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.
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