Focused Ultrasound Therapy
Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with multiple sclerosis (MS). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One is precise ablation (thermal destruction of tissue), which enables treatment without surgery. This treatment is only focused on the movement disorder, and is not intended to treat the underlying cause of MS.
The second mechanism utilizing focused ultrasound is to possibly treat the actual underlying cause of multiple sclerosis and preserve the myelin sheath (insulation around nerves) which allows nerves to transmit signals quickly and efficiently. Preclinical work has shown that focused ultrasound accelerates remyelinization of nerves.
The third area of research takes advantage of the ability of focused ultrasound to open the blood-brain barrier (BBB). Focused ultrasound can reversibly and safely allow the blood vessels in the brain to partially “open” the otherwise tight junctions, allowing certain therapies (genes, stem cells, neuroprotective and/or neurorestorative drugs, and medications) to enter the brain in specific areas. Current avenues of research involve delivering these therapies directly from the bloodstream itself or even within or attached to microbubbles.
An additional approach is being used at Stanford in collaboration with Dutch researchers (https://start2cure.org/projecten/) as they use FUS to make a similar lesion to those in MS, and try to promote an improved recovery from the lesion.
Advantages
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It also offer precision targeting to minimize damage to healthy tissue and opens BBB safely to enhance drug delivery and immune effects. Focused ultrasound can also be repeated, if necessary.
Clinical Trials
A clinical trial has begun in Canada treating patients with multiple sclerosis induced hand tremor with focused ultrasound. This trial is only open to citizens of Canada.
The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here, it will take you to the latest information available from https://www.clinicaltrials.gov/.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for multiple sclerosis is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Gagliardo C, Ragonese P, Iacopino GD, Salemi G, Midiri M, D’Amelio M. Transcranial magnetic resonance-guided focused ultrasound thalamotomy as a safe treatment option in multiple sclerosis patients with essential tremor. Neurol Sci. 2020 Oct 22. doi: 10.1007/s10072-020-04841-4.
Máñez-Miró JU, Martínez-Fernández R, Del Alamo M, Pineda-Pardo JA, Fernández-Rodríguez B, Alonso-Frech F, Álvarez-Cermeño JC, Obeso JA. Focused ultrasound thalamotomy for multiple sclerosis-associated tremor. Mult Scler. 2019 Oct 16:1352458519861597. doi: 10.1177/1352458519861597.
Click here for additional references from PubMed.