IN MEMORIAM
CLINICAL CORNER
The Sound of Healing
Duane Alexander , M.D., a former director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) — After leaving NICHD in 2009, Alexander served as an
BY ABDUL-KAREEM AHMED, M.D. “B ald is beautiful, and it’s better than a rug or a combover,” he said. “Neurosurgeons prefer bald patients,” I replied from our pre-operative wing, where preparation for focused ultrasound treatment includes a shaved head. The patient, 76-year-old John Williams, had been experiencing tremor of his right hand for the past several years. The chief executive officer of a local door manufacturing company in Maryland, Williams had heard about magnetic resonance imaging-guided focused ultrasound for tremor a few years ago. “I couldn’t place a golf ball on a tee,” he revealed. Eating, drinking, and writing all became difficult tasks, especially since he is right-handed. Over the years, Williams had learned to make do with his left hand. He had seen a movement disorder neurologist, who prescribed medications. Essential tremor can affect the hands, feet, face, and voice. Patients find it a challenge to eat, drink, write, or perform other daily functions, and often avoid social outings. Unfortunately, medications did not work for Williams, and his tremor became worse. He had first considered deep brain stimulation (DBS), a more common neurosurgical treatment that has proven effective in treating his disorder. DBS involves thin electrodes implanted into the brain to modulate a specific portion of the thalamus, the brain’s signal relay station. DBS can be effective and last many years, but Williams thought it was too invasive and was wary of rare complications such as infections, bleeds, or need for revision. He instead turned to the University of Maryland Medical Center for focused ultrasound treatment, a less invasive, incisionless surgery pioneered by the brothers William and Francis Fry and more recently modernized by Kullervo Hynynen, M.D., and colleagues. Focused ultrasound to treat essential tremor is available at two dozen institutions in the US, and the University of Maryland was an early site for treatment and contributor to clinical trials. In our multi-center team’s landmark focused ultrasound trial in 2016, patients with essential tremor experienced a 40 percent reduction of symptom severity one year after treatment and a 50 to 60 percent improvement in their
advisor to the director on global maternal and child health issues at the NIH Fogarty International Center. His achievements include the safety and efficacy of amniocentesis for prenatal genetic diagnosis; the prevention of acquired intellectual and developmental disability caused by Haemophilus influenzae type b meningitis, phenylketonuria, and other conditions; the establishment of effective newborn screening programs; and the reduction of Sudden Infant Death Syndrome (SIDS) rates in the US. Alliance for Brain Initiatives — At NIMH, Ungerleider was an NIH Distinguished Investigator whose early work with Mortimer Mishkin at NIMH led to the proposal of two functionally dissociated cortical pathways in the primate brain— one of the most impactful and influential concepts in visual neuroscience. Over the years she also helped to illuminate the nature of perception and attention, working in non-human primate models, and in humans using functional brain imaging. Leslie Ungerleider , Ph.D., chief of the Laboratory for Brain and Cognition at the National Institute of Mental Health (NIMH) and a member of the Dana
Pat Quinn , a co-founder of the ALS Ice Bucket Challenge, a viral fundraising effort that brought in more than $220 million worldwide for Lou Gehrig’s disease research — Quinn, who was diagnosed with Lou Gehrig’s
disease, or amyotrophic lateral sclerosis (ALS), in 2013, a month after his 30th birthday, saw the ice bucket challenge on the social media feed of professional golfer Chris Kennedy, who first dared his wife’s cousin Jeanette Senerchia to take a bucket of ice water, dump it over her head, post a video on social media and ask others to do the same or to make a donation to charity. Senerchia’s husband had ALS. Quinn and co-founder Pete Frates , along with their teams of supporters, helped popularize the challenge.
10 DANA FOUNDATION CEREBRUM | Winter 2021
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