Статья
Neuroprotective effect of remote ischemic preconditioning in MRI-guided focused ultrasound treatment
Abstract: Introduction — Magnetic resonance imaging-guided focused ultrasound (MRgFUS) is used for ablation of various solid tumors and treatment of neurological diseases. During ablation, brain tissue is injured, resulting in the formation of necrosis and edema zones. Therefore, strategies to minimize brain damage are highly relevant. The goal of our research was to study the neuroprotective effect of remote ischemic preconditioning (RIPC) in the treatment of movement disorders using MRgFUS. Material and Methods — The study design was blinded randomized controlled 2-group trial. Patients were randomly assigned to the IPC group (systolic blood pressure +50 mm Hg, n=42) or sham IPC (sIPC) group (diastolic pressure, n=39) prior to MRgFUS in the mode of 3 cycles of 5 min of preconditioning on the forearm with 5 min of rest between cycles. Results — Following MRgFUS ablation of the ventralis intermediate (VIM) nucleus (gray matter), no differences in lesion size or tremor severity were detected after 2 h between the IPC and sIPC groups. When affecting the pallidothalamic tract (PTT, white matter), in the IPC group, in contrast to the sIPC, the main sizes of the necrotic lesion were significantly smaller after 2 h (frontal dimension, p=0.001; vertical dimension, p=0.037; necrosis lesion volume, p=0.007). Also, after 24 h in the IPC group, the dimensions of the lesion in the PTT were smaller (frontal dimension, p
