A team of researchers working at the MR-Center of the University Children's Hospital in Zürich has completed a pilot study using transcranial MR-guided focused ultrasound to treat 10 patients with neuropathic pain.
The origin of chronic pain in these patients included post amputation phantom limb syndrome, nerve injury, stroke, trigeminal neuralgia and post herpetic neuralgia from shingles.
The findings will be published in a forthcoming issue of Annals of Neurology.
The study was partially funded by the Focused Ultrasound Surgery Foundation. The Foundation funds translational and clinical research into new therapeutic applications of MR-guided focused ultrasound (MRgFUS).
“This study showed that we can perform successful operations in the depth of the brain without opening the cranium or physically penetrating the brain with medical tools, something that appeared to be unimaginable only a few years ago,” says Daniel Jeanmonod M.D., a neurosurgeon at the University of Zurich. “By eliminating any physical penetration into the brain, we hope to duplicate the therapeutic effects of invasive deep brain ablation without the side effects, and for a wider group of patients.”
“The research funding from the Focused Ultrasound Surgery Foundation allowed us to conduct the study rapidly and with scientific rigor,” adds Dr Jeanmonod. “We are an academic institution and this type of award is essential to our research process.”
The preliminary results in these patients are consistent with conventional therapy - radiofrequency ablation - which is an invasive procedure and involves making an incision in the scalp, drilling a hole in the skull, inserting an electrode through normal brain tissue into the thalamus, and using radiofrequency to create the lesion.
“This research demonstrates that transcranial MR-guided focused ultrasound can be used non-invasively to produce small thermal ablations with extreme precision and accuracy deep in the brain,” comments Neal Kassell, M.D., a neurosurgeon at the University of Virginia, and Chairman of the Focused Ultrasound Surgery Foundation. “It paves the way for further research into the treatment of a variety of other brain disorders, including Parkinson's disease and essential tremor, epilepsy, brain tumors and stroke,”
According to Dr Kassell, the key advantage of focused ultrasound is that it is non-invasive. This in principle makes it safer than conventional surgery because it avoids the associated risks of complications such as infection, hemorrhage, and collateral damage to normal brain structures.
“We are pleased to have been able to provide funding for this groundbreaking research,” says Dr Eben Alexander, M.D., Director of the Brain Development Program at the Focused Ultrasound Surgery Foundation. “Other research sites are now expected to initiate clinical studies using Transcranial MR-guided focused ultrasound for brain disorders within the next year, including studies for Parkinson’s disease, essential tremor, and brain tumors.”