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Focused ultrasound for functional neurosurgery

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Abstract

Introduction

Brain lesioning is a fundamental technique in the functional neurosurgery world. It has been investigated for decades and presented promising results long before novel pharmacological agents were introduced to treat movement disorders, psychiatric disorders, pain, and epilepsy. Ablative procedures were replaced by effective drugs during the 1950s and by Deep Brain Stimulation (DBS) in the 1990s as a reversible neuromodulation technique. In the last decade, however, the popularity of brain lesioning has increased again with the introduction of magnetic resonance-guided focused ultrasound (MRgFUS).

Objective

In this review, we will cover the current and emerging role of MRgFUS in functional neurosurgery.

Methods

Literature review from PubMed and compilation.

Results

Investigated since 1930, MRgFUS is a technology enabling targeted energy delivery at the convergence of mechanical sound waves. Based on technological advancements in phased array ultrasound transducers, algorithms accounting for skull penetration by sound waves, and MR imaging for targeting and thermometry, MRgFUS is capable of brain lesioning with sub-millimeter precision and can be used in a variety of clinical indications.

Conclusion

MRgFUS is a promising technology evolving as a dominant tool in different functional neurosurgery procedures in movement disorders, psychiatric disorders, epilepsy, among others.

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Data availability

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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Funding

No funding was received to assist with the preparation of this manuscript. The author PG declares that he is on the medical advisory board of Insightec and SonALAsense. The authors LLT, DB, CHH, VPB have no relevant financial or non-financial interests to disclose.

Author information

Authors and Affiliations

  1. Neurosurgery, Stanford University, Stanford, CA, USA

    Lior Lev-Tov, Daniel A. N. Barbosa, Casey H. Halpern & Vivek P. Buch

  2. Radiology, Stanford University, Stanford, CA, USA

    Pejman Ghanouni

Authors
  1. Lior Lev-Tov
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  2. Daniel A. N. Barbosa
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  3. Pejman Ghanouni
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  4. Casey H. Halpern
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  5. Vivek P. Buch
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Contributions

LLT and VPB designed and wrote the draft. DB assisted in content creation and figure generation. PG and CHH provided critical review and expertise. All the authors have approved the submission.

Corresponding author

Correspondence to Lior Lev-Tov.

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Conflict of interest

PG: Serve on the medical advisory board of Insightec and SonALAsense. The other authors declare that they have no conflict of interest.

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Lev-Tov, L., Barbosa, D.A.N., Ghanouni, P. et al. Focused ultrasound for functional neurosurgery. J Neurooncol 156, 17–22 (2022). https://doi.org/10.1007/s11060-021-03818-3

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  • DOI: https://doi.org/10.1007/s11060-021-03818-3

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