Parkinson's Disease Tulip


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Old 08-24-2016, 08:09 PM #1
Bogusia Bogusia is offline
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Default MRI-guided focussed ultrasound for essential tremor

Doctors hope to apply this technology in the treatment of other diseases like Parkinson's and epilepsy.

No scalpel, no drill: Medical procedure to treat uncontrollable hand tremor a 'game changer' - Health - CBC News
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Old 08-25-2016, 02:50 PM #2
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Quote:
Originally Posted by Bogusia View Post
Doctors hope to apply this technology in the treatment of other diseases like Parkinson's and epilepsy.

No scalpel, no drill: Medical procedure to treat uncontrollable hand tremor a 'game changer' - Health - CBC News
As PD is progressive I wonder if the ultrasound treatment would have to be done more and more over time destroying more brain tissue each time. Would that be a good idea?
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Old 08-26-2016, 01:26 PM #3
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I'm absolutely holding out for this and it is not a "progressive" treatment....once performed one cannot go back and "re destroy" the targeted area that controls movement......Isreal, Haifa started this and is offering it now.

Rambam Medical Center

P.O.B 9602, Haifa 3109601


Israel, Ramat Gan

Sheba Medical Center


Focused Ultrasound Treatment

Focused ultrasound is a completely non-invasive way to perform the lesioning procedure described above without exposing the patient to potentially harmful ionizing radiation. Using this treatment modality in conjunction with image guidance, the physician directs a focused beam of acoustic energy through the patient’s scalp, skull, and brain to thermally coagulate a small area of the brain, thereby destroying targeted tissue without damaging nearby tissue or the tissues through which the beam passes on its way to the target.

Using magnetic resonance imaging (MRI) thermometry during the focused ultrasound procedure, the physician is able to control the location and extent of the thermal tissue destruction in real time.

Focused ultrasound is being studied to treat two symptoms of Parkinson’s through lesioning of one of the target areas of the brain:
Parkinsonian tremor – lesioning target in the thalamus (thalamotomy)
Parkinsonian dyskinesia – lesioning target in the globus pallidus (pallidotomy) or subthalamic nucleus
Parkinsonian tremor or akinesia – lesioning target in the pallidothalamic tract

fishman webinar graphicAt this time, focused ultrasound is only being assessed to treat one side of the brain, so it will affect tremor or dyskinesia unilaterally. Using the target in the pallidothalamic tract may offer the possibility of treating patients bilaterally.

Focused ultrasound offers several potential benefits:
Focused ultrasound treatment is non-invasive just like radiosurgery; however, its therapeutic effects are immediate and it does not have the risks or limitations of ionizing radiation.
Compared to radiofrequency ablation, focused ultrasound is non-invasive and therefore has significant reduced risk for infection. Also as focused ultrasound is done under closed loop thermal feedback, it is more likely to damage only targeted tissue and spare non-targeted healthy brain.
Compared to implantation of a deep brain stimulation device, focused ultrasound is a single procedure, and does not require subsequent procedures to replace batteries. It also does not involve the collateral damage to healthy tissue or the risk of blood clots and infections associated with implanting a foreign body.

Pre-clinical Research

In addition to lesioning, pre-clinical studies suggest focused ultrasound may be able to reversibly open the blood-brain barrier to improve the delivery of drugs like dopamine, gene therapy or even stem cells to targeted areas of the brain.

Clinical Trials

Tremor-dominant Parkinson's
This trial has completed enrollment for patients with tremor-dominant Parkinson’s (thalamotomy) disease.

Parkinson's dyskinesia (pallidotomy)
A study evaluating the safety and initial efficacy of focused ultrasound for the treatment of Parkinsonian dyskinesia (pallidotomy) is ongoing in the US, Canada and Korea. Additional US sites may follow. This study is being conducted through the collaboration and funding from the Michael J. Fox Foundation for Parkinson's Research.

To inquire about this trial at the University of Virginia, contact Amy Warren at (434) 243-1435 or email at alh3p@virginia.edu.

peace

BP
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Old 08-29-2016, 11:26 AM #4
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Please remember this is still ablitive brain surgery.

A scalpel isn't used, but focused ultra sound is cutting tissue. Pallidotomy and Thalamomy are the types of surgery. Both were commonly done until DBS become popular.

With DBS you can fine tune things, or even remove the electrodes after surgery. Infection is always a risk, but DBS allows for complete reversal.

With focused ultrasound ablitive brain surgery, no risk of infection but you just hope no errors during surgery as there is not chance of undoing it

For Parkinson's, I'll stick with DBS. For my cancer tumors, I think focused ultrasound is fantastic way to go.
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Old 08-29-2016, 01:02 PM #5
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No DBS for this kid....ever.....but that's just a personal choice like not taking the meds....I feel like im well versed in the subjects surrounding ablative procedures etc after 15 years of data compilation, a solid background in medication administration and a background in O. Chem....im glad you've made a comfortable choice....my good friend had DBS (twice due to screw up) with an accompanying nosocomial infection (MRSA) infection (not uncommon) and of course was told its only good for 7 yrs so 7 short yrs later dbs is ready to quit....that's no way to live in my opinion....additionally my uncle had dbs and that has effected his gait and speech and little benefit for only 2 -3 years.....my grandpa had pd my uncle my brother my cousin and me.......ive lived with it in a close setting my entire life, observed first hand the varying effects of meds on my family with pd ....and...."mistakes" placing the DBS have apparently similar stats on irreversible damage to the speech center as well as gait issues (depending on where you look), as the newer ablative processes. As I'm sure you know....

Thermal necrosis is actually heating the tissue until it dies....

.....The fundamental principles of HIFU ablation are coagulative thermal necrosis due to the absorption of ultrasound energy during transmission in tissue...... (World J Clin Oncol. 2011 Jan 10; 2(1): 8–27)

With MRI guided FUS.....the morbidity and mortality stats associated with "errors" are looking to be diminished extensively........so far......


peace

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