Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson's disease

Abstract

Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel and minimally invasive technology. Since the US Food and Drug Administration approved unilateral ventral intermediate nucleus-MRgFUS for medication-refractory essential tremor in 2016, studies on new indications, such as Parkinson's disease (PD), psychiatric diseases, and brain tumors, have been on the rise, and MRgFUS has become a promising method to treat such neurological diseases. Currently, as the second most common degenerative disease, PD is a research hotspot in the field of MRgFUS. The actions of MRgFUS on the brain range from thermoablation, blood-brain barrier (BBB) opening, to neuromodulation. Intensity is a key determinant of ultrasound actions. Generally, high intensity can be used to precisely thermoablate brain targets, whereas low intensity can be used as molecular therapies to modulate neuronal activity and open the BBB in conjunction with injected microbubbles. Here, we aimed to summarize advances in the application of MRgFUS for the treatment of PD, with a focus on thermal ablation, BBB opening, and neuromodulation, in the hope of informing clinicians of current applications.

Molecular Modeling of Shockwave-Mediated Blood-Brain Barrier Opening for Targeted Drug Delivery

“…The overpressure on BBB membrane surface was calculated using GROMACS-LS, 48 a modified version of GROMACS 4.5.5. For bubbles of different diameters (10,20,40,50, and 60 nm, respectively), the overpressure profiles on the BBB surface over time (Figure S6) present two distinct characteristic peaks, and it is proposed that the overpressure peak generated by the shock wave does not overlap with that of bubble collapse. For example, at D = 40 nm, the pressure peak is 363.3 MPa, when the shock wavefront reaches the outer surface of the BBB.…”

“…Focused ultrasound (FUS) is a promising alternative to other invasive interventions. Magnetic resonance-guided FUS thermoablation has been approved for the treatment of Parkinson . However, owing to the reduced efficiency of ultrasound propagation, the low skull density ratio is a relative contraindication to FUS thermoablation.…”

“…Magnetic resonance-guided FUS thermoablation has been approved for the treatment of Parkinson. 10 However, owing to the reduced efficiency of ultrasound propagation, the low skull density ratio is a relative contraindication to FUS thermoablation. Considerable heat deposition in the skull bone can be intolerably painful and result in injuries to the bone marrow.…”

Magnetic resonance imaging‐guided focused ultrasound thalamotomy launch with remote telemedicine international proctorship

“…In the solo group, we used the VIM nucleus target in 30 cases and the PTT target in 25 cases (including 15 patients with both targets). After publications 17 , 18 , 19 on successful treatments with PTT targets, we added PTT to our therapies. In 7/30 (23%) VIM nucleus target patients and 3/25 (12%) PTT target patients, we observed some recurrence of tremor 1 year after the operation.…”