MR-guided focused ultrasound in movement disorders and beyond: Lessons learned and new frontiers.

Autor: Natera-Villalba E; HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, HM Hospitales, Madrid, Spain; PhD Medicine Program, Universidad Autónoma de Madrid, Madrid, Spain., Ruiz-Yanzi MA; HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, HM Hospitales, Madrid, Spain., Gasca-Salas C; HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, HM Hospitales, Madrid, Spain; CIBERNED, Instituto Carlos III, Madrid, Spain; University CEU-San Pablo, Madrid, Spain., Matarazzo M; HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, HM Hospitales, Madrid, Spain; CIBERNED, Instituto Carlos III, Madrid, Spain., Martínez-Fernández R; HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, HM Hospitales, Madrid, Spain; CIBERNED, Instituto Carlos III, Madrid, Spain; University CEU-San Pablo, Madrid, Spain. Electronic address: rmartinez.hmcinac@hmhospitales.com.
Jazyk: angličtina
Zdroj: Parkinsonism & related disorders [Parkinsonism Relat Disord] 2024 May; Vol. 122, pp. 106040. Date of Electronic Publication: 2024 Feb 12.
DOI: 10.1016/j.parkreldis.2024.106040
Abstrakt: The development of MR-guided focused ultrasound (MRgFUS) has provided a new therapeutic tool for neuropsychiatric disorders. In contrast to previously available neurosurgical techniques, MRgFUS allows precise impact on deep brain structures without the need for incision and yields an immediate effect. In its high-intensity modality (MRgHIFU), it produces accurate therapeutic thermoablation in previously selected brain targets. Importantly, the production of the lesion is progressive and highly controlled in real-time by both neuroimaging and clinical means. MRgHIFU ablation is already an accepted and widely used treatment for medically-refractory Parkinson's disease and essential tremor. Notably, other neurological disorders and diverse brain targets, including bilateral treatments, are currently under examination. Conversely, the low-intensity modality (MRgLIFU) shows promising prospects in neuromodulation and transient blood-brain barrier opening (BBBO). In the former circumstance, MRgLIFU could serve as a powerful clinical and research tool for non-invasively modulating brain activity and function. BBBO, on the other hand, emerges as a potentially impactful method to influence disease pathogenesis and progression by increasing brain target engagement of putative therapeutic agents. While promising, these applications remain experimental. As a recently developed technology, MRgFUS is not without challenges and questions to be addressed. Further developments and broader experience are necessary to enhance MRgFUS capabilities in both research and clinical practice, as well as to define device constraints. This clinical mini-review aims to provide an overview of the main evidence of MRgFUS application and to highlight unmet needs and future potentialities of the technique.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ENV was supported in 2021 by a fellowship from the Movement Disorders Group of the Spanish Neurology Society (Sociedad Española de Neurología) granted by Zambon and has received honoraria for lectures from Zambon and Palex. MARY has received speaker honoraria from Insightec and Palex and is supported by a grant from Fundación Nemesio Díez. MM has received lecture honoraria from Teva, Zambon, Palex, the Spanish Neurological Society and the International Parkinson and Movement Disorders Society. MM has received research grants from the Michael J. Fox Foundation and from Fundación Nemesio Díez. CGS has received speaker honoraria from Exeltis, Esteve, Società Italiana Parkinson e Disordini del Movimento and Fundación ACE, a grant from Asociación Madrileña de Neurología, funded by Bial and reimbursement of travel expenses to attend a scientific conference from Boston Scientific. RMF has received speaker honoraria and reimbursement from travel expenses to attend scientific conferences by Insightec and Palex.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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