Focused ultrasound technology: Non-invasive treatment of neurological disorders
Focused ultrasound has emerged as a non-invasive neurosurgical treatment. With advancements in healthcare technology, Ultrasound has evolved from just a diagnostic method of medical imaging to a therapeutic one.
Recent clinical trials have shown that focused ultrasound technology can effectively treat neurological disorders such as Parkinson’s disease, essential tremor, and epilepsy, that cause involuntary and rhythmic shaking.
This MRI guided focused ultrasound technology now offers ample opportunities for the patients on whom medications and radiation treatment did not work.
The focused ultrasound technology was approved by the FDA in July 2016.
What is the procedure of the treatment?
The focused ultrasound technology utilizes a transducer with an acoustic lens to concentrate sound waves on one point, raising the temperature and destroying the targeted tissue with a high degree of precision and accuracy, while leaving the surrounding tissue unaffected.
This technology allows for treatments that are safe and effective.
The patient’s brain is scanned using MRI to identify the target area and plan the treatment. With MRI scanning doctors can locate specific regions on the brain, with an accuracy less than one millimeter.
A specialized helmet is placed over the patient’s head with assistance of a frame that keeps the head immobilized. The helmet has a continuous flow of water which actively cools patient’s skull that suppresses any kind of discomfort.
The patient is given local anesthetic to help them relax during the procedure.
The ultrasound transducers situated in the helmet are then activated, delivering focused ultrasound waves to the target area in the brain.
Firstly, light doses of ultrasound are applied to identify the right spot in the brain for treatment and then full intensity ultrasound energy is applied to that area.
The ultrasound waves heat the targeted area to a temperature of around 85 degrees Celsius, causing the cells to die, thereby reducing the tremors.
The patient is monitored throughout the procedure using MRI to ensure that the ultrasound is reaching the correct target area and that the correct amount of energy is being delivered.
The doctors get real-time information about the location of the treatment and condition of the patient during the procedure.
Patients are conscious during the procedure and its effectiveness is monitored along with patient response which include drawing inside spirals, writing and replicating hand gestures.
The treatment results in decrease tremors which can also be observed during the patient’s treatment as well as improved functionality after the treatment.
After the procedure, the patient is monitored for any side effects and will be discharged once they are stable.
What is the future of this technology?
Although the focused ultrasound technology is in nascent stages, there are more than a hundred clinical applications of the technology such as treatment of neurodegenerative disorders, brain tumors, breast and prostate cancer.
Focused ultrasound technology can potentially treat epilepsy by ablative treatment in the epileptogenic foci or by disrupting the neural network of epilepsy.
MRI guided focused ultrasound technology is currently being tested for mental disorders such as obsessive-compulsive disorders and depression.
Major limitation to the technology, that of the different size and densities of human skulls that would restrict the ultrasound waves to pass through, is currently under research and development.
According to Dr. Neal Kassell, founder and chairman of the Focused Ultrasound Foundation, “Focused ultrasound is a noninvasive therapeutic technology,” that will replace invasive procedures such as open brain surgeries and develop as a new approach in functional neurosurgery.
For instance, Insightec, an Israel based healthcare company, launched a focused ultrasound platform for treatment of Essential Tremor and Parkinson’s Disease, known as Exablate Neuro in 2016, which has been recently approved by the FDA for treating motor symptoms associated with the aforementioned diseases.
The company claims that their technology can deliver up to 1024 ultrasound waves across the skull to precisely treat a target deep in the brain. The treatment eliminates incisions on the skull or drilling holes into the brain.
As per BIS Research, next generation ultrasound systems are currently in demand.
The global next-generation ultrasound systems market was valued at $8.24 billion in 2020 and is anticipated to reach $21.07 billion by 2031, growing at a CAGR of 9.3% during the forecast period 2021–2031.
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Conclusion
Along with treating neurological disorders, focused ultrasound can also assist in progressive cancer treatments such as radiation and chemotherapy, as well as in fertility clinics to treat infertility by destroying small fibroids or adhesions in the uterus, or by creating small holes in the ovary to allow for the release of eggs.
Adoption of focused ultrasound technology as a mainstream standard of care would bring a revolution in medical therapy as well as transform drug delivery.
With reduction in costs and complexity of the devices involved in the focused ultrasound treatment, the technology could become more accessible and be used worldwide including developing nations.
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