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 neuropathy. This novel technology focuses beams of ultrasound energy precisely and accurately on therapeutic targets without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One mechanism is neuromodulation, which alters the activity from nervous tissue. A second mechanism is vasomodulation, which alters the flow of blood to the region. Both of these can be increased or decreased by the way in which focused ultrasound is administered. While significant 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 neuropathy are limited, and mostly include medication.
For certain patients, focused ultrasound could provide an alternative to medications, which may be more effective and have less risk of side effects and lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
Clinical Trials
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of neuropathy.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for neuropathy is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Hoffman BU, Baba Y, Lee SA, Tong CK, Konofagou EE, Lumpkin EA. Focused ultrasound excites action potentials in mammalian peripheral neurons in part through the mechanically gated ion channel PIEZO2. Proc Natl Acad Sci U S A. 2022 May 24;119(21):e2115821119. doi: 10.1073/pnas.2115821119. Epub 2022 May 17.
Liss A, Hellman A, Patel VJ, Maietta T, Byraju K, Trowbridge R, Acheta J, Panse D, Srikanthan A, Neubauer P, Burdette C, Ghoshal G, Williams E, Qian J, Pilitsis JG. Low Intensity Focused Ultrasound Increases Duration of Anti-Nociceptive Responses in Female Common Peroneal Nerve Injury Rats. Neuromodulation. 2021 Sep 2. doi: 10.1111/ner.13531.
Kim MG, Kamimura HAS, Konofagou EE. Neurogenic Flare Response following Image-Guided Focused Ultrasound in the Mouse Peripheral Nervous System in Vivo. Ultrasound Med Biol. 2021 Jun 24:S0301-5629(21)00211-8. doi: 10.1016/j.ultrasmedbio.2021.04.030.
Lee SA, Kamimura HAS, Konofagou EE. Displacement imaging during focused ultrasound median nerve modulation: A preliminary study in human pain sensation mitigation. IEEE Trans Ultrason Ferroelectr Freq Control. 2020 Aug 4;PP. doi: 10.1109/TUFFC.2020.3014183.
Tan JS, Lin CC, Chen GS. Vasomodulation of peripheral blood flow by focused ultrasound potentiates improvement of diabetic neuropathy. BMJ Open Diabetes Res Care. 2020 Mar;8(1). pii: e001004. doi: 10.1136/bmjdrc-2019-001004.
Ezeokeke CK, Bobola MS, Selby M, Ko JH, Friedly JL, Mourad PD. Case study of an amputee regaining sensation and muscle function in a residual limb after peripheral nerve stimulation by intense focused ultrasound. Brain Stimul. 2020 Jan 7;13(3):527-529. doi: 10.1016/j.brs.2020.01.003. [Epub ahead of print] No abstract available.
Hellman A, Maietta T, Byraju K, Linda Park Y, Shao M, Liss A, Neubauer P, Burdette C, Ghoshal G, Qian J, Nalwalk J, Pilitsis JG. Low Intensity Focused Ultrasound Modulation of Vincristine Induced Neuropathy. Neuroscience. 2020 Mar 15;430:82-93. doi: 10.1016/j.neuroscience.2020.01.021. Epub 2020 Feb 4.
Youn Y, Hellman A, Walling I, Gee L, Qian J, Burdette C, Frith L, Pilitsis JG. High-Intensity Ultrasound Treatment for Vincristine-Induced Neuropathic Pain. Neurosurgery. 2018 Nov 1;83(5):1068-1075. doi: 10.1093/neuros/nyx488.
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