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Abstract #1283

First Evidence of sustained reduction of Essential Tremor with MR-Guided Low-Energy Ultrasound Neuromodulation

Nadya Pyatigorskaya1,2, Thomas Bancel3, Benoit Beranger4, Melanie Didier4, Maxime Daniel3, Eric Bardinet4, Mathieu Santin4, Sara Fernandez Vidal4, Cécile Galléa1, Itay Rachmilevitch5, Yeruham Shapira5, Alexandre Dizeux3, David Attali3, Mickael Tanter3, David Grabli6, Marie Vidailhet1, Stephane Lehericy1, Carine Karachi6, Elodie Hainque1, and Jean-Francois Aubry3
1MOVIT team, Sorbonne Université, Inserm U1127, CNRS 7225, Hôpital Pitié-Salpêtriere, ICM, Paris, France, 2Neuroradiology, APHP, Sorbonne universite, Paris, France, 3Inserm U1273, ESPCI Paris, CNRS UMR8361, PSL University, Physics for Medicine Paris, Paris, France, 4Centre de NeuroImagerie de Recherche – CENIR, Sorbonne Université, Inserm U1127, CNRS 7225, Hôpital Pitié-Salpêtriere, ICM, Paris, France, 5Insightec, Tirat Carmel, Israel, 6Sorbonne Université, Inserm U1127, CNRS 7225, Hôpital Pitié-Salpêtriere, ICM, Paris, France

Synopsis

Keywords: MR-Guided Focused Ultrasound, Focused Ultrasound, MRgFUS, neuromodulation, essential tremor, thermometry

Motivation: Transcranial Ultrasound Stimulation (TUS) is a non-invasive technology for brain stimulation, particularly suited for the neuromodulation of deep brain structures.

Goal(s): We investigated the behavioral effects of low-energy TUS in the thalamus in Essential Tremor patients scheduled for MR-guided ultrasound treatment.

Approach: Two targets were tested: the ventral intermediate nucleus of the thalamus (VIM) and the dentato-rubro-thalamic tract (DRT). MRI was used for procedure guidance and monitoring. The effect was recorded using MR-compatible accelerometers.

Results: VIM low-energy neuromodulation induced transient change in tremor power (p-value< 0.001). DRT neuromodulation reduced tremor power (p-value<0.001) with a sustained post-effect, without MR-thermometry exhibiting any significant thermal rise.

Impact: High precision focusing enhanced by state of the art transcranial aberration correction allowed unprecedent transient tremor reduction in Essential Tremor patients following low-energy thalamic ultrasound stimulation under MRI guidance.

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Keywords