First in Delaware to Offer MR-Guided Ultrasound for Treatment of Essential and Parkinson’s Tremor

Jun 19, 2024

3 min

Justin Martello, M.D.

Revolutionary technology gives patients immediate relief from debilitating tremors without the need for invasive surgery.


ChristianaCare is the first health care provider in Delaware to offer FDA-approved focused ultrasound treatment for people suffering from essential tremor and Parkinson’s disease.


The new option – called MR-guided focused ultrasound – uses sound wave energy to destroy precise areas of brain tissue that is the source of the tremor. No surgical incision or anesthesia is necessary, and many patients experience immediate and significant reduction in tremors, which can make daily activities challenging.


Dr. Martello explains that the procedure involves the use of high-frequency sound waves directed with pinpoint precision by magnetic resonance imaging to ablate, or burn, the focal point deep within the brain that is causing tremors.

“This minimally invasive technology dramatically improves the lives of patients with essential tremor and tremor-dominant Parkinson’s who haven’t fully responded to traditional treatments,’’ said Justin Martello, M.D., director of the Parkinson’s and Movement Disorders Programs, and Focused Ultrasound Program at ChristianaCare.


What is tremor?


Tremor is a neurological condition that includes involuntary shaking or trembling movements in one or more parts of the body. It most commonly affects the hands and can make daily tasks such as writing, eating and using a computer or phone extremely difficult.


Tremor affects approximately 1% of the population overall and 5% of adults age 60+. It is expected to increasingly impact Delawareans as the state’s population ages.


Essential tremor is the most common type of tremor. It can occur at any age but is most common in older adults.


Tremor is also the most well-known symptom of Parkinson’s disease. An estimated 1.5 million Americans suffer from Parkinson’s disease, a progressive neurodegenerative disease that affects movement and can also affect speech, balance and cognitive function.


A newer, better option for patients who don’t respond to medications


The procedure of MR-guided focused ultrasound involves the use of high-frequency sound waves directed with pinpoint precision by magnetic resonance imaging to ablate, or burn, the focal point deep within the brain that is causing tremors. Patients are fitted with a frame affixed to a specialized helmet that combines the focused energy of more than 1,000 high-frequency sonic beams directed through the skull.


The treatment does not require cutting through the skull, or radiation, as in gamma knife technology.


“Today, there are basically three options for managing tremor,” said Pulak Ray, M.D., of Delaware Neurosurgical Group and associate director of the Focused Ultrasound program. “The first is medication, which is effective and affordable for many patients, but its effectiveness tends to diminish over time. The second is deep-brain stimulation, which is the most invasive and costly treatment option. The newest is MR-guided ultrasound, which tends to be the preferable option for most patients who do not respond well to medication, because it is a simple, non-invasive outpatient procedure that is highly effective, safe and produces instant results.”


Benefits of MR-guided Focused Ultrasound


  • MR-guided focused ultrasound reduces tremor immediately, with shorter recovery time, lower risk of side effects and lower associated health care expenses compared to surgical alternatives.
  • This treatment dramatically improves patient experience and quality of life for people with Parkinson’s disease or essential tremor.
  • For many patients, MR-guided ultrasound reduces their dependence on caregivers to assist with activities of daily living.


Candidates must first undergo a CT scan to ensure a skull density sufficiently thick to accommodate the procedure.


The patient is awake during the procedure and situated within an MRI machine for real-time imaging of the brain.


The physician tests the precise location by heating the area, then ensuring the patient is able to control tremors by tracing lines on a spirograph. At that point, the physician then permanently ablates the focal point, usually a sphere a few millimeters in length.


“Our team is very excited to bring this technology to Delaware and to open up access to potentially life-changing treatment that until now has required long wait times and significant travel for patients,” said Kim Gannon, M.D., Ph.D., medical director of the comprehensive stroke program and physician executive of Neuroscience Service Line at ChristianaCare. “Many tremor patients have suffered for years or even decades with this debilitating and progressive condition and helping them live a more active and independent lifestyle is extremely rewarding.”


MR-guided focused ultrasound is covered by Medicare and most insurance plans.

Connect with:
Justin Martello, M.D.

Justin Martello, M.D.

Parkinson's and Movement Disorders Director

Dr. Martello, Delaware's only Parkinson's and movement disorders specialist, has established a comprehensive Parkinson's disease program.

