HIFU, a solution to movement disorders

The Jiménez Díaz Foundation has added the use of high-intensity focused ultrasound (HIFU) to its treatments to control the symptoms of various movement disorders.

Progresses in restorative innovation have moved forward the treatment of neurological clutters. A later and promising advancement is high-intensity centered ultrasound ( HIFU ), utilized at the Jiménez Díaz Foundation to treat headstrong tremor (a sort of tremor that does not react to routine therapeutic medications, such as drugs), central dystonia (a development clutter that causes automatic and maintained muscle compressions in a particular portion of the body), and neuropathic torment (inveterate torment due to a brokenness within the apprehensive framework itself, without any harm having happened). This procedure, as of now successful within the to begin with patients treated, offers a less obtrusive and more secure alternative than profound brain stimulation (DBS), the standard until presently.

What is HIFU?

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High-intensity focused ultrasound is a noninvasive technique that uses ultrasound beams to generate heat in specific areas of the brain , destroying tissue through coagulative necrosis and stopping neural signals that cause movement disorders. Guided by magnetic resonance imaging, HIFU precisely treats essential and parkinsonian tremor , and can also target the subthalamic nucleus in Parkinson’s, as well as relieving symptoms of focal dystonia and neuropathic pain in both strategies, neither of which is, however, curative.

Big differences

Until recently, DBS was the most common treatment to control the symptoms of tremor and other movement disorders. DBS involves the implantation of electrodes in deep areas of the brain that, through electrical stimuli, control involuntary movements. Although effective, this treatment requires a more invasive surgical intervention, with associated risks such as infections, problems with the adjustment of implanted electronic devices and the need for periodic check-ups. HIFU , in comparison, is a procedure that does not require open surgery , nor the implantation of devices, which significantly reduces the associated risks. The operation is performed in just 3 or 4 hours with the patient awake and with a minimal hospital stay, usually just one night. As Dr. Joaquín Ayerbe, a neurosurgery specialist at the Jiménez Díaz Foundation, points out, one of the great advantages of HIFU over DBS is precisely “its simplicity of execution”, which has been a key point for its adoption at the Foundation.

Few but great success stories

To date, the Jiménez Díaz Foundation has successfully treated 15 patients using HIFU, all over 70 years of age and diagnosed with essential tremor . According to Dr. Ayerbe, all patients were able to return to their daily activities 24 hours after the intervention, without requiring further rehabilitation. No significant side effects were reported , demonstrating the safety and efficacy of the procedure. This initial success not only underlines the viability of HIFU as a treatment for essential tremor, but opens the door to its use in younger patients and in more complex cases, such as those with tremor-predominant Parkinson’s. The medium-term goal is to increase the number of interventions and treat at least four patients per month ; betting on HIFU as a reference option in the hospital.

Selection criteria and benefits for patients

The profile of the HIFU candidate understanding is key to guaranteeing success. Patients must meet certain incorporation criteria :
a conclusion of fundamental tremor or tremorigenic Parkinson’s illness, no noteworthy cognitive impedance, and disappointment to reply to ordinary pharmacological medications. In expansion, candidates must understand that the treatment isn’t corrective, but or maybe looks for to soothe indications and progress their quality of life. Not at all like other procedures, patients must not have signs for other lesional treatments or DBS, or must have rejected these alternatives. This specific approach guarantees that patients who get HIFU are those who will advantage most from its negligibly obtrusive preferences . In expansion to its straightforwardness, the method permits for dodging the dangers of contamination and mechanical complications related with implantable DBS gadgets. For numerous patients, these components make HIFU a more appealing alternative, particularly in case they wish to dodge more intrusive surgeries or are unwilling to experience medications that require steady restorative checking.

A multidisciplinary intervention

The victory of HIFU at the Jiménez Díaz Establishment depends not as it were on the innovation utilized, but moreover on the multidisciplinary collaboration of diverse specialties . The treatment is carried out with the facilitated support of the Neurology and Neurosurgery administrations, as well as the Neuroradiology group, in charge of overseeing the attractive reverberation that guides the method. The Neurology group, driven by Dr. Pedro García Ruiz and composed of specialists Javier del Val and Cristina García Campos, is capable for selecting the fitting patients and closely checking their advance. In parallel, the Neurosurgery group, beneath the course of Dr. Mónica Lara, performs the mediation with exactness and control, whereas specialists Julia Montoya and Cristina Ordóñez, from Neuroradiology, are in charge of the errands related to the attractive reverberation.

Future uses

Although the use of HIFU has initially focused on essential tremor, the possibilities for expansion are broad. The Jiménez Díaz Foundation plans to include younger patients in its criteria, as well as those with Parkinson’s disease who present a high tremor component . In addition, it is hoped that HIFU can be used in the future to treat other conditions, such as neuropathic pain that does not respond to conventional treatments. This advance not only positions the Jiménez Díaz Foundation as a reference center in the treatment of movement disorders, but also underlines its commitment to healthcare excellence and technological innovation. The fact that it is the third public hospital in Madrid to offer this technique underlines once again its commitment to patients.