Frontiers in Neurology (Feb 2024)
Focused ultrasound therapy in movement disorders: management roadmap toward optimal pathway organization
- Sara Rinaldo,
- Roberto Cilia,
- Valentina Leta,
- Valentina Leta,
- Mariarosaria Gammone,
- Nico Golfrè Andreasi,
- Fabiana Colucci,
- Arianna Braccia,
- Roberta Telese,
- Marco Fusar Poli,
- Vincenzo Levi,
- Luigi Michele Antonio Romito,
- Francesco Ghilemetti,
- Elena De Martin,
- Maria Luisa Fumagalli,
- Francesca Epifani,
- Sara Prioni,
- Paolo Amami,
- Sylvie Piacentini,
- Antonio Emanuele Elia,
- Grazia Devigili,
- Vittoria Nazzi,
- Elisa Francesca Maria Ciceri,
- Mario Stanziano,
- Marina Grisoli,
- Valentina Caldiera,
- Marisa Catotti,
- Francesco DiMeco,
- Francesco DiMeco,
- Francesco DiMeco,
- Giacomina Clara Moreschi,
- Roberto Eleopra
Affiliations
- Sara Rinaldo
- Health Professions Management, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Roberto Cilia
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Valentina Leta
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Valentina Leta
- Parkinson's Centre of Excellence at King's College Hospital and King's College London, London, United Kingdom
- Mariarosaria Gammone
- Health Professions Management, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Nico Golfrè Andreasi
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Fabiana Colucci
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Arianna Braccia
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Roberta Telese
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Marco Fusar Poli
- Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Vincenzo Levi
- Functional Neurosurgery Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Luigi Michele Antonio Romito
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Francesco Ghilemetti
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Elena De Martin
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Maria Luisa Fumagalli
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Francesca Epifani
- Neuroradiology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Sara Prioni
- Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Paolo Amami
- Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Sylvie Piacentini
- Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Antonio Emanuele Elia
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Grazia Devigili
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Vittoria Nazzi
- Functional Neurosurgery Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Elisa Francesca Maria Ciceri
- Imaging Radiology and Interventional Neuroradiology, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Mario Stanziano
- Neuroradiology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Marina Grisoli
- Neuroradiology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Valentina Caldiera
- Imaging Radiology and Interventional Neuroradiology, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Marisa Catotti
- Health Professions Management, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Francesco DiMeco
- Department of Neurological Surgery Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Francesco DiMeco
- 0Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Francesco DiMeco
- 1Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, United States
- Giacomina Clara Moreschi
- Health Professions Management, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Roberto Eleopra
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- DOI
- https://doi.org/10.3389/fneur.2024.1356310
- Journal volume & issue
-
Vol. 15
Abstract
MRI-guided focused ultrasound (MRgFUS) lesioning is an innovative, safe and effective treatment which provides an innovative development in the field of minimally invasive stereotactic neurosurgery. Based on the application of focused ultrasound energy under full MR planning and thermal imaging control, unilateral lesioning of the thalamus, subthalamic nucleus, and globus pallidus is indicated for the treatment of movement disorders, including essential tremor, Parkinson’s disease, and dystonia. We started to apply this technique in February 2019 for the treatment of patients with movement disorders. The authors developed a diagnostic therapeutic care pathway, which is herewith proposed and applied as an explication of standard clinical practice in use. The project was the result of the application of different methods such as Health Technology Assessment (HTA), Strengths, Weaknesses, Opportunities and Threats analysis (SWOT) and Demin -Plan, Do, Check, Act (PDCA) cycle. The aim of this project was to standardize the MRgFUS diagnostic-therapeutic pathway (DTP), describe its application and the appropriateness of different phases (patient selection, intervention phase and follow-up). Here, we described in detail our experience in the DTP application from 2019 up to now in 610 patients with movement disorders.
Keywords
