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磁共振引导聚焦超声在帕金森病治疗中的应用现状。

Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson's disease.

机构信息

Department of Radiology, Chinese PLA General Hospital/Chinese PLA Medical School, Beijing 100853, China.

School of Medicine, Nankai University, Tianjin 300071, China.

出版信息

Chin Med J (Engl). 2023 Apr 5;136(7):780-787. doi: 10.1097/CM9.0000000000002319.

Abstract

Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel and minimally invasive technology. Since the US Food and Drug Administration approved unilateral ventral intermediate nucleus-MRgFUS for medication-refractory essential tremor in 2016, studies on new indications, such as Parkinson's disease (PD), psychiatric diseases, and brain tumors, have been on the rise, and MRgFUS has become a promising method to treat such neurological diseases. Currently, as the second most common degenerative disease, PD is a research hotspot in the field of MRgFUS. The actions of MRgFUS on the brain range from thermoablation, blood-brain barrier (BBB) opening, to neuromodulation. Intensity is a key determinant of ultrasound actions. Generally, high intensity can be used to precisely thermoablate brain targets, whereas low intensity can be used as molecular therapies to modulate neuronal activity and open the BBB in conjunction with injected microbubbles. Here, we aimed to summarize advances in the application of MRgFUS for the treatment of PD, with a focus on thermal ablation, BBB opening, and neuromodulation, in the hope of informing clinicians of current applications.

摘要

磁共振引导聚焦超声(MRgFUS)是一种新颖的微创技术。自 2016 年美国食品和药物管理局批准单侧腹侧中间核-MRgFUS 用于治疗药物难治性特发性震颤以来,针对新适应症(如帕金森病、精神疾病和脑肿瘤)的研究不断增加,MRgFUS 已成为治疗此类神经疾病的有前途的方法。目前,作为第二大常见退行性疾病,帕金森病是 MRgFUS 领域的研究热点。MRgFUS 对大脑的作用范围从热消融、血脑屏障(BBB)打开到神经调节。强度是超声作用的关键决定因素。通常,高强度可用于精确热消融脑靶标,而低强度可用于分子治疗,以结合注射的微泡调节神经元活动和打开 BBB。在这里,我们旨在总结 MRgFUS 在治疗帕金森病方面的应用进展,重点关注热消融、BBB 打开和神经调节,希望为临床医生提供当前的应用信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faa5/10150909/3c9ef028cffc/cm9-136-780-g001.jpg

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