Evolution of Movement Disorders Surgery Leading to Contemporary Focused Ultrasound Therapy for Tremor

Ahmed, Hena; Field, Wesley; Hayes, Michael T.; López, William Omar Contreras; McDannold, Nathan; Mukundan, Srinivasan; Tierney, Travis S.

doi:10.1016/j.mric.2015.05.008

Cited by 8 publications

(13 citation statements)

References 57 publications

(51 reference statements)

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“…52 Since its development, the most recent technologies have allowed the use of HI-FU in neurosurgical practice. 1,21,28,30,31,52 MRI guidance is used for both the planning and the thermal monitoring of the targeted area, thanks to water proton resonance frequency-shift thermometry. 30,35 At the beginning, MRgFUS was used to treat both benign and malignant neoplasms.…”

mentioning

confidence: 99%

“…3,14,15,35 In functional neurosurgery, transcranial MRgFUS (tcMRgFUS) is definitely emerging as a noninvasive, nonprosthetic, guided, and repeatable technique for treating mostly idiopathic tremor-dominant Parkinson's disease (PD), essential tremor (ET), and neuropathic pain. 1,11,36,51 ET and PD are neurological disorders with a high prevalence. The history of their pathological progression leads to drug resistance and to the decline of quality of life.…”

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confidence: 99%

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Preliminary experience with a transcranial magnetic resonance–guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson’s disease

Iacopino

Gagliardo²,

Giugno

et al. 2018

Neurosurgical Focus

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OBJECTIVETranscranial magnetic resonance–guided focused ultrasound surgery (tcMRgFUS) is one of the emerging noninvasive technologies for the treatment of neurological disorders such as essential tremor (ET), idiopathic asymmetrical tremor-dominant Parkinson’s disease (PD), and neuropathic pain. In this clinical series the authors present the preliminary results achieved with the world’s first tcMRgFUS system integrated with a 1.5-T MRI unit.METHODSThe authors describe the results of tcMRgFUS in a sample of patients with ET and with PD who underwent the procedure during the period from January 2015 to September 2017. A monolateral ventralis intermedius nucleus (VIM) thalamic ablation was performed in both ET and PD patients. In all the tcMRgFUS treatments, a 1.5-T MRI scanner was used for both planning and monitoring the procedure.RESULTSDuring the study period, a total of 26 patients underwent tcMRgFUS thalamic ablation for different movement disorders. Among these patients, 18 were diagnosed with ET and 4 were affected by PD. All patients with PD were treated using tcMRgFUS thalamic ablation and all completed the procedure. Among the 18 patients with ET, 13 successfully underwent tcMRgFUS, 4 aborted the procedure during ultrasound delivery, and 1 did not undergo the tcMRgFUS procedure after stereotactic frame placement. Two patients with ET were not included in the results because of the short follow-up duration at the time of this study. A monolateral VIM thalamic ablation in both ET and PD patients was performed. All the enrolled patients were evaluated before the treatment and 2 days after, with a clinical control of the treatment effectiveness using the graphic items of the Fahn-Tolosa-Marin tremor rating scale. A global reevaluation was performed 3 months (17/22 patients) and 6 months (11/22 patients) after the treatment; the reevaluation consisted of clinical questionnaires, neurological tests, and video recordings of the tests. All the ET and PD treated patients who completed the procedure showed an immediate amelioration of tremor severity, with no intra- or posttreatment severe permanent side effects.CONCLUSIONSAlthough this study reports on a small number of patients with a short follow-up duration, the tcMRgFUS procedure using a 1.5-T MRI unit resulted in a safe and effective treatment option for motor symptoms in patients with ET and PD. To the best of the authors’ knowledge, this is the first clinical series in which thalamotomy was performed using tcMRgFUS integrated with a 1.5-T magnet.

