Ultrasound to treat tremors and even cancer |

A new frontier at the Best Neurological Institute in Milan, where one of the most advanced facilities for treatment with focused ultrasound guided by magnetic resonance is available.

Ultrasound for the treatment of tremors and cancer

A new frontier at the Besta Neurological Institute in Milan, which has one of the most advanced equipment for MRI-guided focused ultrasound treatment

There is no pain, no anesthesia, and the patient, who is always awake during the procedure, sees his tremors which he cannot control.This can be caused by treatment with "high-frequency focused ultrasound guided by magnetic resonance imaging."At Milan's Besta Neurological Institute, 400 such procedures have already been performed since 2019, when the equipment to perform them, the hospital's Revelli Foundation, was donated by the hospital's Reveley Foundation (cost 2 million euros).Now that the Lombardy Region has equipped the Institute with the latest evolution of technology (Exablet Prime) that is offered today, will be able to increase the number of treatments, because, among other numerous advantages, the new instrumentation allows to reduce the time for each operation from approximately 3.5 to 2 hours.Neurosurgery at the Besta Institute and Full Professor of Neurosurgery at the University of Milan.

Focused ultrasound can be used in the nervous area with two goals: to destroy “homes” in the brain that are causing problems or to make the local blood flow more able to “pass” medications that might otherwise reach diseased tissue (e.g. cancer).

Let's take an example: essential tremor (not due to Parkinson's disease) can be managed today with deep brain stimulation (DBS), which requires opening the skull to place an electrode, which is then connected by a cable to an external battery.With Exablate, all of this can be avoided because an MRI (imagine a tube inserted lying down) is inserted into the patient, which will serve to direct focused ultrasound with extreme precision to the affected nerve cells, and on the other hand, will indicate the temperature that group of cells will reach under the action of ultrasounds.

When the temperature reaches 45 degrees, the patient is removed from the MRI and checked to see if the tremor has disappeared.Of course, so far the result may be reversed.If the desired result is obtained, that is to say if the tremor has disappeared, the person returns to Resonance and the process ends up to 55 degrees: this is then the destruction (ablation) of the target.

“High-frequency ultrasound can be used when the area to be treated is small,” explains DiMeco."With tumors, this is usually not possible because the area to be destroyed is usually larger and such an attack can lead to bleeding or other problems, but a low-frequency variant can be used. This allows the connections between the cells of the brain's blood vessel wall to temporarily expand, allowing drugs that cannot normally "penetrate" to reach the tumor.For example, we have already treated 24 glioblastomas on a trial basis.

In addition to the basic vibration, there are other signs with this device now and in the future.it can also be used for pathologies such as obsessive-compulsive disorder and resistant depression."

The National Health Service has passed the treatment."Yes, the Lombardy region has already prepared the reimbursement" confirmed Professor DiMeco.speed of access to a second device." "However, it is important that treatment is reserved for those with the best indications and needs - under Professor DiMeco -.For this reason too (and by neurologists), this work is carried out by neurosurgeons, neuroradiologists, and medical physicists."

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