Stuart Isaacson, MD

“Some patients are willing to take the risk—a small risk, but a risk&mdash;of brain surgery, or there’s deep brain stimulation’s or focused ultrasound’s risk, when some don’t want to take those risks.”

Essential tremor, while common and often impactful on patients’ daily lives, does feature a number of invasive and noninvasive interventions in its arsenal of care. Ranging from surgery to deep brain stimulation (DBS) or focused ultrasound (FUS), there are options for patients outside of physical therapy or oral medications.

, Stuart Isaacson, MD, director, Parkinson's Disease and Movement Disorders Center of Boca Raton, spoke to the patient perspective on making the decision to utilize any one intervention over another, much of which boils down to the risk—albeit small in most cases&mdash;that the patient is willing to take.

Isaacson also provided an overview of these minimally invasive surgical techniques, such as DBS and FUS, and their use in essential tremor, as well as some other methods which have begun to be explored in trials in recent years.

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The director of the Parkinson's Disease and Movement Disorders Center of Boca Raton spoke to the patient perspective and risk assessment when deciding on an intervention for essential tremor.

Stuart Isaacson, MD: Patient Perspective On Essential Tremor Treatment

“It often can run in families, often begins in the 20s or 30s and increases as the decades go on, and it begins to impair daily tasks.”

The most common movement disorder that movement disorder specialists such as Stuart Isaacson, MD, director, Parkinson's Disease and Movement Disorders Center of Boca Raton, need to address is essential tremor. One estimation puts this patient population size between  6.38 to 7.63 million, corresponding to approximately 2.2% of the US population.

Despite this prevalence, there remain challenges in care. Having patients utilize wrist weights and interventions with activities of daily living often are not efficacious, and the available oral therapies are often accompanied by adverse effects. Although, there are available and effective options, such as deep brain stimulation (DBS) and focused ultrasound (FUS), which have allowed for improvements in recent years.

To find out more about the landscape of treatment in essential tremor and what remains to be addressed, 

sat down with Isaacson. He spoke to how a new generation of interventions has led to a shifting backdrop in the field, and what’s to come in the near future.

1. Louis ED, Ottman R. How Many People in the USA Have Essential Tremor? Deriving a Population Estimate Based on Epidemiological Data. 

The director of the Parkinson's Disease and Movement Disorders Center of Boca Raton spoke to how a new generation of interventions has led to a shifting backdrop in the field of care in essential tremor.

Stuart Isaacson, MD: The Essential Tremor Treatment Landscape

“OFF periods are one of the biggest problems our patients continue to face, regardless of what type of levodopa is being administered. At some point, its effects are going to wane.”

In Parkinson disease treatment, physicians are fortunate to have a gold standard medication in levodopa. Although, despite its efficacy and availability, patients still face periods of OFF time during which their medications lose efficacy, with absorption varying due to a number of influencing factors.

Stuart Isaacson, MD, director, Parkinson's Disease and Movement Disorders Center of Boca Raton

, explained that this challenge of absorption can vary not only from patient to patient but for each individual themselves. Factors such as food consumption, gastrointestinal differences, and others can impact how quickly levodopa is absorbed and at what rate.

To find out more about how this challenge is being addressed with combination therapy approaches and what treatments and delivery methods are available to combat absorption variation, 

sat down with Isaacson. He discussed how the current understanding of the disease and its medications is impacting physicians’ ability to reduce their patients’ OFF episodes.

The director of the Parkinson's Disease and Movement Disorders Center of Boca Raton spoke to the challenges which remain in addressing OFF episodes in treating Parkinson disease.

Stuart Isaacson, MD

Articles

Stuart Isaacson, MD: Patient Perspective On Essential Tremor Treatment

Stuart Isaacson, MD: The Essential Tremor Treatment Landscape

Stuart Isaacson, MD: The Challenge of OFF Episodes in Parkinson Disease