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Ultrasound: The go-to treatment for functional brain disorders?

by Loren Bonner, DOTmed News Online Editor | September 19, 2013

Sillay said there's a five percent risk of infection and a one in 200 patient risk of stroke, death or other complication with deep brain stimulation. But the treatment is FDA approved and there have been over 100 thousand patients worldwide implanted using the technique.

According to Kassell, some reported side effects from focused ultrasound treatment with ExAblate might be a little dizziness or numbness in the scalp where the pins were put in.

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"But there's not risk of infection or blood clot because it's not surgery," said Kassell.

As MRI makes focused ultrasound treatment possible, it's also making deep brain stimulation more of a possibility — at least for patients.

"Wouldn't it be great if you could see where the brain shifted to and see where you want to go? That's where MRI guidance comes in," said Sillay.

In recent years, neurosurgeons like Sillay have been using a new system called ClearPoint that uses MRI to pinpoint the target for the pacemaker in real time. In doing so, it gets rid of the need for patient's brain feedback — before this was necessary so that surgeons could be sure they were hitting the precise target, since the brain can shift ever so slightly. Therefore, it removes one of the major drawbacks for patients — the need for them to be awake for that part of the surgery that requires brain feedback.

"The initial impression is that they do as well as other patients — not to say better — that's not the point of this, but rather to remove the anxiety and need to be awake," said Sillay.

Deep brain stimulation is also FDA approved for Parkinson's disease and dystonia and is being tested for even more applications.

Although final results of the ExAblate Phase III trial won't be available for about two years, Kassell said the success with essential tremor could pave the way for other treatment applications, like Parkinson's disease, epilepsy and even OCD and depression.

He said ExAblate could have competition from the French ultrasound company SuperSonic Imagine, which is working on development of a similar device. But this could not be confirmed with a spokesperson from SuperSonic.

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