The following is a summary of “Magnetic Resonance-guided Focused Ultrasound thalamotomy for refractory neuropathic pain: a systematic review and critical appraisal of current knowledge,” published in the June 2023 issue of Neurology by Taranta et al.

For a study, researchers aimed to analyze the existing evidence on the efficacy and safety performance of MRgFUS in the medication of neuropathic pain (NP). 

Investigators identified the study by searching the existing data in the Pubmed and Scopus databases from the beginning to December 2022, and the identification of current studies was registered on the clinicaltrials.gov website. 

They found 9 active studies and 3 published studies. In published research studies, patient numbers ranged from 8 to 46. A total of 66 patients were included and had NP or trigeminal neuralgia. The target lesion was located bilaterally in the posterior region of the thalamic central lateral nucleus.

Through Visual Analogue Scale,  results were analyzed, which showed the variable degree of improvement. Adverse side effects were rare, mild, and temporary (vertigo, paresthesias, and dysesthesias). Intracerebral bleeding as a major adverse effect was reported only in 1 patient. Current studies reported 3 prospective, randomized, sham-controlled crossover trials (RCTs) and 6 observational studies. The failure of more than 3 pharmaceutical therapies in the past and an NP duration of more than 6 months were inclusion criteria. The main proposed target was the thalamus, and assessed outcomes included pain alleviation and procedure accuracy, with follow-up times ranging from 1 week to 1 year.

This systematic study supported the effectiveness and safety of MRgFUS in the clinical therapy of NP.

Source: journals.sagepub.com/doi/full/10.1177/17562864231180729