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Treatment of Movement Disorders With Focused Ultrasound

Although the use of ultrasound as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists or neurologists are familiar with this technology. Stereotactic brain lesioning had been widely used as a treatment for medically refractory patien...

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Autores principales: Fishman, Paul S, Frenkel, Victor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462491/
https://www.ncbi.nlm.nih.gov/pubmed/28615985
http://dx.doi.org/10.1177/1179573517705670
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author Fishman, Paul S
Frenkel, Victor
author_facet Fishman, Paul S
Frenkel, Victor
author_sort Fishman, Paul S
collection PubMed
description Although the use of ultrasound as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists or neurologists are familiar with this technology. Stereotactic brain lesioning had been widely used as a treatment for medically refractory patients with essential tremor (ET), Parkinson disease (PD), and dystonia but has been largely replaced by deep brain stimulation (DBS) surgery, with advantages both in safety and efficacy. However, DBS is associated with complications including intracerebral hemorrhage, infection, and hardware malfunction. The occurrence of these complications has spurred interest in less invasive stereotactic brain lesioning methods including magnetic resonance imaging–guided high intensity–focused ultrasound (FUS) surgery. Engineering advances now allow sound waves to be targeted noninvasively through the skull to a brain target. High intensities of sonic energy can create a coagulation lesion similar to that of older radiofrequency stereotactic methods, but without opening the skull, recent Food and Drug Administration approval of unilateral thalamotomy for treatment of ET. Clinical studies of stereotactic FUS for aspects of PD are underway. Moderate intensity, pulsed FUS has also demonstrated the potential to safely open the blood-brain barrier for localized delivery of therapeutics including proteins, genes, and cell-based therapy for PD and related disorders. The goal of this review is to provide basic and clinical neuroscientists with a level of understanding to interact with medical physicists, biomedical engineers, and radiologists to accelerate the application of this powerful technology to brain disease
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spelling pubmed-54624912017-06-14 Treatment of Movement Disorders With Focused Ultrasound Fishman, Paul S Frenkel, Victor J Cent Nerv Syst Dis Review Although the use of ultrasound as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists or neurologists are familiar with this technology. Stereotactic brain lesioning had been widely used as a treatment for medically refractory patients with essential tremor (ET), Parkinson disease (PD), and dystonia but has been largely replaced by deep brain stimulation (DBS) surgery, with advantages both in safety and efficacy. However, DBS is associated with complications including intracerebral hemorrhage, infection, and hardware malfunction. The occurrence of these complications has spurred interest in less invasive stereotactic brain lesioning methods including magnetic resonance imaging–guided high intensity–focused ultrasound (FUS) surgery. Engineering advances now allow sound waves to be targeted noninvasively through the skull to a brain target. High intensities of sonic energy can create a coagulation lesion similar to that of older radiofrequency stereotactic methods, but without opening the skull, recent Food and Drug Administration approval of unilateral thalamotomy for treatment of ET. Clinical studies of stereotactic FUS for aspects of PD are underway. Moderate intensity, pulsed FUS has also demonstrated the potential to safely open the blood-brain barrier for localized delivery of therapeutics including proteins, genes, and cell-based therapy for PD and related disorders. The goal of this review is to provide basic and clinical neuroscientists with a level of understanding to interact with medical physicists, biomedical engineers, and radiologists to accelerate the application of this powerful technology to brain disease SAGE Publications 2017-06-06 /pmc/articles/PMC5462491/ /pubmed/28615985 http://dx.doi.org/10.1177/1179573517705670 Text en © The Author(s) 2017 This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Fishman, Paul S
Frenkel, Victor
Treatment of Movement Disorders With Focused Ultrasound
title Treatment of Movement Disorders With Focused Ultrasound
title_full Treatment of Movement Disorders With Focused Ultrasound
title_fullStr Treatment of Movement Disorders With Focused Ultrasound
title_full_unstemmed Treatment of Movement Disorders With Focused Ultrasound
title_short Treatment of Movement Disorders With Focused Ultrasound
title_sort treatment of movement disorders with focused ultrasound
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462491/
https://www.ncbi.nlm.nih.gov/pubmed/28615985
http://dx.doi.org/10.1177/1179573517705670
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