Progardia is the first in Denmark to treat patients with focused ultrasound
In 2021 - as the first private hospital in Denmark - Progardia began to carry out treatment of the diseases essential tremor and Parkinson's disease using focused ultrasound.
If you have completed an examination and are in optimal medical treatment, we can offer a preliminary examination and treatment within 4-6 weeks.
At Progardia, we can now treat patients suffering from essential tremor. The hospital will thus be the first hospital in Denmark that can provide the treatment. This is a result of Progardia purchasing the required equipment to treat the disease with the recognized form of treatment: focused ultrasound.
According to the National Board of Health, around 2,100 Danes are affected by essential tremor every year. Of these, only a few are treated and this is done abroad – either at the governments or their own expense. "It is a slow and hard process to wait to be examined and possibly be able to receive treatment," says chief physician at Progardia, Niels Sunde.
”Sygdommen opleves af mange som voldsomt stigmatiserende, den nedsætter ens livsglæde og hæmmer ens hverdag voldsomt. Daglige gøremål, som at drikke et glas vand eller skrive på en computer, kan være voldsomt udfordrende. Nogen patienter ryster kun på hænderne, andre også på hovedet. Begge dele gør sygdommen meget synlig.
Similarly, we treat Parkinson's, where tremors are the predominant symptom. The treatment takes place with focused ultrasound as in essential tremor (shaking disease). Progardia is the only place in Scandinavia that offers this treatment.
According to the National Board of Health, around 8,000 Danes are affected each year by Parkinson's, where approx. 20% have tremors as the predominant symptom. A small group may be candidates to electrode treatment, but the majority do not meet the criteria - most often due to age. To be a candidate for treatment with focused ultrasound at Progardia, medical treatment must be inadequate and the tremors severe.
Facts about Parkinson:
- In Denmark, approx. 12,000 people suffer from Parkinson's disease
- Every year approx. 1500 new cases are diagnosed
- With 26% of patients with Parkinson's, tremor is the most predominant symptom
- The disease often begins with tremor (shaking), later on also stiffness and slow movements develop. The tremor, however, remains and can be quite disabling.
The treatment with focused ultrasound is non-surgical treatment and suitable for patients where medical treatment is not sufficient and / or where surgical treatment with deep-seated brain electrodes is not possible or desirable.
Focused ultrasound is an MRI-guided treatment in which the area of the brain that causes essential tremor is heated using ultrasound. The heat destroys the heated tissue, eliminating the tremors and heals the patient. The treatment lasts only a few hours and lasts long or even a lifetime.
The ultrasound waves carry energy through the skin, muscles, fat and bones. Ultrasonic energy is neither radioactive nor ionizing - and there is no radiation during treatment. During treatment, the patient is placed in an MRI scanner with a MRgFUS helmet strapped to his head. On the basis of initial MRI scans, the right area in the thalamus of the brain is selected, and the treatment begins by applying low intensity focused ultrasound to the area. This causes a temporary paralysis of the brain area so that the patient can tell about side effects and test the effect on the tremors. Based on this test, the neurosurgeon can adjust the treatment before giving a high ultrasound dose, which causes the permanent and thus desired effect.
Many patients experience an immediate effect on the tremors. In cases where side effects of the treatment are noted, then 95% are assessed as mild or moderate - and the vast majority of these are transient.
As a starting point, the treatment is performed on an outpatient basis.
Duration of the treatment is approx. 2-3 hours.
During the pre-outpatient visit with us, our neurologists will assess whether your current medical treatment is optimal. If you are not receiving optimal medical treatment for your essential tremor (shaking disease) / Parkinson's, we can offer a course with optimization of medication before possible treatment with focused ultrasound.
Facts about essential tremor:
- Essential tremor is a rhythmic, mechanically oscillating movement
- About 10 % of all Danes over the age of 60 suffer from essential tremor
- Men and women are affected by the disease just as often
- The National Board of Health has calculated that approximately 2,100 Danes are affected by essential tremor each year
It is the Danish company Vingmed A/S, which supplies the advanced ultrasonic equipment from the manufacturer INSIGHTEC. The equipment works in conjunction with a high quality MRI scanner from GE Healthcare.
MRI-guided focused ultrasound (MRgFUS)
MRgFUS is an abbreviation for "MRI guided focused ultrasound". The method utilizes that when harmless ultrasonic waves from 1,024 individual ultrasound heads are focused with great precision in a single focal point, sufficient energy will be deposited to heat the brain area (few mm in diameter). The energy deposited can be controlled very precisely. Because of this the heating of the brain area can be controlled so that before a permanent damage and when effect is achieved, a temporary and short-term paralysis of the area can be made. This reduces the risk of unintended side effects with the treatment. It is because of this a treatment without surgical opening of the skin and skull. The treatment takes place without anesthesia and with the possibility of sedatives and a little painkiller along the way.
