title: Focused Ultrasound: An Emerging Therapeutic Modality for Neurologic Disease.
abstract: Therapeutic ultrasound is only beginning to be applied to neurologic conditions, but the potential of this modality for a wide spectrum of brain applications is high. Engineering advances now allow sound waves to be targeted through the skull to a brain region selected with real time magnetic resonance imaging and thermography, using a commercial array of focused emitters. High intensities of sonic energy can create a coagulation lesion similar to that of older radiofrequency stereotactic methods, but without opening the skull. This has led to the recent Food and Drug Administration approval of focused ultrasound (FUS) thalamotomy for unilateral treatment of essential tremor. Clinical studies of stereotactic FUS for aspects of Parkinson's disease, chronic pain, and refractory psychiatric indications are underway, with promising results. Moderate-intensity FUS has the potential to safely open the blood-brain barrier for localized delivery of therapeutics, while low levels of sonic energy can be used as a form of neuromodulation.
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. pfishman@som.umaryland.edu.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Fishman
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Frenkel
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000378:metabolism / Q000528:radiation effects; D001927:Brain Diseases / Q000628:therapy; D002493:Central Nervous System Diseases / Q000628:therapy*; D016503:Drug Delivery Systems; D006801:Humans; D008279:Magnetic Resonance Imaging; D009069:Movement Disorders / Q000628:therapy; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000628:therapy; D013238:Stereotaxic Techniques; D059708:Ultrasonic Surgical Procedures; D014464:Ultrasonic Therapy
keywords: Focused ultrasound; MRgFUS; Parkinson’s disease; blood–brain barrier; essential tremor; neuromodulation