Week 1: Aidan

 This week was certainly a bit of whiplash. First time in New York City ever, and within 36 hours I was watching Dr. Kaplitt perform MRI-guided ultrasound ablation treatments to improve tremors in patients with essential tremors and Parkinson's disease. The hat-shaped ultrasound tool is fit around the patients head using a fixation device and rubber gasket, and filled with water. From 1000 individual ultrasound nodes, a target region in the brain is sonicated resulting in highly localized (a few mm) heating. They start the treatment at very low temperature pulses, so that they can visualize the heated region and adjust the targeting and power (they have to be very careful not to hit the nearby structures, as they are implicated in gait and peripheral sensory systems), and the target temperature range is 56-58 deg C - lower will not provide lasting results, higher will damage nearby tissue. The patients are not anesthetized during the procedure, except for some local anesthetic in the skull for the frame attachment. The reductions in tremors in the single session were incredible, with patients able to pass a "spiral drawing test", which was previously impossible with their tremors. On Wednesday, I then had the opportunity to observe 4 of Dr. Kaplitt's surgical cases, which included a spinal stimulation device removal, an implantation of some electrode with rechargable battery, and two ventriculoperitoneal shunt procedures.