One of the newest breakthrough technologies in neurosurgery is the non-invasive neurosurgical system Exablate Neuro, which can be used to treat common neurological conditions: essential tremor, neuropathic pain, and tremor-dominant Parkinson’s disease. Using this system, doctors can perform controlled non-invasive thermal tissue ablation with sub-millimeter precision using focused ultrasound, without ionizing radiation, under real-time MRI guidance.

The procedure affects brain tissue without trepanation and does not require anesthesia. The result is visible immediately after the procedure — the tremor literally disappears “on the table.” The economic benefits of this method are clear: no hospitalization is required, no anesthesia is needed, and no device implantation is necessary.

The ExAblate Neuro system has no equivalent on the medical market, both in terms of operation and in its capabilities for non-invasive brain treatment.
It is used at leading neurosurgical clinics and universities:

• University of Virginia (USA),
• Stanford (USA),
• Rambam Clinic (Israel),
• Mayo Clinic (USA),
• University Hospital Zurich (Switzerland),
• Sunnybrook Research Center (Canada),
• University of Palermo (Italy),
• Yamamoto University (Japan),
• hospitals in Madrid (Spain),
• Seoul College (Korea), etc.

The system is used in more than 100 medical centers. Numerous articles about its effectiveness have been published in leading medical journals worldwide. The technology has been recognized by major medical associations such as ASSFN (American Society for Stereotactic and Functional Neurosurgery) and MDS (International Parkinson and Movement Disorder Society). The system is approved for use in many countries and has FDA (USA) and CE (Europe) certifications.
The focused ultrasound treatment for essential tremor has been included in clinical guidelines in the United Kingdom (NICE – IPG617), Japan, Israel, and Canada. In the USA, UK, Israel, Germany, France, and Switzerland, treatment of essential tremor and tremor-dominant Parkinson’s disease is covered by public healthcare systems and insurance. In Japan, the treatment is fully covered for patients with drug-resistant essential tremor (thalamotomy), as well as for Parkinson’s disease patients (pallidotomy – rigidity, bradykinesia, tremor, postural instability).

The introduction of such a system into clinical practice in the Czech Republic would be highly desirable. Its implementation would allow non-invasive treatment of patients with functional brain disorders and improve their quality of life with minimal budget impact.

Based on economic analysis, the MR-FUS technology has demonstrated statistically significant effectiveness compared to DBS (p < 0.001) and stereotactic radiosurgery (p < 0.001). This is due to the fact that the method does not require hospitalization or anesthesia, shows no significant post-procedure complications, does not require device implantation or replacement, and eliminates the need for repeated visits for parameter adjustments.

Currently, clinical research is ongoing in the treatment of brain tumors and metastases, mental disorders, epilepsy, Alzheimer’s disease, as well as targeted drug delivery via opening of the blood-brain barrier, neuromodulation, sonothrombolysis, staged bilateral thalamotomy, pallidotomy, and subthalamotomy.