What is MR-Guided Focused Ultrasound (MRgFUS) Therapy?

MRgFUS is an innovative, non-surgical method used in the treatment of Parkinson’s and movement disorders.

 In this method:

• 1,024 separate high-intensity ultrasound waves

• combined with Magnetic Resonance Imaging (MRI)

High-intensity ultrasound waves are focused on the target region in the brain that causes tremor through the scalp, and the area is deactivated without any incision. This entire outpatient procedure is performed inside the MRI device, with real-time imaging. Thus tremor can be significantly reduced.

 In five-year follow-ups, 70–73% of patients reported significant and permanent improvement in tremor after MRgFUS.

How is MR-Guided Focused Ultrasound (MRgFUS) performed?

 MRgFUS is a treatment method used for movement disorders that concentrates 1024 mini ultrasound beams on the brain region responsible for tremor, creating permanent lesions in a laser-like manner.

 In the preparation phase, the patient’s hair is shaved, a stereotactic frame is placed to stabilize the head and calculate the coordinates of the target regions.

 The patient does not feel pain other than the pain of 4 narctic injections, while the frame is placed. To prevent heat sensation, a cooling water circulation membrane is also attached.

 After preparation, the patient is laid on the MRI table with the frame on the head and the treatment begins. The patient remains awake and can communicate with the doctors during the procedure. High-resolution MRI images are used to identify tremor-causing brain regions with millimeter accuracy. Then, ultrasound beams are directed to the target area in low doses and in the MR temperature increases are monitored. Temperature rise is evaluated, and when the best clinical improvement is achieved, a permanent effect is obtained by creating a lesion with a high-energy burst.

 The procedure lasts about 2–4 hours, and most patients are discharged on the same day.

Who is suitable for MR-Guided Focused Ultrasound Therapy?

 MRgFUS is applied for tremor disorders, especially Essential Tremor and Parkinson’s Disease, and provides a significant alternative for patients who do not want or are not suitable for surgery.

 To determine suitability, tremor type, severity, and the patient’s general health are evaluated. Additionally, computerized tomography (CT) screening is required to determine whether a patient is an MRgFUS candidate.

 Patients with metallic implants such as pacemakers, brain stimulators, spinal fixators, metal clips, screws, etc., may not be suitable. Such patients require a detailed MR compatibility assessment to prevent damage from the strong magnetic field of the MR machine.

 If an individual cannot endure the overall health condition to undergo treatment or can not stay in the same position for about 3 hours, they may not be a suitable candidate. There are other restrictions as well; suitability is decided by the doctor after necessary evaluations.

 Please remember each patient’s situation is unique.

 To learn if MRgFUS therapy is right for you, contact our support line at +90533 273 40 41.

Who cannot benefit from MR-Guided Focused Ultrasound Therapy (MRgFUS)?

 Patients with metal implants such as MR-incompatible heart stimulators.

 Advanced kidney or dialysis patients.

 Unstable cardiac conditions or severe hypertension patients.

 Patients exhibiting behaviors compatible with alcohol or substance addiction.

 Individuals with a history of abnormal bleeding.

 Patients with cerebrovascular disease or brain tumors.

 Individuals unable or unwilling to maintain the long fixed position required during treatment.

 Pregnant individuals.

In which diseases can MR-Guided Focused Ultrasound Therapy (MRgFUS) be used?

 MRgFUS is a suitable treatment for movement disorders in patients who do not respond to medical therapy or cannot use medications due to side effects.

 Most commonly used for Essential Tremor, but also used for Parkinson’s disease and Dystonia.

In addition to movement disorders, it has begun to be used in psychiatric conditions such as Obsessive-Compulsive Disorder and Depression.

Frequently Asked Questions and Answers

Am I a candidate for MR-Guided Focused Ultrasound Therapy?

 If you have tremor (tremor disease) and no longer benefit from medications, you may be a candidate. However, this must be confirmed through a consultation with a specialist and necessary evaluations. Suitability is assessed by a specialist.

Why must I be awake during the treatment?

To allow the doctor to precisely target the brain region causing the tremor. During the process, the patient may be asked to perform tasks such as opening and closing the hand or writing.

How long does the treatment take?

 The procedure lasts about 3 hours. However, you do not need to stay in the MR machine the entire time; neurological function is assessed intermittently and necessary checks are performed on the MR table.

What will the patient experience during the procedure?

Before the treatment, the patient's hair is shaved to prevent interference with sound waves. A fixation frame is placed on the head, and local anesthesia is applied. Throughout the procedure, vital signs such as pulse, blood pressure, and oxygen levels are monitored, and the team stays in communication with the patient.

Is hospitalization required after the procedure?

 MR-Guided Focused Ultrasound (MRgFUS) therapy is an outpatient procedure. Most patients are discharged the same day and can return to daily life.

When will improvement be observed?

 Clinical improvement can be observed during the procedure. Energy waves are gradually increased, and many patients show rapid improvement even on the MRI table.

How effective is the treatment?

 Clinical studies show high rates of improvement in Essential Tremor, with effects lasting five years or longer in many cases. A significant improvement in quality of life has been observed among beneficiaries.

If the effect decreases in subsequent years, can it be repeated?

 If the effect is insufficient or wanes over time, the necessary evaluations may lead to repeating the procedure or considering alternative treatments.

Can it be applied to patients with DBS?

 For patients with DBS, this treatment cannot be performed. If the brain stimulator has been removed, treatment may be possible.

Is the treatment applied to only one side? Can it be applied to the other side as well?

 At first, the treatment is applied to the side of the brain where symptoms are more pronounced. After a certain period (usually 6–9 months), treatment can be applied to the other brain side as well.

Does treatment block other brain treatments afterward?**

MRgFUS does not prevent other treatments in the future. If needed, the same method or different treatments can be applied.

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