative feedback. Patients remain awake and responsive during the treatment, enabling neurosurgeons to titrate effects and monitor functional improvements in real time.
Dr. Rao emphasized the stringent patient selection criteria, noting that MRgFUS is currently FDA-approved for unilateral treatment only. Candidates typically include those with medication-refractory ET, no contraindications to MRI and without conditions like significant cog-