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Focused Ultrasound in Neuroscience. State of the Art and Future Perspectives.

Authors: Giammalva GR, Gagliardo C, Marrone S, Paolini F, Gerardi RM, Umana GE, Yağmurlu K, Chaurasia B, Scalia G, Midiri F, La Grutta L, Basile L, Gulì C, Messina D, Pino MA, Graziano F, Tumbiolo S, Iacopino DG, Maugeri R

Transcranial MR-guided Focused ultrasound (tcMRgFUS) is a surgical procedure that adopts focused ultrasounds beam towards a specific therapeutic target through the intact skull. The convergence of focused ultrasound beams onto the target produces tissue effects through released energy. Regarding neurosurgical applications, tcMRgFUS has been successfully adopted as a non-invasive procedure for ablative purposes such as thalamotomy, pallidotomy, and subthalamotomy for movement disorders. Several studies confirmed the effectiveness of tcMRgFUS in the treatment of several neurological conditions, ranging from motor disorders to psychiatric disorders. Moreover, using low-frequencies tcMRgFUS systems temporarily disrupts the blood-brain barrier, making this procedure suitable in neuro-oncology and neurodegenerative disease for controlled drug delivery. Nowadays, tcMRgFUS represents one of the most promising and fascinating technologies in neuroscience. Since it is an emerging technology, tcMRgFUS is still the subject of countless disparate studies, even if its effectiveness has been already proven in many experimental and therapeutic fields. Therefore, although many studies have been carried out, many others are still needed to increase the degree of knowledge of the innumerable potentials of tcMRgFUS and thus expand the future fields of application of this technology.

Introduction

Purpose Thermal ablation
Study Objective To review the current applications, demonstrated effectiveness, and future research needs of transcranial MR-guided focused ultrasound (tcMRgFUS) in neuroscience and clinical practice.
MRI or image guidance method Transcranial MR-guided (tcMRgFUS)
Targeted brain region(s) Subthalamic nucleus

Outcomes and Safety

Summary of Outcomes Transcranial MR-guided focused ultrasound produces targeted tissue ablation effective for movement (thalamotomy, pallidotomy, subthalamotomy) and psychiatric disorders and, when applied at low frequencies, transiently disrupts the blood–brain barrier to enable controlled drug delivery.
Safety-related matter The provided text does not mention any safety concerns, adverse effects, or complications associated with tcMRgFUS.

Brain Region

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None

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