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. 2023 Apr 5;136(7):780-787.
doi: 10.1097/CM9.0000000000002319.

Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson's disease

Haoxuan Lu  1 , Xiaoyu Wang  1   2 , Xin Lou  1
Affiliations

Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson's disease

Haoxuan Lu et al. Chin Med J (Engl). .

Abstract

Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel and minimally invasive technology. Since the US Food and Drug Administration approved unilateral ventral intermediate nucleus-MRgFUS for medication-refractory essential tremor in 2016, studies on new indications, such as Parkinson's disease (PD), psychiatric diseases, and brain tumors, have been on the rise, and MRgFUS has become a promising method to treat such neurological diseases. Currently, as the second most common degenerative disease, PD is a research hotspot in the field of MRgFUS. The actions of MRgFUS on the brain range from thermoablation, blood-brain barrier (BBB) opening, to neuromodulation. Intensity is a key determinant of ultrasound actions. Generally, high intensity can be used to precisely thermoablate brain targets, whereas low intensity can be used as molecular therapies to modulate neuronal activity and open the BBB in conjunction with injected microbubbles. Here, we aimed to summarize advances in the application of MRgFUS for the treatment of PD, with a focus on thermal ablation, BBB opening, and neuromodulation, in the hope of informing clinicians of current applications.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
The mechanisms of thermoablation (A) and blood-brain barrier (BBB) opening (B) for magnetic resonance-guided focused ultrasound (MRgFUS). The mechanism of thermoablation using MRgFUS is the use of high-intensity focused ultrasound (FUS) to accurately locate the target and ablate specific brain nuclei. The mechanism of non-thermoablation using MRgFUS is the use of low-intensity FUS to open the BBB, which enables the microbubbles to undergo oscillations of expansion and contraction that cause the transient separation of endothelial tight junctions and enhances the localized delivery of therapeutic agents to the brain.
Figure 2
Figure 2
The multiplanar images of the target ventral intermediate nucleus (Vim) using magnetic resonance-guided focused ultrasound (MRgFUS) at different time points. A 60-year-old male Parkinson's disease patient underwent right Vim-MRgFUS. T2-weighted images show changes in three-ring ablation lesions (indicated by the yellow arrow) in the axial, coronal, and sagittal please at three follow-up periods.
See this image and copyright information in PMC

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