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confidence: 99%

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confidence: 99%

Preliminary experience with a transcranial magnetic resonance–guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson’s disease

Iacopino

Gagliardo²,

Giugno

et al. 2018

Neurosurgical Focus

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“…First‐line oral medications include beta‐blockers and anticonvulsants, but an estimated 25–30% of patients either cannot tolerate medication or have tremor that becomes refractory to the medical treatment . For those, neurosurgical ablation or deep brain stimulation of the ventral part of the ventral lateral posterior thalamic nucleus (VLpv; also called the ventral intermediate nucleus) may be indicated …”

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confidence: 99%

Transcranial MRI‐guided high‐intensity focused ultrasound for treatment of essential tremor: A pilot study on the correlation between lesion size, lesion location, thermal dose, and clinical outcome

Federau

Goubran

Rosenberg

et al. 2017

Magnetic Resonance Imaging

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“…)‐injected MSC to desired locations and shown associations with improved pathology . Image‐guided FUS is a noninvasive modality which is a clinically approved treatment for thermal ablation of patients with essential tremor, uterine fibroids and prostate cancer . pFUS minimizes heating and allows acoustic mechanical effects to predominate.…”

Section: Introductionmentioning

confidence: 99%

“…[17][18][19][20][21][22] Image-guided FUS is a noninvasive modality which is a clinically approved treatment for thermal ablation of patients with essential tremor, uterine fibroids and prostate cancer. [23][24][25] pFUS minimizes heating and allows acoustic mechanical effects to predominate. We have characterized the molecular biological effects of pFUS mechanotransduction in various tissues and show that pFUS stimulates local release of cytokines, chemokines, and trophic factors (CCTF) into the microenvironment and up-regulates cell adhesion molecules on endothelial cells.…”

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confidence: 99%

Mesenchymal stromal cell potency to treat acute kidney injury increased by ultrasound‐activated interferon‐γ/interleukin‐10 axis

Burks

Nagle

Bresler

et al. 2018

J Cellular Molecular Medi

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Mesenchymal stromal cell (MSC) therapies combined with renal pulsed focused ultrasound (pFUS) pretreatment increase MSC homing and improve cisplatin‐induced acute kidney injury (AKI) better than MSC alone. However, mechanisms underlying improved outcomes remain unknown. We hypothesize pFUS up‐regulates renal interferon‐γ (IFNγ) and stimulates MSC to produce interleukin‐10 (IL‐10) after migrating to kidneys. To demonstrate initially, MSC cultured with IFNγ up‐regulated IL‐10. More MSC‐derived IL‐10 was detected in kidneys when IFNγ‐stimulated MSC were infused and they improved AKI better than unstimulated MSC. Next, IFNγ‐knockout mice with AKI received pFUS+MSC, but MSC‐derived IL‐10 expression and AKI were similar to using MSC alone. AKI in wild‐type mice receiving pFUS and IL‐10‐deficient MSC was also unimproved compared to administering IL‐10‐deficient MSC alone. Indoleamine 2,3‐dioxygenase (IDO), an anti‐inflammatory enzyme up‐regulated in MSC by IFNγ, was up‐regulated during AKI, but was not further elevated in MSC from pFUS‐treated kidneys, suggesting that IDO is not involved in improved AKI healing by pFUS+MSC. These data suggest IFNγ is up‐regulated by pFUS and after i.v.‐infused MSC home to pFUS‐treated kidneys, IFNγ stimulates additional IL‐10 production by MSC to improve AKI. Analogous mechanisms of ultrasound‐treated tissue microenvironments stimulating therapeutic MSC may exist in other pathologies where adjuvant ultrasound techniques are successful.

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Evolution of Movement Disorders Surgery Leading to Contemporary Focused Ultrasound Therapy for Tremor

Cited by 8 publications

References 57 publications

Preliminary experience with a transcranial magnetic resonance–guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson’s disease

Preliminary experience with a transcranial magnetic resonance–guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson’s disease

Transcranial MRI‐guided high‐intensity focused ultrasound for treatment of essential tremor: A pilot study on the correlation between lesion size, lesion location, thermal dose, and clinical outcome

Mesenchymal stromal cell potency to treat acute kidney injury increased by ultrasound‐activated interferon‐γ/interleukin‐10 axis

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