Focused ultrasound therapy for movement disorders

Abstract

Functional neurosurgery, such as deep brain stimulation, is an established therapeutic option for many patients with movement disorders. MR-guided focused ultrasound has emerged as an incisionless and minimally invasive neurofunctional treatment. This new approach is based on the delivery of high-intensity ultrasound energy to produce therapeutic thermoablation. Several randomised controlled trials have shown safety and symptomatic efficacy of focused ultrasound ablation, particularly to treat patients with essential tremor or Parkinson's disease. The use of focused ultrasound therapy is expanding to many centres worldwide, and its application for other indications—such as tremor of other origin and dystonia—has also been preliminarily investigated. MR-guided focused ultrasound has been explored in the modality of low-intensity ultrasound, which allows mechanical effects on brain tissue, primarily transient blood–brain barrier opening and neuromodulation, both of which could offer a wide array of experimental and clinical possibilities. Therefore, MR-guided focused ultrasound might have an important role in the future treatment of patients with movement disorders and neurodegenerative diseases.