Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with different types of headaches, including chronic migraine headaches. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How It Works
Where the beams converge, focused ultrasound can cause several different effects that can be helpful.
In clinical use, there has been a single case report where thermal ablation of the nerve pathways have been ablated with good success.
In preclinical models, use of FUS neuromodulation of the occipital nerves that has reduced the severity of headaches.
While significant preclinical work has been accomplished, there is still much to be done before this technology will be widely available.
Advantages
The primary options for treatment of headaches include medication, many of which have side effects or are only partly effective. Possible advantages are:
- Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
Clinical Trials
At the present time, there are no clinical trials recruiting patients for treatment of headaches.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for headaches is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Magara AE, Gallay MN, Moser D, Jeanmonod D. Complete resolution of chronic cluster headache following central lateral thalamotomy using incisionless MRI-guided focused ultrasound with 6 years of follow-up: illustrative case. J Neurosurg Case Lessons. 2022 Nov 28;4(22):CASE22259. doi: 10.3171/CASE22259. Print 2022 Nov 28.
Franzini A, Moosa S, D’Ammando A, Bono B, Scheitler-Ring K, Ferroli P, Messina G, Prada F, Franzini A. The neurosurgical treatment of craniofacial pain syndromes: current surgical indications and techniques. Neurol Sci. 2019 May;40(Suppl 1):159-168. doi: 10.1007/s10072-019-03789-4.
Chiou JY, Abd-Elrehim T, Lin CC, Chen GS. Feasibility study of greater occipital nerve blocks by focused ultrasound – an animal study. J Neural Eng. 2020 Nov 4;17(5):056030. doi: 10.1088/1741-2552/abb14d.
Mikhailov N, Leskinen J, Fagerlund I, Poguzhelskaya E, Giniatullina R, Gafurov O, Malm T, Karjalainen T, Gröhn O, Giniatullin R. Mechanosensitive meningeal nociception via Piezo channels: Implications for pulsatile pain in migraine? Neuropharmacology. 2019 Feb 13;149:113-123. doi: 10.1016/j.neuropharm.2019.02.015.
Walling I, Panse D, Gee L, Maietta T, Kaszuba B, Kumar V, Gannon S, Hellman A, Neubauer P, Frith L, Williams E, Ghoshal G, Shin DS, Burdette C, Qian J, Pilitsis JG. The use of focused ultrasound for the treatment of cutaneous allodynia associated with chronic migraine. Brain Res. 2018 Aug 2. pii: S0006-8993(18)30416-5. doi: 10.1016/j.brainres.2018.08.004.
Walling IT, Gee L, Neubauer P, Frith L, Williams E, Burdette C, Pilitsis JG. Pulse Modulation of the Occipital Nerve Using Focused High-Intensity Ultrasound Improves Mechanical Thresholds in a Chronic Migraine Rat Model. Neurosurgery. 2016 Aug;63 Suppl 1:150-1. doi: 10.1227/01.neu.0000489692.13840.05.
Rodrigo D, Acin P, Bermejo P. Occipital Nerve Stimulation for Refractory Chronic Migraine: Results of a Long-Term Prospective Study. Pain Physician. 2017 Jan-Feb;20(1):E151-E159.
Click here for additional references from PubMed.
