Evening Ufa: Treatment of the Future. No Pain, No Blood, No Anesthesia

Original article here.

In Russia, the first-ever unique operation was successfully performed, allowing a patient with Parkinson’s disease to be freed from the tremor that had tormented him for several years. The most joyful part of this news is that the victory over the severe complication of the disease was achieved by doctors at a clinic in Ufa .

…Sabit Sadykovich worked as a veterinarian in the village all his life. He was highly respected by the villagers because he was a professional in his field. Not everyone would undertake, for example, a cesarean section on a cow. But he would take on any complex case.  

But at some point in Sabit’s life, everything changed. Parkinson’s disease deprived him of the ability not only to work: the retiree could not even care for his animals. The tremor in his right hand increased, and there came a time when he could barely perform simple actions. It wouldn’t be long before he gave up entirely, especially since Sabit lived alone. His niece came to the rescue. She really wanted to help her uncle and scoured the entire internet. They say, those who search will always find.

And she discovered the website of a private clinic in Ufa, read it, watched videos, and realized: this is what her relative needs.  To be honest, I hadn’t heard of the V.S. Buzaev International Medical Centre “Clinic of Intelligent Medicine.” And it’s no wonder, as the center opened not so long ago. A close-knit team of doctors spent two years preparing to realize their dream—to help a person with tremor, relieving them of suffering in just a few hours, painlessly, non-invasively, and without anesthesia.

On the clinic’s website, there is a video with fragments of this operation, which doctors call therapy using MRI-guided focused ultrasound. When I watched this video, I thought to myself: “These scenes would enhance any science fiction movie”!     I saw—and anyone can see this—how a special helmet was placed on a patient’s head. And how his right hand was literally shaking so much that it made the heart ache with pain and compassion at the sight. How Sabit Sadykovich was placed on the table, and the MRI was turned on.

The MRI machine during therapy allows the doctor to see a real-time image of the brain, explains the clinic director, neurosurgeon, PhD Rezida Galimova, who led the operation. — The patient is placed on a special table with an integrated helmet. The helmet is unique, containing 1024 ultrasound transmitters. Doctors use a special program to determine the number of sound waves that will be directed precisely to the part of the brain responsible for the development of tremor.  

According to Rezida Galimova, the therapy consists of two stages. It turns out that cells have a unique ability: when heated to 40-45°C, they lose their functional activity while remaining viable. This particularity is used by doctors in the first stage. The patient performs movement tests, and the doctor observes to ensure there are no complications or neurological “failures.” The doctor carefully conducts preliminary heating of the brain area responsible for the development of tremor. As soon as the nerve cells experience a temperature of 45°C, the patient’s tremor amplitude decreases, and the limb’s motor activity is fully restored. Only after the doctor is convinced that the impact on the brain does not cause any side effects on the nervous system does he proceed to the second stage and complete the therapy. Within 3 hours, the patient returns to the ward and can go home by evening.   

Now this unique method is available to Russians, and such operations have been performed abroad for several years.  Professor Shamil Makhmutovich Safin, Head of the Department of Neurosurgery and Medical Rehabilitation at Bashkir State Medical University, Head of the Department of Neurosurgery at Gumer Kuvatov City Clinical Hospital, Chief Freelance Neurosurgeon of the Ministry of Health of the Republic of Bashkortostan, observed the surgery from home. For known reasons, he was in self-isolation during those days.

— We have been nurturing this idea for about 5 years and are very pleased that it is now available to patients in Russia. The therapy is in high demand, as Parkinson’s disease and essential tremor are unfortunately not uncommon among the elderly today, and the statistics give cause for concern and the search for treatment options, says Shamil Makhmutovich.

— And here, it seems, fate happily aligned so that our young doctor Rezida Maratovna Galimova completed an internship in the USA, learning everything necessary about this non-invasive method. Investors were found, thanks to whom the clinic was opened and the latest equipment was purchased. And, as you can see, we have the first good result.     It’s important to say that not all patients can receive such assistance. There is a selection system and specific conditions to ensure the procedure is effective. For example, with the first patient, the clinic corresponded for almost a year, conducting necessary studies and tests.

— The fact that we were the first in Russia to conduct such therapy is gratifying, as today the surgical treatment of tremor is a rather complex, invasive process involving the implantation of deep electrodes in the brain, explains Shamil Makhmutovich.

— A neurostimulator is implanted under the skin, it is expensive, and the batteries need to be replaced once every five years. The operation is performed under anesthesia, and the patient wakes up in the recovery room. Therefore, I consider therapy using the new, non-invasive method to be ideal.  The professor expressed hope that this experience will serve as a good example for other clinics in Russia. In the future, this method could be applied in the treatment of epilepsy and brain tumors.

Research is already being conducted in this field worldwide.  Recently, Sabit Aby sent a video from home to his doctor, Rezida Galimova, whom he affectionately calls “daughter.” He is happy and full of hope, planning to do some renovations.     I look at her—a gentle, fragile young woman—and wonder: where does she get so much energy, how did she manage to bring such a complex project to life, and even become pioneers in this field in Russia?

— When I was a little girl, I watched a movie about space. I remembered a device that allowed people to heal without incisions and anesthesia. Thanks to the movie, I wanted to become a doctor, believing that someday we would also have such a device, says Rezida Galimova.

— I became a doctor. But the help we provided in the neurosurgery department was not at all like what I remembered from childhood. It was associated with pain, lengthy treatment, and long patient recovery. Imagine my surprise when such a device appeared two years ago  — And along with this, did a strong desire to fulfill your dream appear? This is a true victory.  — Something important can only be done as a team, clarifies the neurosurgeon.

— And I am grateful to everyone who works there.  These are radiologists Elvira Zakirova and Dmitry Krekotkin; neurologist Olga Kachemaeva and interventional cardiologist Igor Buzaev; MRI-technician Tatyana Kaveshnikova, anesthesiologist Agash Beymirza-ogly Alyshlov, Aivar Kireev, who analyzed all the data and connected the two teams.  

Professor Sergey Nikolaevich Illarioshkin, Corresponding Member of the Russian Academy of Sciences, Deputy Director for Research and Head of the Brain Research Department at the Scientific Center of Neurology, President of the National Society for the Study of Parkinson’s Disease and Movement Disorders from Moscow, and our esteemed Professor Shamil Makhmutovich Safin joined the treatment online.     In the video recording of the surgery, the doctors were speaking in English…

— We were supposed to perform the first operation under the careful online guidance of the company’s staff Insightec — Paul Wragg from the United Kingdom, Tessa Case from Spain and Daniel Molchanov from Russia. This is the company from which we purchased the equipment, clarifies Rezida Maratovna

— But the situation in the world related to the epidemic did not allow them to come here. Therefore, our team first received permission to carry out the therapy after an online course, and then during the procedure, we were supervised — also online — by company representatives who gave a good evaluation.  …And we hope that the result of this operation in the republic will please everyone, and perhaps this event will be the first step towards implementing therapy in other medical institutions of the republic, allocating quotas for operations. Especially since, as we see today, the country’s leadership is showing increased care for the elderly and people who are of working age but, for certain reasons, cannot return to professional activities.

Tatiana BARABASH  IN THE IMAGES: surgery in progress.  
Photos provided by the “Intelligent neurosurgery clinic, Ltd”.
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