Quality ImprovementParkinson's DiseaseNeurologyMovement Disorders

You might also like...

Check out some other posts from ChristianaCare

3 min

How ChristianaCare Built a Blueprint for Better Caregiver Health and Lower Costs

By Donna Antenucci, MHA, BSN, RN, and Emily Sahm, EA We know rising health care costs can feel overwhelming for both employers and employees. As Delaware’s largest private employer — with nearly 23,000 employees, spouses and dependents enrolled in our self-funded health plan — ChristianaCare faces these challenges every day. That’s why we’re committed to finding smart, innovative solutions that improve employee health while keeping costs in check. We don’t stop there — ChristianaCare partners with businesses that have an interest in providing high-quality health care for their employees while keeping costs manageable. Prioritizing preventive care The key to a healthier, more resilient workforce is tackling health issues early in order to prevent the need for costly emergency or “rescue” care. By prioritizing prevention and early intervention, we’ve made progress in improving employee health while controlling costs. In 2023, inpatient facility costs for our employees — which include hospital admissions for surgeries, medical treatments and other care requiring overnight stays — dropped by 9%. Wellness incentives and chronic disease management that shifted care to more cost-effective outpatient settings are driving these results. One of ChristianaCare’s differentiators is CareVio®, our care coordination and chronic disease management platform. CareVio provides personalized support to help employees and their families manage conditions and stay on track with preventive care. CareVio’s diabetes program, for example, has delivered remarkable results. Nearly all participants improved their blood sugar levels in 2023, with average A1c reductions of 1.7 points. Enhancing primary care and wellness programs We’ve also focused on encouraging primary care visits through collaboration between our Population Health and Total Rewards teams. Together, we designed a voluntary wellness incentive program that rewards employees and their families for healthy choices, including support for tobacco-cessation programs to help employees quit smoking and lead healthier lives. In 2023, we expanded our wellness incentive program to include primary care visits for employees and their spouses. Over the next eighteen months, primary care utilization increased over 10%, rising from 66% to 77% as of January 2025. Employees who stay connected to primary care catch health problems early and build stronger relationships with their doctors. We’ve launched programs targeting specific health needs. Our breast cancer screening initiative, focused on women ages 52 to 74, increased participation rates from 63% to 72% in 2023, exceeding our target. Additionally, the CareVio metabolic health program is helping a growing number of participants manage complex conditions with tailored support. Flexibility is essential. That’s why we created the Center for Virtual Health, which provides virtual-first primary care to more than 1,200 employees. This program makes high-quality, preventive care more accessible. Employees can fit care into their schedules while maintaining consistent support for their health. We encourage employees to stay up to date on immunizations by offering frequent vaccination events and tying participation to eligibility for the Caregiver Rewards Program payout. By making it easy and rewarding to stay protected, we’re fostering a safer, healthier workplace for everyone. Collaborative networks and cost management In January 2023, we announced the ChristianaCare Clinical Alliance, a new clinically integrated network in partnership with Highmark. Implemented in our employee health plan in July 2024, the network connects ChristianaCare-employed and community clinicians to provide evidence-based, coordinated care. Focused on improving wellness and managing chronic conditions, the Clinical Alliance is helping caregivers and their families stay healthier while reducing costly emergency visits and hospital stays. Employees who choose Clinical Alliance providers also enjoy lower deductibles for their care. Through all these initiatives, we are making a meaningful difference for our caregivers and our costs. In 2023, thanks to our focus on prevention and smarter care delivery, we kept our overall health care cost growth below the national average. Healthier employees lead to lower expenses and a more engaged, productive workforce. By showing that we value employee health, we’re creating a stronger, more resilient workplace. To learn how ChristianaCare can help you provide better care and control costs for your workforce, contact Donna Antenucci at donna.antenucci@christianacare.org. Donna Antenucci is vice president of population health operations for ChristianaCare. Emily Sahm is vice president of Total Rewards for ChristianaCare.

