Brain-Focused Ultrasound Therapy: Current Applications and Future Prospects

F. Botero
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Abstract

Interventional therapies to address brain disorders carry out an additional risk due to the central nervous system’s difficult access and intrinsic complexity. Focused ultrasound therapy (FUT) is an incision-free, minimally invasive procedure that employs sound waves to produce either thermal ablation or neuromodulation according to the waveform intensity. Despite the growing evidence of the benefits and advantages of FUT, many of its potential applications have not been explored in their entirety. The mechanism of action of Focused Ultrasound involves the generation of mechanical and thermal effects on the target tissue. Magnetic resonance-guided is the most common method for delivery of FUT in the brain. Most benefits of brain FUT can be attributed to its ability to ablate target tissue or modulate neuronal activity. However, this technology can also be used to open, temporarily and reversibly, the blood-brain barrier to allow the delivery of medications directly to the affected tissue. Currently, there are few FDA-approved brain FUT applications, including the treatment of essential tremor, Parkinson’s disease tremor, and other kinetic disorders. However, several other therapeutic applications are in the early stages of research, such as epilepsy, trigeminal neuralgia, obsessive-compulsive disorder, depression, and utilizing FUT for the local delivery of drugs. This review aims to highlight some of the most significant present and future applications of focused ultrasound therapy in neurological conditions. Considering its apparent safety profile and efficacy, this emerging technology could become a feasible therapeutic alternative for multiple nervous system disorders.
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脑聚焦超声治疗:当前应用和未来展望
由于中枢神经系统的难以进入和内在的复杂性,治疗脑部疾病的介入治疗带来了额外的风险。聚焦超声治疗(FUT)是一种无切口的微创手术,利用声波根据波形强度产生热消融或神经调节。尽管越来越多的证据表明FUT的好处和优势,但它的许多潜在应用尚未得到全面探索。聚焦超声的作用机制包括对靶组织产生机械和热效应。磁共振引导是在大脑中输送FUT最常用的方法。脑FUT的大多数益处可归因于其消融靶组织或调节神经元活动的能力。然而,这项技术也可以用来暂时和可逆地打开血脑屏障,使药物直接输送到受影响的组织。目前,fda批准的脑FUT应用很少,包括治疗原发性震颤、帕金森病震颤和其他运动障碍。然而,其他一些治疗应用仍处于研究的早期阶段,如癫痫、三叉神经痛、强迫症、抑郁症,以及利用FUT局部给药。本文综述了聚焦超声治疗在神经系统疾病中的一些最重要的应用。考虑到其明显的安全性和有效性,这种新兴技术可能成为多种神经系统疾病的可行治疗选择。
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