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Transcranial Focused Ultrasound in Functional Neurosurgery for Essential Tremor and Parkinson’s Disease: A Review Article

Parisa Azimi
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Abstract

PURPOSE: Transcranial magnetic resonance guided focused ultrasound (MRgFUS) is a new development in the field of functional neurosurgery. A comprehensive review of the current literature was performed to evaluate of transcranial MRgFUS in treatment of essential tremor (ET) and Parkinson’s disease.

METHODS: Articles available in electronic databases of PubMed, and Web of Science, as of July 2016 were reviewed. The strategy included a combination of key words 'MRgFUS', 'tremor', 'Parkinson', 'brain', ' head ', 'tumor', 'transcranial' and 'focused ultrasound' in the title and abstract of the manuscripts. In addition transcranial MRgFUS systems and cost-effectiveness of treatment were assessed. Finally, the major findings are summarized.

RESULTS: Fifty-eight articles met the inclusion criteria for review. Among these, 15 studies eligible for inclusion in this review. The synthesis of the data demonstrated that, transcranial MRgFUS have been successfully used for treatment of essential tremor and Parkinson’s disease. Lesions were created under real-time MRI guidance, with peak temperatures of between 52° C and 63° C. Adverse events during transcranial MRgFUS reported such as headache, dizziness, vertigo, lip paresthesia, and hypogeusia. However, there were no significant treatment-related complications or side effects. At present, one of the limitations of transcranial MRgFUS is high price of treatment. However, continued advances in technology can be expected to further refine the high price market of transcranial MRgFUS.

CONCLUSION: The findings showed that essential tremor and Parkinson’s disease can be effectively treated with transcranial MRgFUS method. Long-term clinical data are forthcoming.


Keywords

Transcranial focused ultrasound; Essential Tremor; Parkinson’s disease

References

Abboud H, Ahmed A, Fernandez HH. Essential tremor: choosing the right management plan for your patient. Cleve Clin J Med. 2011 Dec; 78(12):821-8..

http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm. June, 2016.

Sveinbjornsdottir S. The clinical symptoms of Parkinson's disease. J Neurochem. 2016 Jul 11. [Epub ahead of print]

Fekete R, Jankovic J. Revisiting the relationship between essential tremor and Parkinson’s disease. Mov Disord. 2011 Feb 15;26(3):391-8.

Chang WS, Jung HH, Kweon EJ, Zadicario E, Rachmilevitch I, Chang JW. Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes. J Neurol Neurosurg Psychiatry 2014 Mar;86(3):257- 64.

Lynn JG, Zwemer RL, Chick AJ. The biological application of focused ultrasonic waves. Science. 1942 Jul 31;96(2483):119-20.

Fry WJ, Barnard JW, Fry EJ, Krumins RF, Brennan JF. Ultrasonic lesions in the mammalian central nervous system. Science. 1955 Sep 16;122(3168):517-8.

Jolesz FA, McDannold NJ. Magnetic resonance-guided focused ultrasound: a new technology for clinical neurosciences. Neurol Clin 2014;32:253–69.

Bauer R, Martin E, Haegele-Link S, Kaegi G, von Specht M, Werner B. Noninvasive functional neurosurgery using transcranial MR imaging-guided focused ultrasound. Parkinsonism Relat Disord 2014 Jan; 20 Suppl 1:S197–9.

Hynynen K, McDannold N, Vykhodtseva N, Raymond S, Weissleder R, Jolesz FA, et al. Focal disruption of the blood-brain barrier due to 260-kHz ultrasound bursts: a method for molecular imaging and targeted drug delivery. J Neurosurg. 2006 Sep;105(3):445-54.

King RL, Brown JR, Newsome WT, Pauly KB. Effective parameters for ultrasound-induced in vivo neurostimulation. Ultrasound Med Biol. 2013 Feb;39(2):312-31.

Monteith S, Sheehan J, Medel R, Wintermark M, Eames M, Snell J, et al. Potential intracranial applications of magnetic resonance-guided focused ultrasound surgery. J Neurosurg. 2013 Feb;118(2):215-21.

Wintermark M, Huss DS, Shah BB, Tustison N, Druzgal TJ, Kassell N, et al. Thalamic connectivity in patients with essential tremor treated with MR imaging-guided focused ultrasound: in vivo fiber tracking by using diffusion-tensor MR imaging. Radiology. 2014 Jul; 272(1):202-9.

Elias WJ, Huss D, Voss T, Loomba J, Khaled M, Zadicario E, et al. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2013; 369(7):640–8.

McDannold N, Clement G, Black P, Jolesz F, Hynynen K. Transcranial MRI-guided focused ultrasound surgery of brain tumors: Initial findings in three patients. Neurosurgery. 2010 Feb; 66(2):323-332.

Tsai SJ. Transcranial focused ultrasound as a possible treatment for major depression. Med Hypotheses. 2015 Apr;84(4):381-3.

Schlesinger I, Eran A, Sinai A, Erikh I, Nassar M, Goldsher D, et al. MRI guided focused ultrasound thalamotomy for moderate-to-severe tremor in Parkinson’s disease. Parkinsons Dis 2015;2015:219149.

Weintraub D, Elias WJ. The emerging role of transcranial magnetic resonance imaging-guided focused ultrasound in functional neurosurgery. Mov Disord. 2016 Apr 8. [Epub ahead of print]

http://www.insightec.com/us/clinical/neurosurgery/ June 2016

Lipsman N, Schwartz ML, Huang Y, Lee L, Sankar T, Chapman M , et al. MR-guided focused ultrasound thalamotomy for essential tremor: a proof-of-concept study. Lancet Neurol 2013 May;12(5):462-8.

