About this Research Topic
Transcranial focused ultrasound (FUS) is a ground-breaking technology that has ablative and non-ablative applications for neurological and psychiatric disorders. FUS was revived in the 1990s with the advent of MRI guidance and the invention of phase array ultrasound transducers. Today, there are a variety of approved and investigational transcranial FUS applications. In 2016, FUS ablation of the thalamic ventral intermediate nucleus (Vim) received FDA approval for medication refractory essential tremor (ET) and subsequently for tremor-dominant Parkinson’s disease. Ablative therapy uses a high-frequency 650 kHz transducer to achieve targeted heating up to 60°C at a sub-centimeter focal point. A 220kHz focused ultrasound system can induce targeted cavitations following the administration of intravenous microbubbles and has been shown to induce transient opening of the blood brain barrier. The applications for neuromodulation and targeted drug delivery are only beginning to be explored.
Currently there is significant interest in MRgFUS indications and therapeutic outcomes; the number of publications and abstracts on this topic has risen dramatically in the last 10 years. There remains significant interest in exploring novel applications of this emerging technology, while optimizing the outcomes and defining the mechanisms of action. The purpose of this collection of articles includes:
1. To describe the current challenges and future advancements of transcranial FUS therapy for ablative, blood brain barrier opening, and neuromodulation applications;
2. To optimize treatment technique through precise targeting including advanced neuroimaging and tractography and improve the outcomes of FUS therapy;
3. To determine the mechanisms of action of FUS therapy, and to link those to clinical outcomes in the currently approved indications;
4. To provide the rationale and to investigate the feasibility of new targets and diseases applications.
With this Research Topic we would like to provide an expert view on key aspects of transcranial FUS therapy. With this we would like to establish a foundation on the mechanisms/approaches to be used to improve the current status of practice through the use of advanced imaging and tractography, to develop strategies to further optimize treatment technique, to improve long term outcomes, and to provide a framework to develop new indications. We welcome submissions of Systematic Reviews and Original Research, the goal is to highlight a ‘take-home message’ and rationales that can be useful to new providers interested in FUS therapy.
Topic Editors Vibhor Krishna and J. Levi Chazen have received grants for research purposes from Insightec Inc. The other Topic Editors declare no competing interests with regard to the Research Topic subject.
Keywords: MRgFUS, ablation, neuromodulation, ultrasound, network, acoustics
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