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Ten years after his focused ultrasound procedure, Cliff Tony Lightfoot still enjoys the independence and mobility he gained that day.Sunnybrook Health Sciences Centre

Sunnybrook’s new Garry Hurvitz Brain Sciences Centre will be a world-leading hub where researchers investigate new ways to treat debilitating brain disorders

Cliff Tony Lightfoot’s tremors were so bad in 2012 he could barely eat or get dressed on his own.

In meetings with clients, the mechanical engineer couldn’t turn the pages of a proposal without shaking. When he was nervous or stressed, his body would shake from his stomach through both arms. And there were uncontrollable spasms.

“I would take something out of the fridge and think I had it, and then I’d throw it and it would be all over the kitchen,” he says. “It got so bad, I would cry at times.”

Cliff was living with essential tremor, a movement disorder caused by a malfunction of the part of the brain called the thalamus. After 15 years with the condition, medications were not working for him anymore, and the involuntary shaking in his arms and hands was getting worse.

Then, everything changed. At the age of 68, Cliff became one of the first patients in Canada with essential tremor to be treated with focused ultrasound (FUS), a procedure pioneered at Sunnybrook Health Sciences Centre, in Toronto. Focused ultrasound (FUS) is a minimally invasive surgical method that uses magnetic resonance imaging (MRI) to guide ultrasound energy to targeted areas of the brain responsible for the tremors.

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Dr. Michael Schwartz adjusts the frame around Cliff’s head before the procedure.Doug Nicholson, Sunnybrook Health Sciences Centre

Right away, Cliff’s tremors were dramatically reduced in his right arm and hand. Immediately following the procedure, he took a drink from a cup of water using just one hand, the first time he had done so in more than 10 years.

“I was just totally awestruck that I could do that,” he says.

Cliff was overjoyed to be able to write with a pen and paper again and enjoy a cup of coffee in the morning. Now, on the 10th anniversary of the milestone procedure that led to the approval of focused ultrasound treatment for patients with essential tremor, Cliff is still enjoying the independence and mobility he gained that day.

“I vacuum the house and I do a lot of other things like water the garden. I can eat, drink, write and look after myself properly,” Cliff says. “With focused ultrasound, it [was] like life had just begun that day.”

‘Game-changing innovation’

The success of that early study of four patients, including Cliff, showed that focused ultrasound was a safe and effective treatment for essential tremor and the study was published in the prestigious journal, The Lancet Neurology. Subsequently, both Health Canada and the U.S. Food and Drug Administration approved focused ultrasound as a treatment for essential tremor in 2016.

To date, Sunnybrook has treated close to 300 patients with this approach and continues to do groundbreaking research on the procedure, including a new study to assess doing the surgery on patients’ non-dominant arm and hand as a follow-up to a first surgery.

“FUS was a major shift away from the conventional treatment of essential tremor, which typically is open brain surgery; this was a less invasive approach, without scalpels or incisions,” says Dr. Nir Lipsman, neurosurgeon and director of the Harquail Centre for Neuromodulation at Sunnybrook. “Focused ultrasound was then, and continues to be, a game-changing innovation in the treatment of brain disorders.”

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Cliff is guided into the MRI machine, where ultrasound energy targets areas of the brain responsible for tremors.Doug Nicholson, Sunnybrook Health Sciences Centre

The success of FUS in treating essential tremor has sparked discoveries in other areas. Over the past decade, Sunnybrook has become a global leader in FUS research, becoming the first site in North America to treat severe depression and obsessive-compulsive disorder with high-intensity FUS and the first in the world to study low-intensity FUS to treat brain cancer, Parkinson’s disease, Alzheimer’s disease, and amyotophic lateral sclerosis (ALS).

“With a decade of experience, the team at Sunnybrook is finding ways to help more patients experience better quality of life,” says Dr. Michael Schwartz of the division of neurosurgery at Sunnybrook, who led the pioneering study on focused ultrasound. “We’re improving the surgery all the time. It’s now quicker and has a faster recovery time.”

A multidisciplinary approach to brain research

Sunnybrook will further its cutting-edge work with brain disorders by enabling even more innovation with the under-construction Garry Hurvitz Brain Sciences Centre – a new, 121,000-square-foot, three-storey facility. The new Centre will support the Harquail Centre for Neuromodulation, the Murphy Family Centre for Mental Health, Ontario’s first circadian sleep centre and world-leading clinics related to ALS, traumatic brain injury and more.

By employing a multidisciplinary approach to brain research, researchers can speed up discovery by taking treatments used for one disorder and adapting them to treat others.

The continued support by donors for investments in infrastructure, equipment and people has been a key part of driving Sunnybrook’s world-class brain innovation forward.

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Architectural rendering of the Garry Hurvitz Brain Sciences Centre (GHBSC).SUPPLIED

“Over the last 10 years, there has been almost $50-million in philanthropic investment at Sunnybrook in research and development for focused ultrasound and related therapies and technologies, to significantly advance this work,” says Dr. Kullervo Hynynen, vice-president of research and innovation at Sunnybrook.

“For our team and our patients, each milestone – whether in ALS, Alzheimer’s or brain tumors – is progress, and philanthropy has been a critical catalyst and plays a major role in advancing our work.”

The investment has paid off: Approximately half of patients receiving focused ultrasound surgery for essential tremor have near or complete relief of their symptoms, while 40 per cent have some degree of improvement.

Looking back on his participation in the study that started it all, Cliff Tony Lightfoot says he is proud to have done his part to help change the prognosis for so many others living with debilitating brain disorders.

“I knew if it was a success, it would help other people,” he says. “Focused ultrasound can change a person’s life.”

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Advertising feature produced by Globe Content Studio with Sunnybrook Health Sciences Centre. The Globe’s editorial department was not involved.

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