Restoring Neurological Physiology: The Innovative Role of High-Energy MR-Guided Focused Ultrasound (HIMRgFUS). Preliminary Data from a New Method of Lesioning Surgery

被引:3
作者
Giugno, Antonella [1 ]
Maugeri, Rosario [1 ]
Graziano, Francesca [1 ]
Gagliardo, Cesare [2 ]
Franzini, Angelo [3 ]
Catalano, Carlo [4 ]
Midiri, Massimo [2 ]
Iacopino, Domenico Gerardo [1 ]
机构
[1] Univ Palermo, Neurosurg Clin, Sch Med, Dept Expt Biomed & Clin Neurosci, Via Vespro 129, I-90100 Palermo, Italy
[2] Univ Palermo, Sect Radiol Sci, DIBIMED, I-90127 Palermo, Italy
[3] Fdn IRCCS, Ist Neurol Carlo Besta, Unit Funct & Stereotact Surg, Milan, Italy
[4] Sapienza Univ Rome, Dept Radiol Oncol & Anatomopathol Sci, Rome, Italy
来源
TRENDS IN RECONSTRUCTIVE NEUROSURGERY: NEUROREHABILITATION, RESTORATION AND RECONSTRUCTION | 2017年 / 124卷
关键词
Parkinson's disease; Essential tremor; Functional neurosurgery; Lesioning surgery; MRI-guided focused ultrasound (MRgFUS); STATIC MAGNETIC-FIELDS; ESSENTIAL TREMOR; THALAMOTOMY;
D O I
10.1007/978-3-319-39546-3_9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Tremor is a disabling condition, common to several neuro-degenerative diseases. Lesioning procedures and deep brain stimulation, respectively, of the ventralis intermedius nucleus for intentional tremor, and of the subthalamic nucleus for parkinsonian resting tremor, have been introduced in clinical practice for patients refractory to medical treatment. The combination of high-energy focused ultrasound (HIFUS) with sophisticated magnetic resonance (MR) instrumentation, together with accurate knowledge of the stereotactic brain coordinates, represents a revolution in neuromodulation. Methods At the Neurosurgical Clinic and the Radiology Department of the University of Palermo,, two patients affected by severe and refractory forms of intentional tremor were treated by MRI-guided FUS (MRgFUS) with a unique 1.5 T MR scanner prototype that uses FUS. This apparatus is the only one of its type in the world." Findings This is the first Italian experience, and the second in Europe, of treatment with MRI-gFUS for intentional tremor. But this is the very first experience in which a 1.5 T MRI apparatus was used. In both patients, the treatment completely abolished the tremor on the treated side, with results being excellent and stable after 7 and 5 months, respectively; no side effects were encountered. Conclusion MRgFUS, recently introduced in clinical practice, and widely used at several clinical centers, has been shown to be a valid therapeutic alternative in the treatment of tremor in several neurodegenerative diseases. It is virtually safe, noninvasive, and very efficacious. We report this technique in which a 1.5 T MR scanner was used. Further investigations with long-term follow up and larger clinical series are needed.
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页码:55 / 59
页数:5
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