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Using Sound Waves For Outpatient Neurosurgery
eldavojohn writes "Got a piece of malfunctioning brain tissue in your head? Want to avoid messy lobotomies and skull saws? Well, you're in luck; a study shows that acoustic waves can do the trick and will hopefully treat patients with disorders like Parkinson's disease. A specialist said, 'The groundbreaking finding here is that you can make lesions deep in the brain — through the intact skull and skin — with extreme precision and accuracy and safety.' They focus beams on the part of the brain needing treatment and it absorbs the energy, which turns to heat. The temperature hits about 130 F, and they can burn 10 cubic millimeters at a time. Using an MRI to see areas of heat, they can watch the whole time and target only what needs to be burned. The study consisted of nine subjects suffering from chronic pain that did not subside with medication (normally they need to go in and destroy a small part of the thalamus on these patients). After the outpatient procedure, all nine reported immediate pain relief and none experienced neurological problems or other side effects after surgery."
Unless, of course, you have the regions overlap.
130 F is right between rare and medium rare. I wonder what well done feels like.
Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
You'd think that an outpatient procedure like this would be considerably cheaper than the traditional alternative. For a while the technology will be expensive, but the cost will come down, whereas the cost of human labor (i.e., of surgeons and nurses) will not. So in the long run, perhaps this is cheaper.
Could this be used on other parts of the body for cancer and such? Since the brain does not feel pain, you would have to use some kind anesthetic on other parts of the body.
whereas the cost of human labor (i.e., of surgeons and nurses) will not.
Eventually though it might. Eventually automated machines can take care of a lot of stuff. While surgeries might have to have more human intervention, eventually all minor procedures and general care-taking could be done via machine. So while for the foreseeable future you would need a human surgeon, in the two weeks you are in the hospital you might not need hardly any other people to take care of you.
Taxation is legalized theft, no more, no less.
You are logically correct. However, you would never get real people to go along with such a system because people quickly go illogical when their own lives, or the lives of loved ones are on the line. We are much more likely to have a healthcare system paid for by a preset percentage of the economy, the size of which will be quite large.
--why?
Actually I find the fact that we just go in there and destroy a relatively large part of the brain as the leading edge technology kind of amazing. The fact that it seems to work is even more amazing. But essentially this is a hammer, made to work on the opposite side of the wall. You still go in there and destroy whatever is there. Just weird to me that this is the cutting edge so far in brain surgery is all. Just goes to show how far we still have to go.
I concur. Chances are that this new kind of acoustic brain surgery will sooner be cheaper than a ticket to a Metallica concert.
Ezekiel 23:20
that I needed to keep the volume down on my headphones and not blast that garbage into my head. I guess one day they'll look around in my skull and find tissue cooked into a rude shape.
I'm curious to know how they control the heat disippation. In fact, there are probably other invasive procedures involving burning away tissue with lasers as well, where I wonder how they protect surrounding tissue from the heat. It seems that in the brain in particular, some tissue would be susceptible to damage by high temperatures, even if that temp doesn't actually burn anything away.
Any ideas, Dr. Slashdot?
blood carries away heat, but not instantly.
if you can add the heat in 1/100 of a second, and it takes the blood a second to get rid of this heat...
and now my ice cream thinks trees are precisely why shoe laces bark the 1812 overture spatula rice mommy.
"I'm just here to regulate funkiness."
Sorry but this comment is just a whole bunch of fail -- first of all, neither you nor I know how this process works. First off, you are complaining about the deficiencies of something we have never been able to do before? You do realize that the alternative is cutting open your skull and digging around in your brain, right? And then it never states in the article that the size is fixed at 10mm3 (although it very well might be) and even if it is, I am fairly certain that they would have figured out a way around this deficiency, like, you know, overlapping treatment regions or something?
To the haters: You can't win. If you mod me down, I shall become more powerful than you could possibly imagine
I think this would mean that you would have to carefully plan your meals -- times, portions, specific foods -- for the rest of your life. Or die of starvation and never even be aware of it.
It would work, sure, but it really strikes me as a case of the cure being worse than the disease. And if you are capable of putting that kind of care into your diet, you can probably lose weight without burning out a part of your brain.
The correlation between ignorance of statistics and using "correlation is not causation" as an argument is close to 1.
Maybe, but unfortunately most morbidly obese people cannot fit into or be supported by the MRI machines that hospitals have. It is quite the reality check when these people have to be sent to the Zoo to make use of the same equipment they use for large animals.
don't worry, the tinfoil should block the acoustic waves
They already use it on some other tumors--I think some uterine tumors, for example. This version is for the brain and has some particular tricky problems associated with it, notably that the skull can absorb sound waves and its density varies--kind of like how when you build a nuke you need to focus the shock waves right, through solid materials of different densities.
(Only on Slashdot could you simplify something by comparing it to building a nuke)
I concur. Chances are that this new kind of acoustic brain surgery will sooner be cheaper than a ticket to a Metallica concert.