Huss DS, Dallapiazza RF, Shah BB, Harrison MB, Diamond J, Elias WJ. Functional assessment and quality of life in essential tremor with bilateral or unilateral DBS and focused ultrasound thalamotomy. Mov Disord. 2015 Dec;30(14):1937-43.

Chauvet D, Marsac L, Pernot M, Boch AL, Guillevin R, Salameh N, et al. Targeting accuracy of transcranial magnetic resonance-guided high-intensity focused ultrasound brain therapy: a fresh cadaver model. J Neurosurg. 2013 May;118(5):1046-52.

Moser D, Zadicario E, Schiff G, Jeanmonod D. MR-guided focused ultrasound technique in functional neurosurgery: targeting accuracy. J Ther Ultrasound. 2013 Apr 25;1:3.

Wintermark M, Druzgal J, Huss DS, Khaled MA, Monteith S, Raghavan P, et al. Imaging findings in MR imaging-guided focused ultrasound treatment for patients with essential tremor.AJNR Am J Neuroradiol. 2014 May;35(5):891-6.

Ahmed H, Field W, Hayes MT, Lopez WO, McDannold N, Mukundan S Jr, et al. Evolution of Movement Disorders Surgery Leading to Contemporary Focused Ultrasound Therapy for Tremor. Magn Reson Imaging Clin N Am. 2015 Nov;23(4):515-22.

Jenne JW. Non-invasive transcranial brain ablation with high-intensity focused ultrasound. Front Neurol Neurosci. 2015;36:94-105.

Chang JW, Min BK, Kim BS, Chang WS, Lee YH. Neurophysiologic correlates of sonication treatment in patients with essential tremor. Ultrasound Med Biol. 2015 Jan;41(1):124-31.

Jung HH, Chang WS, Rachmilevitch I, Tlusty T, Zadicario E, Chang JW. Different magnetic resonance imaging patterns after transcranial magnetic resonance-guided focused ultrasound of the ventral intermediate nucleus of the thalamus and anterior limb of the internal capsule in patients with essential tremor or obsessive-compulsive disorder. J Neurosurg. 2015 Jan;122(1):162-8.

Bond AE, Dallapiazza R, Huss D, Warren AL, Sperling S, Gwinn R, et al. A Randomized, Sham-Controlled Trial of Transcranial Magnetic Resonance-Guided 132 Focused Ultrasound Thalamotomy Trial for the Treatment of Tremor-Dominant, Idiopathic Parkinson Disease. Neurosurgery. 2016 Aug;63 Suppl 1:154.

Gallay MN, Moser D, Rossi F, Pourtehrani P, Magara AE, Kowalski M, et al. Incisionless transcranial MR-guided focused ultrasound in essential tremor: cerebellothalamic tractotomy. J Ther Ultrasound. 2016 Feb 13;4:5.

Magara Magara A, Bühler R, Moser D, Kowalski M, Pourtehrani P, Jeanmonod D. First experience with MR-guided focused ultrasound in the treatment of Parkinson’s disease. Journal of Therapeutic Ultrasound 2014 May 31;2:11.

Na YC, Chang WS, Jung HH, Kweon EJ, Chang JW. Unilateral magnetic resonance-guided focused ultrasound pallidotomy for Parkinson disease. Neurology. 2015 Aug 11;85(6):549-51.

A pivotal study to evaluate the effectiveness and safety of ExAblate transcranial MRgFUS thalamotomy treatment of medication refractory essential tremor subjects. National Library of Medicine (US). 2000 [cited 2015 Oct 31]. Available at: http://clinicaltrials. gov/show/NCT01827904 NLM identifier: NCT01827904. Accessed 31 October 2015.

A feasibility clinical trial of the management of the medicallyrefractory dyskinesia symptoms of advanced idiopathic Parkinson’s disease with unilateral lesioning of the globus pallidum using the ExAblate transcranial system. National Library of Medicine (US). 2000 (cited 2015 Oct 31). Available at: http://clinicaltrials.gov/ show/NCT02263885 NLM identifier: NCT02263885. Accessed 31 October 2015.

Feasibility trial evaluating the safety and efficacy of ExAblate transcranial magnetic resonance guided focused ultrasound (MRgFUS) for unilateral pallidotomy for the treatment of L-dopa induced dyskinesia (LID) of Parkinson’s disease. National Library of Medicine (US). 2000 [cited 2015 Oct 31]. Available at: http:// clinicaltrials.gov/show/NCT02347254. NLM identifier: NCT02347254. Accessed 31 October 2015.

A feasibility study to evaluate safety and initial effectiveness of ExAblate transcranial MR guided focused ultrasound for unilateral pallidotomy in the treatment of dyskinesia of Parkinson’s disease. National Library of Medicine (US). 2000 [cited 2015 Oct 31]. Available at: http://clinicaltrials.gov/show/NCT02003248. NLM identifier: NCT02003248. Accessed 31 October 2015.

A feasibility study to evaluate safety and initial effectiveness of ExAblate transcranial MR guided focused ultrasound for unilateral thalamotomy in the treatment of medication-refractory tremor dominant idiopathic Parkinson’s disease. National Library of Medicine (US). 2000 (cited 2015 Oct 31). Available at: http://clinicaltrials clinicaltrials. gov/show/NCT01772693 NLM Identifier: NCT01772693. Accessed 31 October 2015.

A feasibility clinical trial of the management of the medicallyrefractory motor symptoms of advanced idiopathic Parkinson’s disease with staged, unilateral lesioning of the subthalamic nucleus using the ExAblate transcranial system. National Library of Medicine (US). 2000 (cited 2015 Oct 31). Available at: http://clinicaltrials. gov/show/NCT02246374 NLM Identifier: NCT02246374. Accessed 31 October 2015.




DOI: http://dx.doi.org/10.22037/icnj.v3i3.13733

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