The DOI matches its Crossref record; 70 of the 71 references it cites were found in a registry or an index.
A Review of the Current Therapies, Challenges, and Future Directions of Transcranial Focused Ultrasound Technology: Advances in Diagnosis and Treatment
Abstract
Importance: Magnetic resonance imaging-guided focused ultrasound ablation has been approved for the treatment of refractory essential tremor and is being studied for other neurological indications, including dyskinesias and tremor in Parkinson disease, dystonia, neuropathic pain, obsessive-compulsive disorder, epilepsy, and brain tumors. Objective: To review the scientific foundations of FUS technology, existing neurological applications, and future advances. Evidence Review: PubMed was searched for the past 10 years using the terms "transcranial ultrasound," "focused ultrasound," and "neurological applications." Relevant references were selected from the author's reference collection. From the 2855 unique records, 243 publications were screened. After excluding abstracts detailing in vitro studies or non-neurological applications, 86 full texts were retrieved for qualitative review. Findings: Advances in the transducer design and electronic phase correction have allowed efficient focusing of ultrasounds for transcranial treatment. The mid-frequency (650 kHz) transducer can make small (4-6 mm in diameter) and precise (accuracy of <2 mm) brain lesions. The treatment monitoring is achieved via "live" anatomical thermography imaging and clinical feedback. The initial results from its clinical application in movement disorders are encouraging. Emerging applications in epilepsy and neurobehavioral and cognitive disorders are being explored. The low-frequency (220 kHz) transducer coupled with microbubbles can potentially enable targeted drug delivery for novel applications, such as Alzheimer disease and brain tumors. Finally, neuromodulation with subthreshold sonications may allow the interrogation of brain areas previously not accessible for electrical stimulation. Conclusions and Relevance: Transcranial focused ultrasound for both ablative and nonablative applications is noninvasive, making it suitable for selected patients who are not candidates for conventional surgical options. Future advancements in imaging and sonication algorithms will improve the safety and efficacy of this technology.
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“Animal studies have demonstrated safe and reversible BBB opening (4, 6, 7) as well as reduction of amyloid-beta plaque, neurogenesis, and improvement of memory.”
From Noninvasive hippocampal blood-brain barrier opening in Alzheimer's disease with focused ultrasound. (2020) · cites this paper as [4]
In the citing paper
“Animal studies have demonstrated safe and reversible BBB opening (4, 6, 7) as well as reduction of amyloid-beta plaque, neurogenesis, and improvement of memory.”
From Noninvasive hippocampal blood-brain barrier opening in Alzheimer's disease with focused ultrasound. (2020) · cites this paper as [4]
Citations
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Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus
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The connectomics of brain disorders
Fornito, A., Zalesky, A., & Breakspear, M. (2015) · Nature Reviews Neuroscience · doi:10.1038/nrn3901 · Cited by 1,734
A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor
Elias, W. J., Lipsman, N., Ondo, W. G., Ghanouni, P., Kim, Y. G., Lee, W., Schwartz, M., Hynynen, K., Lozano, A. M., Shah, B. B., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1600159 · Cited by 1,167
Basic principles of thermal dosimetry and thermal thresholds for tissue damage from hyperthermia
Dewhirst, M. W., Viglianti, B. L., Lora‐Michiels, M., Hanson, M., & Hoopes, P. J. (2003) · International Journal of Hyperthermia · doi:10.1080/0265673031000119006 · Cited by 1,014
Transcranial focused ultrasound modulates the activity of primary somatosensory cortex in humans
Legon, W., Sato, T. F., Opitz, A., Mueller, J., Barbour, A. J., Williams, A., & Tyler, W. J. (2014) · Nature Neuroscience · doi:10.1038/nn.3620 · Cited by 1,008
Transcranial Pulsed Ultrasound Stimulates Intact Brain Circuits
Tufail, Y., Matyushov, A. D., Baldwin, N. G., Tauchmann, M. L., Georges, J., Yoshihiro, A., Tillery, S. I. H., & Tyler, W. J. (2010) · Neuron · doi:10.1016/j.neuron.2010.05.008 · Cited by 958
A pilot study of focused ultrasound thalamotomy for essential tremor.
Elias, W., Huss, D., Voss, T., Loomba, J., Khaled, M., Zadicario, E., Frysinger, R. C., Sperling, S., Wylie, S., Monteith, S., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1300962 · Cited by 833
Proton Resonance Shift of Water in the Gas and Liquid States
Hindman, J. C. (1966) · The Journal of Chemical Physics · doi:10.1063/1.1726676 · Cited by 661
MR-guided focused ultrasound thalamotomy for essential tremor: a proof-of-concept study
Lipsman, N., Schwartz, M. L., Huang, Y., Lee, L., Sankar, T., Chapman, M., Hynynen, K., & Lozano, A. M. (2013) · The Lancet Neurology · doi:10.1016/s1474-4422(13)70048-6 · Cited by 604
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Sorted by citations
Thijs, R. D., Surges, R., O'Brien, T. J., & Sander, J. W. A. S. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32596-0 · Cited by 2,359
Noninvasive hippocampal blood-brain barrier opening in Alzheimer's disease with focused ultrasound.
Rezai, A. R., Ranjan, M., D’Haese, P.-F., Haut, M. W., Carpenter, J., Najib, U., Mehta, R. I., Chazen, J. L., Zibly, Z., Yates, J. R., et al. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2002571117 · Cited by 365
Self-citationUltrasound Blood–Brain Barrier Opening and Aducanumab in Alzheimer’s Disease
Rezai, A. R., D’Haese, P.-F., Finomore, V., Carpenter, J., Ranjan, M., Wilhelmsen, K., Mehta, R. I., Wang, P., Najib, U., Vieira Ligo Teixeira, C., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2308719 · Cited by 312
Self-citationBeisteiner, R., Matt, E., Fan, C., Baldysiak, H., Schönfeld, M., Philippi Novak, T., Amini, A., Aslan, T., Reinecke, R., Lehrner, J., et al. (2020) · Advanced Science · doi:10.1002/advs.201902583 · Cited by 269
Belykh, E. G., Shaffer, K. V., Lin, C., Byvaltsev, V. A., Preul, M. C., & Chen, L. (2020) · Frontiers in Oncology · doi:10.3389/fonc.2020.00739 · Cited by 200
Metadata
- Authors
- Krishna, V., Sammartino, F., & Rezai, A.
- Affiliations
- The Ohio State University (US)
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2018-02-01
- Volume
- 75
- Issue
- 2
- Pages
- 246
- ISSN
- 2168-6149 (ISSN-L)
- OpenAlex
- W2771503729
- Cited by
- 289
- References
- 71
- Citations by year
- 2026: 32 · 2025: 40 · 2024: 45 · 2023: 47 · 2022: 31 · 2021: 28 · 2020: 32 · 2019: 20 · 2018: 14
- FWCI
- 8.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Ultrasound and Hyperthermia Applications
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Physical Sciences › Engineering › Biomedical Engineering › Photoacoustic and Ultrasonic Imaging
- Keywords
- transcranial focused ultrasound, essential tremor, movement disorders, Parkinson's disease, dystonia, neuropathic pain, epilepsy, neuromodulation, microbubbles, targeted drug delivery, Alzheimer's disease, brain tumors, transducer design, phase correction, infrared thermography
- MeSH terms
- Brain Diseases, Humans, Magnetic Resonance Imaging, Therapy, Computer-Assisted, Ultrasonography, Doppler, Transcranial
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