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Dallapiazza R, Khaled M, Eames M, et al. Feasibility and Safety of MR-Guided Focused Ultrasound Lesioning in the Setting of Deep Brain Stimulation. Stereotact Funct Neurosurg. 2015;93(2):140-146doi: 10.1159/000368908.
Dallapiazza, R., Khaled, M., Eames, M., Snell, J., Lopes, M. B., Wintermark, M., & Elias, W. J. (2015). Feasibility and Safety of MR-Guided Focused Ultrasound Lesioning in the Setting of Deep Brain Stimulation. Stereotactic and functional neurosurgery, 93(2), 140-146. https://doi.org/10.1159/000368908
Dallapiazza, Robert, et al. "Feasibility and Safety of MR-Guided Focused Ultrasound Lesioning in the Setting of Deep Brain Stimulation." Stereotactic and functional neurosurgery vol. 93,2 (2015): 140-146. doi: https://doi.org/10.1159/000368908
Dallapiazza R, Khaled M, Eames M, Snell J, Lopes MB, Wintermark M, Elias WJ. Feasibility and Safety of MR-Guided Focused Ultrasound Lesioning in the Setting of Deep Brain Stimulation. Stereotact Funct Neurosurg. 2015;93(2):140-146. doi: 10.1159/000368908. Epub 2015 Feb 27. PMID: 25765151.
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Stereotact Funct Neurosurg. 2015;93(2):140-146. doi: 10.1159/000368908. Epub 2015 Feb 27.

Feasibility and Safety of MR-Guided Focused Ultrasound Lesioning in the Setting of Deep Brain Stimulation.

Stereotactic and functional neurosurgery

Robert Dallapiazza, Mohamad Khaled, Matthew Eames, John Snell, M Beatriz Lopes, Max Wintermark, W Jeffrey Elias

Affiliations

  1. Department of Neurosurgery, University of Virginia, Charlottesville, Va., USA.

PMID: 25765151 DOI: 10.1159/000368908

Abstract

BACKGROUND: Patients treated with deep brain stimulation (DBS) often develop symptom progression. If safe, focused ultrasound (FUS) lesioning could be used for patients unable to undergo further DBS surgery.

OBJECTIVE: To test the feasibility and safety of MR-guided FUS surgery in the setting of a previously implanted DBS system.

METHODS: Three preclinical experiments were designed to test feasibility and safety. Hydrogels were implanted with an electrode, and FUS lesions were targeted adjacently. Cadavers were implanted with a thalamic electrode, and FUS lesions were targeted in the contralateral thalamus. Finally, DBS systems were implanted in swine, and FUS lesioning was targeted to the contralateral thalamus, MRI was used to assess the treatments, and histological analyses were performed at 2 days and at 1 month.

RESULTS: In gel experiments and cadavers, FUS resulted in target heating to 29-32°C without any heating at the electrode. In animal experiments, there were no FUS-related MRI signal changes near the electrode. Histological analysis showed typical FUS lesions with no evidence of damage surrounding the electrode tracts.

CONCLUSIONS: FUS is feasible in the setting of a preimplanted DBS device. There was minimal heating of the device during the procedure and no apparent FUS-related tissue injury. © 2015 S. Karger AG, Basel.

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