3 min

ChristianaCare Becomes First in Delaware to Offer CAR-T Therapy for Advanced Multiple Myeloma

ChristianaCare’s Helen F. Graham Cancer Center & Research Institute is the first in Delaware to offer a powerful new tool in the fight against multiple myeloma—a type of blood cancer that affects plasma cells in the bone marrow. That tool is a new chimeric antigen receptor (CAR) T-cell therapy, called CARVYKTI, which can improve treatment for adults with multiple myeloma that has returned or stopped responding to other treatments. “CAR-T cell therapy represents a paradigm shift in the treatment of multiple myeloma,” said Thomas Schwaab, M.D., Ph.D., Bank of America Endowed Medical Director of the Helen F. Graham Cancer Center & Research Institute." We are expanding access to this life-extending therapy right here in Delaware — close to home, close to hope. This is part of our ongoing commitment at the Graham Cancer Center to ensure our community has access to the most advanced cancer therapies.” Multiple myeloma is a relatively rare cancer, but it still affects a significant number of people each year. In the United States, it is estimated that around 36,110 new cases will be diagnosed in 2025, according to the American Cancer Society What is CAR-T Therapy? CAR-T cell therapy uses a patient’s own immune cells to fight cancer. Doctors first collect the patient’s T cells, which are a type of white blood cell that helps the body fight infections. In the lab, these T cells are reprogrammed by adding a special receptor called a chimeric antigen receptor (CAR). This receptor allows the T cells to recognize specific proteins on cancer cells, acting like a navigation system to help the T cells find and attack the cancer. After this genetic modification, the reprogrammed T cells are expanded in the lab to create a larger army of cancer-fighting cells. Then, they are infused back into the patient’s body, where they go on to find and destroy the cancer cells. This therapy is approved for adults who have already tried several standard treatments, like proteasome inhibitors, immunomodulators and anti-CD38 antibodies, without success. When those treatments stop working, CARVYKTI can offer a powerful new option. CAR T-cell therapy has given new hope to patients with multiple myeloma whose cancer has returned or stopped responding to other treatments. Many people see their cancer shrink or even disappear for a period of time, which can help them live longer and feel better. While the treatment can have short-term side effects, many patients report feeling stronger and having fewer symptoms once they recover. It’s not a cure, but for some, it can mean more time with loved ones and a better quality of life. “This therapy gives our patients a chance when other treatments have failed,” said Zhifu Xiang, M.D., medical oncologist at ChristianaCare Oncology Hematology. “It’s a deeply personalized approach that uses the patient’s own immune system to fight the cancer in a powerful new way. Being able to offer this locally means our patients don’t have to travel far for world-class care.” A Leader in Cell Therapy The Graham Cancer Center’s dedicated team of specialists have been offering CAR-T cell therapy for other cancer types, such as lymphoma and leukemia, since 2018. The center is also recognized by the Foundation for the Accreditation of Cellular Therapy (FACT) for meeting the highest standards in safety, quality and patient care. To learn more about CAR-T cell therapy or other cancer treatments at ChristianaCare, visit christianacare.org/cancer or call the Helen F. Graham Cancer Center & Research Institute at 302-733-HOPE (4673).

1 min

ChristianaCare Appoints Jennifer Moberg, DNP, Vice President of Emergency Services

Jennifer Moberg, DNP, MPA, RN, CPPS, NEA-BC, has been appointed vice president of Emergency Services at ChristianaCare. In this role, she will oversee the delivery of safe, high-quality, patient-centered care across ChristianaCare’s emergency departments and support prehospital services and trauma programs. Jennifer Moberg, DNP, has been appointed vice president of Emergency Services at ChristianaCare. Moberg has a strong track record of improving care quality, safety and caregiver engagement in complex health care settings. She has helped build more diverse teams, reduce staff turnover and lead major emergency department renovation projects. She has also worked to make patient care more efficient and improve safety for caregivers by strengthening security practices. Prior to joining ChristianaCare, Moberg served as director of Emergency Services at HealthPartners in Bloomington, Minnesota. She also worked as a senior advisor assessing and standardizing security protocols across hospitals and clinics. Earlier in her career, she spent more than 20 years at Abbott Northwestern, where she served as a critical care nurse and later as a patient care manager. Moberg earned a Doctor of Nursing Practice in executive leadership from Baylor University. She holds a Master of Public Affairs in nonprofit leadership from the University of Minnesota and a Bachelor of Science in nursing from Bethel University. She reports to Chief Nurse Executive Danielle Weber, DNP, MSM, RN-BC, NEA-BC.

View all posts