Which is appropiate, since both have the potential to damage your brain
No sig for the moment.
For a while the technology will be expensive, but the cost will come down, whereas the cost of human labor (i.e., of surgeons and nurses) will not. So in the long run, perhaps this is cheaper.
I suspect that sometime in the near future (10 to 25 years), that most surgeries will not involve a human being for the operation itself.
For all its worth, I suspect America will never political solve the problem with Universal Healthcare, but technology will eventually fill in the gap.
At the cost of how many lives in the meantime until that day...
"I am the king of the Romans, and am superior to rules of grammar!"
-Sigismund, Holy Roman Emperor (1368-1437)
Try taking ethics. If we followed your slippery slope logic we'd start killing people when they hit retirement age. After all, they'll never again go back to work and 'pay back' their value after they start collecting social security. Same for the mentally retarded, just drown them right?
"Realistically we need to start realizing that not every person DESERVES the best treatment". And who decides that?
New procedures are always expensive, do you think the first x-ray machines were worth the cost to say "yup, you got a broken leg son". Now they are standard practice.
"so costly that society can never regain that investment". Public education is costly, if a kid isn't learning and behaving by second grade should society perform a retroactive abortion? After all without an education they'll just be a burden on society, and its not worth paying for the education if they aren't being productive, why not save the money for the other years of school?
Did you have a 4.0 GPA in school? what about college? How much are you contributing to society now? I'm not so sure I am getting back my investment in you. Most of the education system in the world are funded by tax dollars.
What about no child left behind? Why don't we get real efficient and just let them starve? They'll never pay enough in taxes to 'regain investment'.
Would be nice if they could use this to destroy the two pinpoint spots of brain damage my girlfriend has that cause her epilepsy. She's afraid of surgery (doesn't want her skull opened up, and who can really blame her?) but she would be one to try something like this in a heartbeat.
Actually, as a researcher in the field, controlling cost is one of the motivations behind this method.
Do you have any idea how much open brain surgery costs? It's several days in the hospital, plus a team of surgeons, plus an operating room. All in all, from $50,000 to $200,000. High intensity focused ultrasound (HIFU) doesn't need any of that. There are hopes this could almost be an outpatient type of procedure.
One my childhood friends suffered from epilepsy for many years until as a teenager, he had exploratory brain surgery (in 1988) where they removed a cubic centimeter of diseased tissue. He was in the hospital for a week.
Not every new idea in medicine costs more money.
What springs to mind first is the terrible potential to abuse this technology on political prisoners, criminals, etc.
Depending on how well you pinpoint certain areas of the brain, but I wonder if you can permanently destroy a person's effectiveness at whatever skills the government doesn't want them pursuing. It sounds like this procedure doesn't leave any external evidence, and the internal lesion may not be readily identifiable without biopsy.
"We will release you to your family immediately, but only if you consent to this minor procedure...."
Currently, all brain surgery consists of excising something, implanting something, or making a lesion in something. We do not have the ability to make a repair on anything in the brain. The best we can do is find the part that is malfunctioning and kill it off so it at least won't interfere with the rest.
What this does is avoid the whole drilling holes in the skull part and the infection risk that goes with it.
I'm pretty sure this technique is already in daily use. From what I can tell, it involves rap, subwoofers, and the patient driving by my house at 11:30 p.m.
Well, it'll get cheaper until we finally hit that impending shortage of helium (http://www.wired.com/wired/archive/8.08/helium.html) - you know, that situation where virtually all of the helium in the world comes from one deposit in Texas, and the well's running dry. It's also, at the moment, completely unrecoverable, as when it gasifies and escapes, it simply floats to the farthest reaches of the atmosphere.
When that happens, the price of performing MRI will skyrocket. MRI needs superconducting electromagnets, and when helium (and thus liquid helium) goes, superconductors go too.
So, until we get metallic, or at least, non-ceramic, high-k superconductors, or find a way to recover or synthesize helium (Hi, hydrogen fusion!) ... this, and most other NMR-based technologies, are just going to get more expensive.
As someone who lives with chronic pain, let me say you are so far off the mark.
I do respond to medication, but the only pain-killers that work are very heavy - Fentanyl.
I haven't had a full time job for many years. I never will without advances in the treatment of pain. If a procedure like this may mean I can work again, and pay taxes. Then I can afford expensive medical insurance.
More importantly, my kids then have a Dad who works full-time. They see that working leads to reward. They see that working hard at school can lead to a better life. At the moment my 16 y.o. sees no point in trying, as life can throw a curve ball and fuck you over. So if I could get something closer to a "normal" life, my kids will see me modelling better work-ethics and will be more likely to emulate my success. They see there's a point to trying to achieve their level of personal excellence, earn more money, pay more taxes and have more productive and potentially happier lives.
That's 6 people now pay more taxes.
