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What is MRI Guided Focused Ultrasound (MRgFUS)?

MRI-Guided Focused Ultrasound is a minimally invasive modern treatment for essential tremor, Parkinson’s disease, and other movement disorders. It is usually performed in an outpatient setting and does not require general anesthesia or hospitalization. The entire procedure takes about 2 to 3 hours while the patient is awake.

MRgFUS at Melbourne NeuroCare is a safe and effective alternative treatment to traditional ablative surgery and deep brain stimulation (DBS). Results from human clinical trials suggest that MRgFUS has a high success rate with a very low risk of complications.

How Does MRgFUS Work?

MRgFUS combines the technology of magnetic resonance imaging (MRI) and high-intensity focused ultrasound (HIFU) for precise targeting of specific areas of the brain responsible for the movement disorder.

MRgFUS works by thermal ablation, which means the targeted brain area is heated and disrupted by focused ultrasound waves. Ultrasound is a form of energy that can pass through different body tissues such as blood, fat, muscle, and bone.

With the help of MRI, the Neurologist, Neurosurgeon, and Radiologist locate the core areas of the brain that trigger symptoms of movement disorders. Ultrasound gently heats the affected tissue while sparing the surrounding healthy tissue. Disrupting abnormal brain activity in this region reduces or eliminates the symptoms of the movement disorder.

MRgFUS has many possible applications, from treating tumours and bone metastasis to pain management.

  • MRgFUS for Parkinson’s disease: some patients with Parkinson’s disease have a disabling tremor that does not respond to medications. MRgFUS targets the thalamus area in the brain, which is responsible for producing tremors. Other targets – Pallidotomy can effectively treat other bothersome symptoms, such as dyskinesia.
  • MRgFUS for essential tremor: the procedure is approved to treat patients with essential tremor that medications cannot control.
  • MRgFUS for dystonia: MRgFUS for this condition is being researched in clinical trials but has shown positive outcomes in certain types of dystonia.
  • MRgFUS for Neuropathic pain: MRgFUS for neuropathic pain conditions, such as those resulting from injuries to the spine, nerves, strokes or Trigeminal neuralgia.
  • MRgFUS for psychiatric conditions: MRgFUS has substantially improved in patients with OCD and major depressive disorder.
  • MRgFUS for other neurological conditions: MRgFus is being explored as an alternative treatment for tremors in multiple sclerosis, epilepsy, and Tourette’s syndrome.
MRgFUS is generally safe and effective. It is approved for treating essential tremor and Parkinson’s disease, and other movement disorders.
    • Non-invasive

    The entire process is non-invasive and requires no surgical incisions or anesthesia. Instead, it uses sound waves, which can be focused on a particular area without having to break through any skin or muscle tissue.

    • Improved quality of life

    By reducing the severity of symptoms and improving overall function, MRgFUS can improve the quality of life for patients with movement disorders.

    • Reduced recovery time

    MRgFUS is typically performed as a day procedure, allowing patients to resume regular activities faster without having any lasting negative effects from their procedure.

    • Precise targeting

    MRI monitors and controls the sound waves, ensuring that only the targeted tissue is heated and the adjacent healthy tissue is spared.

    • Less pain and discomfort

    Because MRgFUS does not involve cutting into tissues or implanting a device, patients may experience less pain or discomfort than traditional surgical methods.

The most common complication after the procedure is ataxia or impaired coordination. Patients may experience slurred speech and difficulty walking, swallowing, and eye movements. But these side effects often resolve with time. Your movement disorder neurologist will discuss other serious complications associated with the procedure.

Other side effects of MRgFUS

  • Dizziness or vertigo
  • Headaches
  • Numbness
  • Muscle weakness
  • Sensory loss

What to Expect with MRgFUS?

Before Surgery

Patients can expect to undergo a few diagnostic scans and tests. This includes an MRI scan to get an image of the brain and measure the size and shape of the thalamus. The neurologist could also perform a neurological examination and assess the severity of your tremor and other neurological condition. You will receive instructions on preparing for the procedure, such as fasting and avoiding certain medications.

During Surgery

The procedure is performed inside an MRI scanner. You will be awake during the procedure but may receive a mild sedative to help you relax. The Neurosurgeon will put a stereotactic frame around the skull under local anaesthetics. MRI enables the Focused Ultrasound treating team to visualize the targeted area and ensure that the correct tissue is being treated. The ultrasound waves are directed to specific areas of the brain that are causing the tremors and other symptoms.

After Surgery

Our team of experts will monitor you in the recovery room to ensure there are no immediate adverse effects from the procedure. After evaluating your neurological status, the neurologist will decide if you can be allowed to go home. You may experience temporary side effects such as headache, fatigue, or slight imbalance, which should resolve within a few days.

Results

Tremor symptoms may improve within a few days or weeks after the procedure. Patients report over 70 per cent improvement in their symptoms three months after the procedure. Follow-up appointments are arranged with your neurologist to monitor your progress and assess the effectiveness of the treatment.

Book an appointment

Melbourne Neurocare is one of the few clinics that offer MRgFUS. We are fully equipped to diagnose and treat various movement disorders and neurological conditions with precision and accuracy. To schedule an appointment with our movement disorder neurologists, call us!