Magnetresonanz-gesteuerter (MR-gesteuerter) fokussierter Ultraschall (MRgFUS) zur Tremor-Behandlung

Zusammenfassung

Die Behandlung von Tremor stellt eine Herausforderung im klinischen Alltag dar; nur selten gelingt es, Tremor bei Bewegungsstörungen, wie beim essentiellen oder orthostatischen Tremor (ET, OT) oder bei Morbus Parkinson (MP), durchgreifend medikamentös zu lindern. Eine Alternative zur Tiefenhirnstimulation bietet die gezielte lokale Ausschaltung spezifischer Strukturen des Thalamus und der Basalganglien mittels transkraniellem Magnet-Resonanz-Tomographie-gesteuerten fokussierten Ultraschall (MRgFUS). MRgFUS erlaubt es, kleine Bereiche des Gehirns sicher und präzise thermisch zu abladieren. Die MRgFUS-Behandlungen erfolgen ohne Öffnung des Schädels unter MRT-Kontrolle („incisionless surgery“). Durch diesen schonenden, minimal-invasiven Eingriff kann die oft stark beeinträchtigte Lebensqualität der meist älteren Betroffenen innerhalb kurzer Zeit grundlegend verbessert werden. Die Erfolge der Läsionsbehandlung wurden bislang über 4 Jahre nachuntersucht und dokumentiert.

Abstract

Treatment of tremor is a challenge in everyday clinical practice; tremor in movement disorders such as essential or orthostatic tremor (ET, OT) or Parkinson’s disease (PD) can rarely be treated sufficiently with oral medication. An alternative to deep brain stimulation is the targeted local lesion of specific structures of the thalamus and basal ganglia by means of transcranial magnetic resonance imaging guided focused ultrasound (MRgFUS). MRgFUS allows to thermally ablate small areas of the brain safely and precisely. MRgFUS treatments are performed without opening of the skull under MRI control (‘incisionless surgery’). This minimal invasive procedure can improve the often severely impaired quality of life of the mostly elderly patients on a day to day basis without the need for long in-patient procedures. A sustained effect of the lesion treatment has so far been investigated and documented over 4 years.

Schlüsselwörter

Tremorbehandlung - Magnetresonanz-gesteuerter (MR-gesteuerter) fokussierter Ultraschall - Parkinson - essentieller Tremor

Key words

Tremor - essential tremor - magnetic resonance tomography-guided focused ultrasound - Parkinson’s disease

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