.Vita gazette – Researches and new methods continue on Parkinson’s disease, which has become one of the common diseases with the development of technology. One of them is ultrasound therapy. Parkinson’s and tremors can be treated with focused ultrasound.

MRgFUS

Is it possible to cure the trembling that people with Parkinson’s disease have? There is an innovative path called MRgFUS, an acronym for MR-guided Focused Ultra-Sound, which translates into focused ultrasound under the guidance of Magnetic Resonance.

For selected cases

It is a lesioning procedure indicated for treating essential tremors and selected cases of parkinsonian tremors resistant to drug treatment.

The purpose of the procedure

The purpose of the procedure is to carry out the lesion of a small nucleus involved in the genesis of the tremor of the thalamus, or nucleus Globo pallidum Internus. The process is performed with a Nuclear Magnetic Resonance (MRI) in an awake and cooperative subject.

Only in one location

The lesion is performed using focused ultrasound beams to induce tissue necrosis through heat, which blocks the tremor on the side contralateral to the treatment: Currently, the procedure is indicated to be performed only in one site. Generally, the one opposite the side is most affected by the trio.

How does it work?

Lesion surgery with MRgFUS The treatment lasts a few hours (on average 3-4), during which quality checks are performed on the equipment, MRI scans, and measurements to identify the target nucleus, and then proceed with the delivery of ultrasounds focus. For the entire operation, the patient remains to lie on the bed dedicated to MRgFUS.

The patient must cooperate

A stereotaxic helmet will fix the patient’s head to the table. A membrane containing water will be inserted between the head and the helmet to facilitate the passage of the ultrasounds.

The patient must cooperate actively. During the procedure, they must be awake and conscious so that the neurologist can constantly monitor them after each ultrasound delivery, clinically evaluating them and interacting in person.

The patient stays two nights.

The night following the treatment, the patient remains hospitalised to be discharged, in most cases, two days after the treatment.

Are there any side risks?

The procedure is minimally invasive, yet lesional, so it is not without risk.

The main risks are related to the development of cerebral oedema around the lesion, following the MRgFUS procedure, which can take up to 3 months to reabsorb.

During this period, the patient may experience side effects, albeit mild and transient, such as speech disturbances, an unsteady gait or numbness, more rarely, weakness in the treated arm or leg. Most of these side effects are usually transient but can also persist in some cases. For this reason, instrumental checks (MRI) and clinical evaluations are carried out, after the execution of the procedure, at one month, at three months, at six months and at annutoder to evaluate the progress of the lesion and the clinical effect of the treatment.

It can free those who have been suffering from tremors for years. And it is also a method used to treat brain tumours. But unfortunately, only a few well-selected patients can benefit from this treatment. In Italy, this type of ultrasound is practised in Milan, Naples, Rome, Palermo, Verona, and L’Aquila. On the website of the Carlo Besta Neurological Institute in Milan, they explain how it works.