Around the world, MRgFUS is used for several things, but primarily for the treatment of tremor (essential tremor) and Parkinson's disease, where the tremors are the predominant one.
Patients with tremor or Parkinson's disease, where the tremors are severe and where medical treatment either has no effect or where the treatment has severe side effects. Other treatment such as surgery with insertion of electrodes deep into the brain should also be considered.
Our neurologists specializing in movement disorders determine if you can be a candidate for treatment. You must be very bothered by your tremors and you must have tried medical treatment.
The treatment takes place at Progardia MRgFUS, Teglgårdsparken 118, Middelfart.
In newly decorated rooms, we have installed an MR scanner with associated MRgFUS equipment. After examination by our neurologists, you will have an appointment for treatment. Before the treatment, all hair on the head is removed.
The treatment begins with you having a frame strapped to your head under local anesthesia. A rubber membrane is mounted on the frame, which is filled with cool and gas-free water. You will then be assisted into the MRI scanner, and after some initial planning scans, treatment will begin. First, a temporary trial lesion is performed, and when the right place for treatment has been found – corresponding to the place where it has the best effect on your genes with a minimum of side effects. Then the strength is increased and a permanent damage is developed, whereby the intended result of the treatment is achieved.
In most cases the treatment does not hurt. Some people find it uncomfortable to lie in the scanner for a long time. Others feel pain in the scalp when the MRgFUS device intensity is turned up. In either case, just let us know. We have a specialist in anesthesia and pain relief present, who will always try to make the treatment as comfortable for you as possible.
Some experience minor side effects such as sensory disturbances in the arms or legs and dizziness. Otherwise, very few risks have been reported.
About 75% of treated patients had effect of the treatment for more than 5 years.
We have put together a team of Danish specialists in neurology, neurosurgery, neuroradiology and neuroanesthesia to perform the treatments. The team consists of:
Morten Blaabjerg, professor, chief physician, neurologist and specialist in movement disorders
Mathias Bode, chief physician, neurologist and specialist in movement disorders
Niels Sunde, chief physician, neurosurgeon and specialist in functional neurosurgery
Christian Bonde Pedersen, chief physician, clinical associate professor, neurosurgeon and specialist in skull surgery
Frantz Rom Poulsen, professor, chief physician neurosurgeon and specialist skull surgery
Nicolai Hatting, chief physician, specialist in neuroanesthesiology (anesthesia and pain relief)
Willy Krone, specialist in radiology
The course of treatment costs 197,000 Danish Kroner (DKK)
It costs 4,000 Danish Kroner (DKK) for a neurological specialist examination, which must assess whether you are a candidate for the treatment. This amount will be deducted from the treatment price at treatment.
Specialist in neurology, professor
Frantz Rom Poulsen
Specialist in neurosurgery, professor
At OUH, he works primarily with surgical treatment of patients with tumors in the brain and skull as well as with research and development within neurosurgical disorders.
In 2001, Frantz completed his education as a doctor from the University of Southern Denmark. In parallel with his medical studies, Frantz has been associated with the University of Southern Denmark as a student researcher in brain research, and after completing his medical studies, Frantz took his PhD degree in experimental neurobiology. After completing his PhD, Frantz was employed at the University of Southern Denmark as a researcher and lecturer.
Frantz took medical training at Fredericia Hospital and in a medical practice in Kolding. Since 2005, Frantz has been employed in neurosurgery at Odense and Aarhus University Hospital.
Specialist in neurosurgery
At OUH, he works with binocular brain surgery as well as open surgical treatment of patients with tumors in the brain and skull.
Christian graduated in 2005 as a doctor from the University of Southern Denmark. Alongside medicine, Christian has been affiliated with the University of Southern Denmark as a researcher in brain research and completed his PhD degree in experimental neurobiology in 2002 prior to completing his medical examination in 2005.
Since his education, Christian has worked as a doctor at OUH, interrupted by a short period at Aarhus University Hospital. In addition to employment at OUH and Progardia, Christian works as a consultant at the Danish Agency for Patient Safety and the Danish Agency for Patient Complaints.
Specialist in neurology
Specialist in neurosurgery
Willy Altinok Krone
Specialist in radiology
Willy graduated from the University of Southern Denmark in 2011 and worked for the first three years after his education on Zealand, where he after his basic clinical education completed an introductory position in first anesthesiology and intensive care and subsequently in radiology.
In 2018, after 4 years, he completed his specialist training in radiology with appointments at OUH Odense and Svendborg.
Willy was employed as a specialist in radiology by the neuroradiology section at OUH Odense, where he is currently employed again after a one-year period at the X-ray department at Lillebælt Hospital in Kolding.
Specialist in anaesthesiology
Nikolaj has trained as a specialist in anesthesiology since 2014. He graduated from the University of Southern Denmark in 2006.
On a daily basis, he works in the neuroanesthesiological section at OUH, as well as at the emergency medical cars at Hospital Sønderjylland.