MRI Guided Focused Ultrasound Thalamotomy for Moderate-to-Severe Tremor in Parkinson’s Disease

Schlesinger, Ilana; Eran, Ayelet; Sinai, Alon; Erikh, Ilana; Nassar, Maria; Goldsher, Dorith; Zaaroor, Menashe

doi:10.1155/2015/219149

Cited by 87 publications

(95 citation statements)

References 13 publications

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“…58,68 The adverse events profile was similar to that reported in earlier MRgFUS thalamotomy work. Jeanmonod et al subsequently reported their experience targeting the pallidothalamic tract with sonication parameters used for MRgFUS thalamotomy and found a mean improvement of 57% on the Unified Parkinson's Disease Rating Scale (UPDRS) in a series of 8 patients.…”

Section: Parkinson's Diseasesupporting

confidence: 80%

Focused ultrasound in neurosurgery: a historical perspective

Harary

Segar

Huang

et al. 2018

Neurosurgical Focus

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Focused ultrasound (FUS) has been under investigation for neurosurgical applications since the 1940s. Early experiments demonstrated ultrasound as an effective tool for the creation of intracranial lesions; however, they were limited by the need for craniotomy to avoid trajectory damage and wave distortion by the skull, and they also lacked effective techniques for monitoring. Since then, the development and hemispheric distribution of phased arrays has resolved the issue of the skull and allowed for a completely transcranial procedure. Similarly, advances in MR technology have allowed for the real-time guidance of FUS procedures using MR thermometry. MR-guided FUS (MRgFUS) has primarily been investigated for its thermal lesioning capabilities and was recently approved for use in essential tremor. In this capacity, the use of MRgFUS is being investigated for other ablative indications in functional neurosurgery and neurooncology. Other applications of MRgFUS that are under active investigation include opening of the blood-brain barrier to facilitate delivery of therapeutic agents, neuromodulation, and thrombolysis. These recent advances suggest a promising future for MRgFUS as a viable and noninvasive neurosurgical tool, with strong potential for yet-unrealized applications.

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Section: Parkinson's Diseasesupporting

confidence: 80%

Focused ultrasound in neurosurgery: a historical perspective

Harary

Segar

Huang

et al. 2018

Neurosurgical Focus

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“…55 In 2015, Schlesinger et al reported on the treatment of moderate to severe tremor in PD in 7 patients with VIM thalamotomy using MRgHIFU. 72 The same team reported additional experience in 30 patients with PD and ET in February 2017. 72 This study included 18 patients with ET, 9 with PD, and 3 with ET-PD who underwent MRgFUS VIM thalamotomy to relieve medication-resistant tremor.…”

Section: Parkinson's Diseasementioning

confidence: 99%

“…72 The same team reported additional experience in 30 patients with PD and ET in February 2017. 72 This study included 18 patients with ET, 9 with PD, and 3 with ET-PD who underwent MRgFUS VIM thalamotomy to relieve medication-resistant tremor. Adverse events experienced postprocedure in some patients included gait ataxia, unsteady feeling, taste disturbances, asthenia, and hand ataxia.…”

Section: Parkinson's Diseasementioning

confidence: 99%

High-intensity focused ultrasound: past, present, and future in neurosurgery

Quadri¹,

Waqas

Khan

et al. 2018

Neurosurgical Focus

123

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Since Lynn and colleagues first described the use of focused ultrasound (FUS) waves for intracranial ablation in 1942, many strides have been made toward the treatment of several brain pathologies using this novel technology. In the modern era of minimal invasiveness, high-intensity focused ultrasound (HIFU) promises therapeutic utility for multiple neurosurgical applications, including treatment of tumors, stroke, epilepsy, and functional disorders. Although the use of HIFU as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists, neurologists, or even neurosurgeons are familiar with it. In this extensive review, the authors intend to shed light on the current use of HIFU in different neurosurgical avenues and its mechanism of action, as well as provide an update on the outcome of various trials and advances expected from various preclinical studies in the near future. Although the initial technical challenges have been overcome and the technology has been improved, only very few clinical trials have thus far been carried out. The number of clinical trials related to neurological disorders is expected to increase in the coming years, as this novel therapeutic device appears to have a substantial expansive potential. There is great opportunity to expand the use of HIFU across various medical and surgical disciplines for the treatment of different pathologies. As this technology gains recognition, it will open the door for further research opportunities and innovation.

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“…Other small retrospective series also described similar improvements in tremor-dominant Parkinson's disease after lesioning the ventral intermediate nucleus (50%) and globus pallidus (55%), although some of the improvements were only temporary. 23,24 Recently, indications for MRFUS have expanded to potentially include mesial temporal lobe epilepsy, neuromodulation, and even Alzheimer's disease. To date, the majority of these functional studies were performed in Vivo, investigating the possible role of MRFUS for a wide breadth of neurological diseases.…”

Section: Functional Neurosurgerymentioning

confidence: 99%