Significance of mri Guided Focused Ultrasound Thalamotomy for Parkinson Disease: a Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Pooja ◽  
SK Pahuja ◽  
Karan Veer
Keyword(s):  
Focused Ultrasound ◽  
Online Resources ◽  
Research Review ◽  
Brain Disorders ◽  
Invasive Procedures ◽  
Internal Globus Pallidus ◽  
Non Invasive ◽  
Safe Technique ◽  
Ventral Intermediate Nucleus ◽  
Mri Guided

Background: Magnetic-Resonance guided Focused Ultrasound (FUS) thalamotomy is a new and less invasive surgical technique for treating Parkinson’s disease (PD). During therapy the required part of cerebral (as STN, Internal Globus Pallidus, and Ventral Intermediate Nucleus) is ablated with less possibility of infection and brain hemorrhage as normally happen in invasive procedures. Introduction: New advancement in the technique enable it for transcranial transportation of US. Now a days, US coupling with MRI confirms the accurate energy transferring and monitoring. So, MRI guided FUS lesioning is discovered for various psychiatrics and brain disorders. Methods: A technical overview of non-invasive MRI-FUS thalamotomy to treat various tremors is described here. Research, review articles, and book chapters are extracted from online resources using related search strings from year 1994-2020. Results: MRgFUS is concluded a non-invasive, satisfactory and safe technique to reduce the tremor. Table 1 shows the significance of it.

scholarly journals BOT-01 BLOOD-BRAIN BARRIER OPENING USING 220-KHZ TRANSCRANIAL MRI-GUIDED FOCUSED ULTRASOUND AND MICROBUBBLES IN MOUSE AND RAT

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii12-ii12
Author(s):  
Michiharu Yoshida ◽  
Kazuo Maruyama ◽  
Yasutaka Kato ◽  
Rachmilevitch Itay ◽  
Syuji Suzuki ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Blood Brain Barrier ◽  
Focused Ultrasound ◽  
Brain Barrier ◽  
Maximum Temperature ◽  
Non Invasive ◽  
Therapeutic Drugs ◽  
Blood Brain ◽  
Mri Guided ◽  
Bbb Opening

Abstract OBJECTIVE In neuro-oncology, it is believed that one major obstacle to effective chemotherapy is the high vascularity and heterogenous permeability of brain tumors. Focused ultrasound (FUS) exposure with the microbubbles has been shown to transiently open the blood-brain barrier (BBB) without depositing thermal energy, and thus may enhance the delivery of various therapeutic drugs into brain tumors. The aim of this study was to evaluate the BBB opening using 220-kHz transcranial MRI-guided FUS (TcMRgFUS) device and microbubbles in mouse and rat. METHODS The experiments were performed with the 220-kHz ExAblate Neuro TcMRgFUS system (InSightec) and novel lipid bubbles (LB, Teikyo Univ.). Normal mouse and rat brains were irradiated with TcMRgFUS (output power, 5W; duration of irradiation, 30 s; duty cycle 100%) following intravenous injection of 6x107 LB per mouse and rat, respectively. On irradiation, target temperature rise & cavitation signal were monitored by MR thermometry and cavitation receiver, respectively. Immediately after irradiation, BBB opening and complications were detected based on T1, T2, T2*, and Gadolinium (Gd) enhanced T1-weighted images. RESULTS The maximum temperature of brain tissue was under 42 C. There were no risky-cavitation signals causing hemorrhage. The FUS-LB exposure induced successful BBB opening effect in both mouse and rat, confirmed by Gd enhancement in the target region, lateral ventricles, and sulcus. In addition, there were no complications such as edema, coagulation, and hemorrhage. CONCLUSIONS Although there remain many conditions to be optimized, BBB opening using a 220-kHz TcMRgFUS device and LB can offer a non-invasive and feasible drug delivery for brain malignancies.

scholarly journals Non-invasive delivery of stealth, brain-penetrating nanoparticles across the blood − brain barrier using MRI-guided focused ultrasound

