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Focused Ultrasound for Treatment of Epilepsy: A Systematic Review and Meta-Analysis of Preclinical and Clinical Studies Publisher Pubmed



Soltani Khaboushan A1, 2 ; Zafari R1 ; Sabahi M3 ; Khorasanizadeh M4 ; Dabbagh Ohadi MA1, 2 ; Flouty O5 ; Ranjan M6 ; Slavin KV7
Authors
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Authors Affiliations
  1. 1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, United States
  4. 4. Department of Neurosurgery, Mount Sinai Hospital, Icahn School of Medicine, New York City, NY, United States
  5. 5. Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, United States
  6. 6. Department of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
  7. 7. Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, United States

Source: Neurosurgical Review Published:2024


Abstract

Various preclinical and clinical studies have demonstrated the neuromodulatory and ablative effects of focused ultrasound (FUS). However, the safety and efficacy of FUS in clinical settings for treating epilepsy have not been well established. This study aims to provide a systematic review of all preclinical and clinical studies that have used FUS for the treatment of epilepsy. A systematic search was conducted using Scopus, Web of Science, PubMed, and Embase databases. All preclinical and clinical studies reporting outcomes of FUS in the treatment of epilepsy were included in the systematic review. Random-effect meta-analysis was performed to determine safety in clinical studies and seizure activity reduction in preclinical studies. A total of 24 articles were included in the study. Meta-analysis demonstrated that adverse events occurred in 13% (95% CI = 2–57%) of patients with epilepsy who underwent FUS. The frequency of adverse events was higher with the use of FUS for lesioning (36%, 95% CI = 4–88%) in comparison to neuromodulation (5%, 95% CI = 0–71%), although this difference was not significant (P = 0.31). Three-level meta-analysis in preclinical studies demonstrated a reduced spike rate in neuromodulating FUS compared to the control group (P = 0.02). According to this systematic review and meta-analysis, FUS can be considered a safe and feasible approach for treating epileptic seizures, especially in drug-resistant patients. While the efficacy of FUS has been demonstrated in several preclinical studies, further research is necessary to confirm its effectiveness in clinical practice and to determine the adverse events. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
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