| Transcranial Focused Ultrasound, a New Paradigm in Neurosurgery: from Past to Future and from Theory to Practice |
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So Hee Park, Jin Woo Chang |
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Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea |
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| Abstract |
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Transcranial focused ultrasound (FUS) is a new emerging technology with considerable potential in a wide range of clinical fields. Although there have been times the ultrasound was not used due to lack of imaging to guide target and technological challenges in delivering acoustic energy through the skull, transcranial FUS has become a new notable therapeutic option with advances in ultrasound transducer technology and integration with magnetic resonance imaging guidance. Currently, a lesioning procedure using the thermal ablation effect of ultrasound has been developed, and the US Food and Drug Administration has approved magnetic resonance-guided focused ultrasound (MRgFUS) for unilateral thalamotomy in medication-refractory essential tremor and tremor-dominant Parkinson's disease (PD). Since then, MRgFUS for PD, obsessive-compulsive disorder and neuropathic pain has been approved in several countries, and several studies are underway. In addition, FUS is also capable of opening the blood brain barrier and neuromodulating with a mechanical effect. There have been preclinical studies and based on which, clinical studies are underway and the results are now being published. There were some limitations, but with the development of ultrasound technology to overcome the limitations, FUS is gradually expanding the therapeutic field and would be a new paradigm for intractable neurological disorders. |
| Key Words:
High-Intensity focused ultrasound ablation, Neurological disorder, Ablation, Blood-brain barrier. |
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