Functional Brain Disorders /Neuropathic Pain
Conditions
Keywords
FUS, focused ultrasound, functional brain disorders, neuropathic pain, movement disorders
Brief summary
The aim of this study is to asses the efficacy and the clinical safety of the transcranial magnetic resonance guided high intensity focused ultrasound system ExAblate 4000, InSightec Ltd. for functional neurosurgery. The treatments to be conducted in this study are non-invasive, i.e. without opening the skull, and will create micro-thalamotomies in specific target areas such as thalamus, subthalamus and pallidum. The data obtained in this study will be used to evaluate the basic safety aspects of this new treatment technology and will serve as a basis for the clinical introduction of MR-guided ultrasound-neurosurgery.
Interventions
DEVICEExAblate 4000 focused ultrasound brain intervention
Non-invasive brain intervention using MR-guided focused ultrasound
Sponsors
University Children's Hospital, Zurich
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Male and female patients 18 years and older 2. Clinical indication for a medial thalamotomy 3. Stereotactic targets within thalamus, subthalamus and pallidum 4. All targets supposedly accessible by TcMRgFUS 5. Physically and mentally able to understand the risks of participating in this study and to give written informed consent based on the patient information provided 6. Sufficient proficiency in one of the languages German, French, Italian or English to al-low for verbal communication during all phases of the study 7. Physically and mentally able to communicate the personal condition and all feelings during the TcMRgFUS treatment 8. Physically and mentally able to undergo the TcMRgFUS treatment
Exclusion criteria
1. Anomalies of brain anatomy, especially in or around thalamus or pallidum that will in-fluence the atlas-based navigation 2. Existing lesions in close proximity (\<5mm) to planned ablation targets 3. Extended anomalies of scalp such as scars, inflammations, etc. 4. Clips or other implanted objects close to (\< 3cm) target 5. Non-MRI-compatible cardiac pacemaker 6. Previous hemorrhages in the brain 7. Uncontrolled arterial hypertension 8. Any coagulopathy or patient under anticoagulant therapy 9. Sensitivity to MRI contrast agents 10. Contraindications to MRI such as non-MRI-compatible implanted devices 11. Large patients not fitting comfortably into the MRI unit (generally \>110kg) 12. Difficulty to lie supine and still for up to 4 hours in the MRI unit or claustrophobia 13. Other known life-threatening systemic disease 14. Patients currently participating or participated in another clinical trial in the last 30 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Precision of lesioning | 3 months | Comparison of size and location of sonicaion lesions on MRI with planning coordinates. |
| Safety measurements | 6 months | Number of Participants with Adverse Events as a Measure of Safety and Tolerability. |
| Lesion characteristics | 3 months | Size of lesions as a function of applied energy/temperature. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Efficacy | 1 year | Pain Scores on the Visual Analog Scale following intervention and at follow-up. |
Countries
Switzerland
Contacts
Primary ContactErnst - Martin, MD
Backup ContactBeat - Werner, MSc
Outcome results
None listed