- Country: TAIWAN
- Official Title: 主治醫師/副教授
- Department: 臺北榮民總醫院/國立陽明交通大學醫學院
Speech Title
Neuromodulation of FUS in Epilepsy Treatment
聚焦式超音波神經調節效果在癲癇治療的角色
Transcranial focused ultrasound in the treatment of epilepsy
Epilepsy is a chronic neurological disorder and 70% of people with epilepsy (PWE) whose seizures could be well controlled by antiseizure medication. For the remaining 30% of PWE, defined as drug-resistant epilepsy (DRE), surgical treatment and other alternatives are options. Seizure freedom could be achieved in 60-80% of surgically-remediable DRE patients. For patients who are not suitable for resective surgery, neuromodulation is a consideration. The present approved neuromodulation for epilepsy (VNS, DBS, and RNS) need device implantation and it increased the risk of device related adverse effect, for example, bleeding, infection and device break issue. Transcranial focused ultrasound (tFUS) is an emerging treatment for various neurological disorders, and it has been proven for the treatment of essential tremor and Parkinson’s disease by its lesioning effect. tFUS has the potential to be a new solution for DRE. Recent reports in human had demonstrated that seizure frequency reduced after lesioning the key target by tFUS. At our site, two cases has undergone MRI guided tFUS to reduce seizures. The effect of neuromodulations of tFUS was demonstrated by the preclinical data showing seizure activities reduction by tFUS in acute and chronic epilepsy animal models. In our phase 1 study we exhibited the intracranial EEG alternation after low intensity sonication at the seizure onset targets. In our phase 2 study, the preliminary data showed a seizure reduction 2 months after tFUS treatment. There was no lesioning effect in the post-treatment MRI, nor was no severe adverse effect after treatment of the subjects. It suggested the low intensity tFUS a feasible and safe for treatment of DRE through a neuromodulation effect. Compared to the present neuromodulation methods for DRE, the tFUS has advantages of incisionless procedures, new mechanisms, and access of deep structures. It has potential as an adjunctive treatment in this field.