摘要：

磁共振引导下聚焦超声（MRgFUS）作为一种非侵入性、实时、精准的神经调控技术，近年逐渐应用于运动障碍疾病的治疗。高强度聚焦超声通过精准热消融丘脑腹中间核、丘脑底核、苍白球内侧部和苍白球丘脑束等关键靶点，改善震颤、肌强直、运动迟缓和异动症，与脑深部电刺激术疗效相当，且避免植入手术及相关并发症。低强度聚焦超声则通过可逆性血脑屏障开放和神经调控，为靶向药物递送和非侵入性神经调控提供新方向。本文综述MRgFUS在特发性震颤、帕金森病、肌张力障碍等疾病中的治疗进展，总结MRgFUS的安全性和围手术期管理要点，并展望MRgFUS与脑机接口等新兴技术融合的发展前景，以期为运动障碍疾病的无创、精准和个体化治疗提供参考。

关键词: 超声疗法, 磁共振成像, 特发性震颤, 帕金森病, 张力障碍, 综述

Abstract:

Magnetic resonance-guided focused ultrasound (MRgFUS) has been increasingly applied to the treatment of movement disorders in recent years as a non-invasive, real-time and precise neuromodulation technology. By inducing precise thermal ablation of key targets including the ventral intermediate nucleus (Vim), the subthalamic nucleus (STN), the globus pallidus internus (GPi), and the pallidothalamic tract (PTT), high-intensity focused ultrasound (HIFU) can significantly improve tremor, myotonia, bradykinesia and dyskinesia, with clinical efficacy comparable to deep brain stimulation (DBS), while avoiding implantation procedures and related complications. Low-intensity focused ultrasound (LIFU) provides novel directions for targeted drug delivery and non-invasive neuromodulation by inducing reversible blood-brain barrier opening and neuromodulation. This review systematically reviews the clinical applications of MRgFUS in essential tremor (ET), Parkinson's disease (PD), dystonia and other movement disorders, summarizes its safety profile and key aspects of perioperative and discusses the future prospects of integrating MRgFUS with emerging technologies such as brain-computer interface (BCI), aiming to provide a comprehensive reference for non-invasive, precise and individualized treatment strategies for movement disorders.

Key words: Ultrasonic therapy, Magnetic resonance imaging, Essential tremor, Parkinson disease, Dystonic disorders, Review

中图分类号: 

• R741.05