Now I'm a maths teacher by vocation. If I was able to teach full-time I would be able to show several hundred kids a year that maths is easy, maths is fun, and that they can use it to solve real problems in everyday life. A few of these kids will go on to do amazing things, just because I can do what I am good at doing, and I can do it well. Over say 20 years there would be a significant number of people who have happier lives, earn more money and pay more taxes.
That's say 300 people now pay more taxes.
It's been shown in the literature that children of professionals are significantly more likely to undergo tertiary study and become professionals. So the children of the kids that were inspired to greatness by having a great teacher are more likely to have happier, more productive lives with higher paying jobs.
So there are potentially thousands of people who are paying more taxes, who are making great discoveries, and are generally happier, just because my pain is better managed without putting knives inside my head.
Look past the short-term benefits to the individual, and look at the potential returns to society and humanity as a whole, and the pay-off of a (admittedly) expensive procedure becomes enormous. And the return to the individual who suffers otherwise incurable chronic pain is not something measured in $$. To not wake up crying because I didn't die in my sleep would bloody marvellous. It's the possibility that there will be advances that help me that has kept me from suicide, and I'm not Robinson Crusoe.
no it DOESN'T! what you need is some earplugs, that 'll keep those acoustic waves out of your head.
I don`t get where this meme is coming from. Ive seen it mentioned lots of places...the kooky idea that robots and computer software will soon be doing SURGERY.
Out of all the jobs on this planet, surgery is going to be one of the last ones replaced by automation. Nearly every other form of employment is easier to automate. Surgery is a series of delicate, deliberately chosen steps that requires an enormous pool of knowledge and experience to do successfully. Surgeons go through more years of training than any other job on the planet. The actual physical motions and dexterity have little to do with what makes it difficult : as the Dean of my medical school said, surgery is about knowing when to operate, not doing the procedure itself.
Yes, telepresence bots are used to hold some of the instruments...but that in no way even slightly reduces the need for an educated professional at the controls of the robot.
they're using Britney Spears waves to create the lesions.
Also, we now know what makes the RIAA people brain dead.
First they ignore you. Then they laugh at you. Then they fight you. Then you win. -Gandhi
"During traditional surgery for Parkinson's, for example, the neurosurgeon stimulates the target area with the electrode to make sure he or she has identified the piece of the brain responsible for the patient's motor problems, and then kills that piece of tissue."
I got my PhD in psychology, but the work was done in the Center for Parkinson's Research in the chemistry department. At NIH I worked for a guy that did lots of studies on Parky's, and he loaned me out to other labs doing Parky's work to help develop new data collection and analysis techniques. I did work for a review paper on Parky's research and treatment techniques when I was with the psychiatry department at Yale Medical School. I've worked in surgery doing intra-operative neural monitoring -- I don't hold a knife, but I do hold that probe, test the target areas, and tell the surgeon where he can and can't cut. I know my way around a brain and a good bit about Parky's. That's not to ring my own bell, but is a set up for my response to TFA.
I've never heard of surgery for Parky's. If someone said they were going to have it I'd convince them not to. If a surgeon said they were going to do it, I'd offer to smack his hands. There are so many other things that can be done that it's foolish to kill off perfectly functioning brain tissue (motor area or thalamic circuitry feeding it) just because the circuitry that suppresses all but the desired actions (dopamine carrying inhibitory innervation) is running low on power because its source (substantia nigra) is itself dying off. Quite often the problem resolves itself because the various uninhibited signals wear themselves out fighting against each other, and some motor control can be retained. But if you kill the circuitry, it can't possibly be recovered.
When motor activity must be brought down due to disinhibition allowing random activity to become harmful, you can always do cryo-ablation of the nerve trunk coming off the spinal cord, killing off a small portion of it temporarily. It lasts around 18 months. You can redo it then if the problem returns, or let it recover if not. This is done as outpatient treatment in clinics by anesthesiologists all over, for chronic pain and such. Doing it to motor nerves differs not one iota in principle.
There's plenty of other alternatives, some approved by cross over for treatment of other symptoms, such as hydergine + nootropil conjunct (approved to delay or prevent dementia; helps sensitize the cortex to a lower level of dopamine), and high dose gabapentin to make those neurons that receive the dopamine signal and control cortical pyramidal cell circuitry to make them more effective.
If I ever run across a surgeon that wants to ablate some cortex or otherwise kill off brain tissue to treat a chemically based control signal failure, I'm going to attempt to alter his consciousness on the subject with an experimental technique of my own: corrective phrenology.
For the unlearned, phrenology is the discredited technique of reading the bumps in the various regions on one's head to determine the greater or lesser contributions from those areas to one's collective make up. Corrective phrenology is applying kinetic energy in the form of a good whack in order to change the size of the bumps and so the relative contributions of the areas this is applied to. The technique is discredited because nobody ever proved what areas do what, although we know that applies to the brain. So my technique would be experimental in that I'd have to give a good many whacks in various places to see what accomplishes the job. I'm thinking a Craftsman five pound ball peen cranial impact probe would be an appropriate tool.
"I may be synthetic, but I'm not stupid." -- Bishop 341-B