First neuropathic pain patient in US receives MRI focused ultrasound treatment

A pilot study conducted by researchers at the University of Maryland Medical Center, in Baltimore has successfully treated the first U.S. patient using MRI-guided focused ultrasound for chronic neuropathic pain, according to a university press release published Oct. 28.  

“If we can interrupt or carefully destroy the nucleus in the brain responsible for processing and amplifying pain signals, then we can disrupt this network and stop the neuropathic pain,” lead author Dheeraj Gandhi, director of neurointerventional radiology at the University of Maryland Medical Center, said in a prepared statement.  

Gandhi and colleagues performed the three-hour procedure on a 56-year-old female from Kansas City, Missouri who had been suffering from chronic neuropathic pain in her leg for the last eight years. She reportedly tried every treatment available—from nerve stimulators to narcotics—only to find they would either temporarily relive pain or not at all, according to the press release.  

The benefit of MRI-guided focused ultrasound is it doesn’t use radiation or require invasive surgery. For this method, acoustic energy is used to ablate cells within a patient's body.  

With MRI, the researchers were able to determine an appropriate target inside the patient’s brain and create a heat map of where to aim the acoustic energy onto the patient's skull.  

“We have pioneered a technique for high-resolution structural imaging of the thalamus and brain, which allows us to perfectly localize and target the nucleus responsible for amplifying the neuropathic pain network,” Gandhi said, who noted that a personalized approach using this technique is necessary for each patient due to differing skull shapes and brain structures.  

Once doctors were sure they had identified the correct target, they increased the temperature and created bilateral lesions with the ultrasound transducer which converts sound energy to heat energy. This then successfully destroyed the patient’s part of the brain responsible for sending pain signals to their hip and leg, according to the release.  

In the future, the researchers hope to hold larger trials to expand the use of the method to help alleviate other types of neuropathic pain.