When it comes to treating physical and psychological disorders in the brain, MRI-guided Focused Ultrasound (MRgFUS or simply FUS) is versatile and powerful. What makes it stand out is the fact that it is noninvasive. No cuts, punctures, drills or probes—none of the conventional routes into the brain.

To boldly go where no scalpel has gone

Thanks to advances in neurosurgery, there are surgical interventions for many illnesses, abnormalities and injuries in the brain. This is great news since it can mean the difference between life and death. However, many patients with non-life threatening conditions that might be surgically treated anguish over the decision to have their skulls penetrated using scalpels, drills and probes. As with all surgery, there are risks of infection and possible collateral damage from physically manipulating or cutting delicate brain tissue. For instance, many people with essential tremor (ET) that does not respond to medication are eventually offered Deep Brain Stimulation (DBS), yet they choose to hold off.

Now they have an alternative. FUS avoids the potential harm of a scalpel or probe in the brain because it is noninvasive. On its way to the target, the soundwaves pass harmlessly through skull and brain tissues until they intersect at the target. FUS can access points deep in the brain without the need for physical penetration. FUS can thus go where inserting a scalpel or probe would be risky. Because of this, scientists and researchers are asking, “Where else in the brain can we apply FUS?”

Treating a broad range of brain disordersⁱ

Internationally, FUS is widely approved to treat ET. In the U.S., neurological FUS is only FDA-approved for ET. However, U.S. clinical trials are in process other conditions such as Parkinson’s disease (PD). Like ET, PD also causes tremors of the hands and other body parts, but unlike the action tremors of ET, with PD they are resting tremors. For PD, MRgFUS targets a different brain center than ET treatment.

In many centers outside the U.S., FUS is already approved to control the following problems:

• Depression
• Neuropathic (nerve) pain
• Obsessive-compulsive disorder (OCD)
• Parkinson’s disease

In addition, U.S. and international FUS clinical trials are ongoing for depression, dystonia, epilepsy, Holmes’ tremor, Huntington’s disease, neuropathic pain, OCD, painful amputation neuromas (phantom limb pain), PD, and traumatic brain injury.

Meanwhile, very early research has begun on the potential use of FUS to treat addiction, anorexia nervosa, cerebral cavernous malformations, hydrocephalus, migraine headaches, multiple sclerosis (MS), stroke and trigeminal neuralgia. The fact that so many applications are envisioned means that in the future, many conventional surgical treatments will be replaced by noninvasive therapies like FUS.

What we witness in our Center

At Sperling Neurosurgery Associates, we are thrilled with the newfound happiness we witness with each qualified FUS candidate who comes for control of ET-related tremors. The discovery that they can once again sign their name, drink without spilling, eat without special utensils, and say goodbye to medications and their side effects is a thrill.

As the FDA gradually approves FUS to treat other brain disorders, perhaps our Center will be privileged to offer our services to these patients, as well. The day will come when FUS brings relief to those who live with migraines, depression, nerve pain, etc. and we hope to be part of it. It is just a matter of time.

ⁱSource: https://www.fusfoundation.org/diseases-and-conditions/neurological