Image-guided HIFU neurolysis of peripheral nerves to treat spasticity and pain

Foley, Jessica L.; Little, James W.; Starr, Frank; Frantz, Carie M.; Vaezy, Shahram

doi:10.1016/j.ultrasmedbio.2004.07.004

Cited by 66 publications

(50 citation statements)

References 30 publications

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“…11 The results of the initial acute study indicated that HIFU can produce suppression of sciatic nerve function. Suppression was measured by a diminished response of the plantarflexion muscles of the rabbit foot to electrical stimulation of the nerve proximal to the treatment site.…”

Section: Introductionmentioning

confidence: 99%

Image-Guided High-Intensity Focused Ultrasound for Conduction Block of Peripheral Nerves

2006

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The objective of our work has been to investigate the use of ultrasound image-guided high-intensity focused ultrasound (HIFU) to non-invasively produce conduction block in rabbit sciatic nerves in vivo, a technique that could become a treatment of spasticity and pain. The work reported here involved the investigation of the duration of such conduction blocks after HIFU treatment and whether they resulted in axon degeneration. The right sciatic nerves of 12 rabbits were treated, under guidance of ultrasound imaging, with repeated 5-s applications of 3.2 MHz HIFU with in situ intensity of 1930 W/cm(2) (spatial-average, temporal-average) until conduction block was achieved. Survival endpoints were 0, 7, or 14 days after HIFU treatment, at which point the nerve conduction was assessed. Qualitative and quantitative histological analysis of nerve sections proximal and distal to the HIFU site was performed. Conduction block of all 12 nerves was achieved with average HIFU treatment time of 10.5+/-4.9 s (mean+/-SD). The volume of necrosis of adjacent muscle was measured to be 1.59+/-1.1 cm(3) (mean+/-SD). For all nerves, conduction block remained at the survival endpoint and the block resulted in degeneration of axons distal to the HIFU site, as confirmed by electrophysiological and histological methods. Potential clinical applications include treatment of spasticity in patients with spinal cord injury or pain in cancer patients.

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Section: Introductionmentioning

confidence: 99%

Image-Guided High-Intensity Focused Ultrasound for Conduction Block of Peripheral Nerves

2006

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“…Polyvinylpyrrolidone (PVP, K30), potassium ferricyanide (K 3 [Fe(CN) 6 ]), hydrochloric acid (HCl, 36.0 %~38.0 %) and perfluorohexane (PFH, Sigma-Aldrich-Co. LLC., St. Louis, MO, US) were purchased from Sinopharm Chemical Reagent Co., Ltd. PVP (3.0 g), K 3 [Fe(CN) 6 ] (132 mg) and HCl solution (0.01 M, 40 mL) were mixed under magnetic stirring. After achieving a clear solution, the vial was placed in an electric oven at 80 °C for 24 h. Then, by centrifugation and several washes in distilled water, mesoporous Prussian blue nanoparticles (MPBs) were obtained.…”

Section: Synthesis Of Hmpbsmentioning

confidence: 99%

“…However, the technique has limitations that hinder its broad application. Although ultrasound imaging is the most common imaging technique for guiding HIFU therapy in the great majority of clinical therapies [6][7], its inadequate accuracy and low image contrast restrict noninvasive localization and treatment evaluation [8]. Furthermore, the release of high-focused acoustic power during treatment could damage normal tissue through the ultrasound…”

Section: Introductionmentioning

confidence: 99%

A Multifunctional Theranostic Nanoagent for Dual-Mode Image-Guided Hifu/Chemo- Synergistic Cancer Therapy

Zhang

Cai

2017

Ultrasound in Medicine & Biology

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High-intensity focused ultrasound (HIFU) is deemed to be a promising noninvasive therapeutic modality for cancers as well as non-neoplastic diseases. However, the accuracy of the technique in the diagnosis and treatment of tumors remains unsatisfactory. HIFU, when combined with multifunctional synergistic agents (SAs), has the potential to be of greater diagnostic and therapeutic efficacy. Here we describe a smart and multifunctional hollow mesoporous Prussian blue (HMPBs) theranostic nanoplatform, the hollow structure of which is capable of encapsulating doxorubicin (DOX) and perfluorohexane (HMPBs-DOX/PFH). In vitro and in vivo studies validated that HMPBs-DOX/PFH can be used as an amplifiable dual-mode imaging contrast agent, which can simultaneously enhance ultrasound (US) and photoacoustic (PA) imaging for guiding and monitoring tumor therapy. When exposed to HIFU, this versatile HMPBs-DOX/PFH agent could increase the cavitation effect and use lower HIFU intensity to achieve coagulative necrosis. Furthermore, it significantly accelerated the release of DOX thereby enhancing chemotherapeutic efficacy and avoiding systemic side effects of the drug. Such a novel theranostic nanoplatform is expected to integrate dual-mode guided imaging with greater therapeutic efficacy and fewer side effects and is very promising for the noninvasive synergistic tumor therapy.

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“…Through MRgFUS, however, this "functional testing" might be possible. Localized acoustic energy delivery can block nerve conduction; thus, "local acoustic anesthesia" can be used for pain control and the treatment of spasticity (56). The FUS-induced nerve block may be reversible (57; K. Hynynen, V. Colucci, G. Strichartz, et al, unpublished results).…”

Section: Clinical Applications Of Mrgfus Ablationmentioning

confidence: 99%

MRI-Guided Focused Ultrasound Surgery

2007

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MRI-guided focused ultrasound (MRgFUS) surgery is a noninvasive thermal ablation method that uses magnetic resonance imaging (MRI) for target definition, treatment planning, and closed-loop control of energy deposition. Integrating FUS and MRI as a therapy delivery system allows us to localize, target, and monitor in real time, and thus to ablate targeted tissue without damaging normal structures. This precision makes MRgFUS an attractive alternative to surgical resection or radiation therapy of benign and malignant tumors. Already approved for the treatment of uterine fibroids, MRgFUS is in ongoing clinical trials for the treatment of breast, liver, prostate, and brain cancer and for the palliation of pain in bone metastasis. In addition to thermal ablation, FUS, with or without the use of microbubbles, can temporarily change vascular or cell membrane permeability and release or activate various compounds for targeted drug delivery or gene therapy. A disruptive technology, MRgFUS provides new therapeutic approaches and may cause major changes in patient management and several medical disciplines.

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Image-guided HIFU neurolysis of peripheral nerves to treat spasticity and pain

Cited by 66 publications

References 30 publications

Image-Guided High-Intensity Focused Ultrasound for Conduction Block of Peripheral Nerves

Image-Guided High-Intensity Focused Ultrasound for Conduction Block of Peripheral Nerves

A Multifunctional Theranostic Nanoagent for Dual-Mode Image-Guided Hifu/Chemo- Synergistic Cancer Therapy

MRI-Guided Focused Ultrasound Surgery

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