2014 ◽  
Vol 189 ◽  
pp. 123-132 ◽  
Author(s):  
Elizabeth Nance ◽  
Kelsie Timbie ◽  
G. Wilson Miller ◽  
Ji Song ◽  
Cameron Louttit ◽  
...  
Keyword(s):  
Blood Brain Barrier ◽  
Focused Ultrasound ◽  
Brain Barrier ◽  
Non Invasive ◽  
Blood Brain ◽  
Mri Guided

scholarly journals Non-Invasive Targeted Peripheral Nerve Ablation Using 3D MR Neurography and MRI-Guided High-Intensity Focused Ultrasound (MR-HIFU): Pilot Study in a Swine Model

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0144742 ◽  
Author(s):  
Merel Huisman ◽  
Robert M. Staruch ◽  
Michelle Ladouceur-Wodzak ◽  
Maurice A. van den Bosch ◽  
Dennis K. Burns ◽  
...  
Keyword(s):  
Pilot Study ◽  
Peripheral Nerve ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Swine Model ◽  
Mr Neurography ◽  
Non Invasive ◽  
Mri Guided

scholarly journals Functional lesional neurosurgery for tremor: a systematic review and meta-analysis

2018 ◽  
Vol 89 (7) ◽  
pp. 717-726 ◽  
Author(s):  
Sebastian R Schreglmann ◽  
Joachim K Krauss ◽  
Jin Woo Chang ◽  
Kailash P Bhatia ◽  
Georg Kägi
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Radiofrequency Ablation ◽  
Side Effects ◽  
Focused Ultrasound ◽  
Meta Analysis ◽  
Consistency Effect ◽  
Rubral Tremor ◽  
Ventral Intermediate Nucleus ◽  
Mri Guided

BackgroundThis work evaluates the consistency, effect size and incidence of persistent side effects of lesional neurosurgical interventions in the treatment of tremor due to Parkinson’s disease (PD), essential tremor (ET), multiple sclerosis (MS) and midbrain lesions.MethodsSystematic review and meta-analysis according to PRISMA-P guidelines. Random effects meta-analysis of standardised mean difference based on a peer-reviewed protocol (PROSPERO no. CRD42016048049).ResultsFrom 1249 abstracts screened, 86 peer-reviewed studies reporting 102 cohorts homogeneous for tremor aetiology, surgical target and technique were included.Effect on PD tremor was better when targeted at the ventral intermediate nucleus (V.im.) by radiofrequency ablation (RF) (Hedge’s g: −4.15;) over V.im. by Gamma Knife (GK) (−2.2), subthalamic nucleus (STN) by RF (−1.12) and globus pallidus internus (GPi) by RF (−0.89). For ET MRI-guided focused ultrasound (MRIgFUS) ablation of the cerebellothalamic tract (CTT) (−2.35) and V.im. (−2.08) showed similar mean tremor reductions to V.im. ablation by RF (−2.42) or GK (−2.13). In MS V.im. ablation by GK (−1.96) and RF (−1.63) were similarly effective.Mean rates of persistent side effects after unilateral lesions in PD were 12.8% (RF V.im.), 13.6% (RF STN), 9.2% (RF GPi), 0.7% (GK V.im.) and 7.0% (MRIgFUS V.im.). For ET, rates were 9.3% (RF V.im.), 1.8% (GK V.im.), 18.7% (MRIgFUS V.im.) and 0.0% (MRIgFUS CTT), for MS 37.7% (RF V.im.) and for rubral tremor 30.3% (RF V.im.).ConclusionThis meta-analysis quantifies safety, consistency and efficacy of lesional neurosurgical interventions for tremor by target, technique and aetiology.

Intravenous and Non-invasive Drug Delivery to the Mouse Basal Forebrain Using MRI-guided Focused Ultrasound

BIO-PROTOCOL ◽  
2021 ◽  
Vol 11 (12) ◽  
Author(s):  
Kristiana Xhima ◽  
Dallan McMahon ◽  
Emmanuel Edward Ntiri ◽  
Maged Goubran ◽  
Kullervo Hynynen ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Basal Forebrain ◽  
Focused Ultrasound ◽  
Non Invasive ◽  
Mri Guided ◽  
Mouse Basal Forebrain

The Efficacy of Bisphosphonate to Increase the Skull Density Ratio of MRI-guided Focused Ultrasound Candidates with Brain Disorders

