TABLE 3.
Series or trials of FUS for treatment of epilepsy using low‐intensity FUS
| Series/trial | N | Age, years | Type of FUS device | FUS protocol | Target and Tx goal | SOZ localization | EEG monitor | EEG change | Seizure frequency decrement | Adverse effects |
|---|---|---|---|---|---|---|---|---|---|---|
| Author, year (site) | ||||||||||
| Yamaguchi, 2020 (Japan) 20 | 1 | 26 | MRgFUS (Insightect, ExAblate) | Six sonications at 50–53°C were applied to five target sites | Hypothalamic hamartoma, lesioning | Via image | No | No spikes post‐FUS | Yes, seizure‐free | Nausea and vomiting |
| Abe, 2020 (Japan) 17 | 1 | 36 | MRgFUS (Insightect, ExAblate) | Repetitive, low power, 10–20 s, 42–44°C | MTS, lesioning | Via image | No | N/A | Yes, seizure‐free for 1 year | Dizziness |
| Parker, 2020 (New York, USA) 19 | 2 | – | MRgFUS (Insightect, ExAblate) | N/A | MTS, lesioning | Via image | No | N/A | N/A | No |
| Brinker, 2020 (BWH, USA) 21 | 1 | 26 | PLIFUS | ISPTA: .5–2.25 W/cm2, duty cycle: 36%−50%, 7‐second interstimulations lasting 140s | MTS, modulation | Via image | Yes, scalp EEG | N/A | N/A | No |
| Current study (Taiwan) | 6 | 26–42 | LIFUP (NaviFUS system) | ISPTA: 2.8 W/cm2, .75 MI, duty cycle: 30%, 600 s | SOZ proved via SEEG, modulation | Via SEEG | Yes, SEEG | Yes | 33%, n = 2/6 | Heat and FND, n = 2/6 |
| Clinical trial [recruiting] | ||||||||||
| Stanford, Mayo Clinic, UVA (USA) | 20 | – | MRgFUS (Insightect, ExAblate) | N/A | SOZ proved via noninvasive study, lesioning | Via image | No | – | – | – |
| Ohio State University (USA) | 10 | – | MRgFUS (Insightect, ExAblate model) | N/A | ANT, lesioning | Via image | No | – | – | – |
| BWH (USA) | 10 | – | PLIFUS | ISPTA: .5–2.25 W/cm2, duty cycle: 36%−50%, interstimulation interval: 7 s, 140 s | MTS, modulation | Via image | Yes, scalp EEG | – | – | – |
| UCLA (USA) | 12 | – | LIFUP (BX pulsar 1002) | ISPTA: .2–.3 W/cm2, duty cycle: 5%, 60 s | Temporal lobe, modulation | Via image | Yes, Scalp EEG | – | – | – |
| MGH (USA) | 3 | – | LIFUP (BX pulsar 1002) | ISPTA: .2–.3 W/cm2, duty cycle: 5%, 60 s | Temporal lobe, modulation | Via image | No | – | – | – |
Abbreviations: ANT, anterior nucleus of thalamus; BWH, Brigham and Women's Hospital; EEG, electroencephalographic; FND, functional neurologic disorder; FUS, focused ultrasound; ISPTA, spatial‐peak temporal‐average intensity; LIFUP, low‐intensity focused ultrasound pulsation; MGH, Massachusetts General Hospital; MI, mechanical index; MRgFUS, magnetic resonance‐guided focused ultrasound; MTS, mesial temporal sclerosis; N/A, not available/applicable; PLIFUS, pulsed low‐intensity focused ultrasound; SOZ, seizure onset zone; Tx, treatment; UCLA, University of California, Los Angeles; UVA, University of Virginia.