gms | German Medical Science

Objective: The field of MRI guided high intensity focused ultrasound surgery (MRgFUS) is evolving and offers the new hope for the treatment of many neurological disorders through both ablative mechanism and non-ablative mechanisms such as drug delivery, neuromodulation and etc. Currently, Jeanmond et al demonstrated the beneficial effect of MRgFUS by performing noninvasive central lateral thalamotomies as a treatment for chronic neuropathic pain. And we believe that certain benefits of this MRgFUS are the elimination or the current surgical risk such as infection and hemorrhage by making a lesion with a noninvasive, precise method.

Method: Thus, we also want to evaluate the role of MRgFUS for the management of essential tremor, Parkinson’s disease and obsessive compulsive disorders especially for those who are not good candidates for invasive surgery such as deep brain stimulation (DBS) or conventional lesioning procedures. And we had an approval of the feasibility studies of essential tremor, Parkinson’s disease and obsessive compulsive disorders from the Korean FDA and the IRB of Yonsei University College of Medicine. As well, we had fully informed written consent for making unilateral thalamotomy to control the tremor of the dominant hand or unilateral pallidotomy to control the parkinsonian symptoms or making bilateral lesioning of the anterior portion of the internal capsule to control the symptoms of obsessive compulsive disorders.

Results: The treatment was performed in a 3T MRI (Signa, GE) using the Exablate 4000 device (Insightec), which features a 30 cm diameter hemispherical 1024 elements phased array transduced operating at 680 KHz. The patient's head was immobilized by fixation in an MRI compatible stereotactic frame (Radionics).

Conclusions: In this presentation, we will demonstrate the results of patient with essential tremor, Parkinson’s disease and obsessive compulsive disorders after MRgFUS with our imaging studies.