2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Hisashi Ito ◽  
Jordi Rumia ◽  
Shigeru Fukutake ◽  
Kazuaki Yamamoto ◽  
Toshio Yamaguchi ◽  
...  
Keyword(s):  
Focused Ultrasound ◽  
Density Ratio ◽  
Brain Disorders ◽  
Mri Guided

scholarly journals ET-04 Enhancing drug delivery with MRI-guided focused ultrasound for diffuse intrinsic pontine glioma model

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii6-ii6
Author(s):  
Joji Ishida ◽  
Saira Alli ◽  
Andrew Bondoc ◽  
Naohide Fujita ◽  
Hynynen Kullervo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cell Lines ◽  
Tumour Growth ◽  
Focused Ultrasound ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Therapeutic Effects ◽  
Pontine Glioma ◽  
Non Invasive ◽  
Response To Chemotherapy ◽  
Mri Guided

Abstract Diffuse intrinsic pontine glioma (DIPG) is surgically unresectable and one of the most devasting tumours in children. To date, there have been no effective chemotherapeutics against DIPG, despite a myriad of clinical trials. The intact blood-brain barrier (BBB) is partly responsible for the limited clinical response to chemotherapy. MRI-guided focused ultrasound (MRgFUS) is a promising non-invasive tissue ablation method for treating CNS tumours. Moreover, MRgFUS allows for temporary and repeatable BBB disruption. Our first objective was to determine the feasibility and safety of temporary BBB disruption within the brainstem using MRgFUS following intravenous administration of microbubbles in vivo. Our second objective was to select effective chemotherapeutics against DIPG cell lines, and to examine their therapeutic effects with MRgFUS in a murine model of DIPG which exhibits an intact BBB. Non-invasive opening of the BBB was determined in the brainstem of normal rodents using physiological monitoring and histological analysis. Doxorubicin was selected from a drug screen consisting of conventional chemotherapeutics tested against DIPG cell lines. We established SU-DIPG17 orthotopic xenografts which demonstrated diffusely infiltrative tumour growth. By LC-MS/MS analysis, MRgFUS led to a 4-fold increase in doxorubicin concentrations within the brainstem tumours as compared to controls. Moreover, the volumetric tumour growth rate was significantly suppressed in MRgFUS-treated animals, which also exhibited decreased Ki-67 expression. We demonstrated the feasibility and safety of MRgFUS in the rodent brainstem and have shown that MRgFUS increases doxorubicin uptake in the brainstem of a rodent model of DIPG. This preclinical data provides critical support for clinical trials investigating MRgFUS-mediated BBB opening, which may greatly improve chemotherapeutic efficacy against DIPG in children.

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

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ilana Schlesinger ◽  
Ayelet Eran ◽  
Alon Sinai ◽  
Ilana Erikh ◽  
Maria Nassar ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Focused Ultrasound ◽  
Disease Duration ◽  
Innovative Technology ◽  
Efficacy And Safety ◽  
Noninvasive Surgery ◽  
Ventral Intermediate Nucleus ◽  
Mri Guided

Background. Thalamotomy is effective in alleviating tremor in Parkinson’s disease (PD).Methods. Seven PD patients, mean age 59.4 ± 9.8 years (range, 46–74) with a mean disease duration of 5.4 ± 2.8 years (range, 2–10) suffering from severe refractory tremor, underwent ventral intermediate nucleus thalamotomy using MRI guided focused ultrasound (MRgFUS), an innovative technology that enables noninvasive surgery.Results. Tremor stopped in the contralateral upper extremity in all patients immediately following treatment. Total UPDRS decreased from 37.4 ± 12.2 to 18.8 ± 11.1(p=0.007)and PDQ-39 decreased from 42.3 ± 16.4 to 21.6 ± 10.8(p=0.008)following MRgFUS. These effects were sustained (mean follow-up 7.3 months). Adverse events during MRgFUS included headache(n=3), dizziness(n=2), vertigo(n=4), and lip paresthesia(n=1)and following MRgFUS were hypogeusia(n=1), unsteady feeling when walking (n=1, resolved), and disturbance when walking tandem (n=1, resolved).Conclusions. Thalamotomy using MRgFUS is safe and effective in PD patients. Large randomized studies are needed to assess prolonged efficacy and safety.

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