The role of MRI-guided focused ultrasound in neurosurgery: A narrative review

Introduction. MRgFUS is a novel technology, which can have profound implications in the current treatment of neurological disorders. Its applications range widely, from the alteration of the blood-brain barrier, ablation of tumours to the treatment of movement disorders. Objective. To review, following thorough research of the literature, the principles of its use in the treatment of neurological diseases and the main reported evidence of its clinical implementation. Material and method. Interrogation of the MEDLINE database, using the PubMed search engine, for the following  MESH words: “MRgFUS”, “FUS” “BRAIN”, from 2000 to the current year. Conclusion. MRgFUS can be safely used today for the treatment of Essential Tremor. New research is warranted for the evaluation of its safety and effectiveness in other neurological disorders

Microvesicles and Microvesicle-Associated microRNAs Reflect Glioblastoma Regression: Microvesicle-Associated miR-625-5p Has Biomarker Potential

Glioblastoma (GB) is the most aggressive and recurrent form of brain cancer in adults. We hypothesized that the identification of biomarkers such as certain microRNAs (miRNAs) and the circulating microvesicles (MVs) that transport them could be key to establishing GB progression, recurrence and therapeutic response. For this purpose, circulating MVs were isolated from the plasma of GB patients (before and after surgery) and of healthy subjects and characterized by flow cytometry. OpenArray profiling and the individual quantification of selected miRNAs in plasma and MVs was performed, followed by target genes’ prediction and in silico survival analysis. It was found that MVs’ parameters (number, EGFRvIII and EpCAM) decreased after the surgical resection of GB tumors, but the inter-patient variability was high. The expression of miR-106b-5p, miR-486-3p, miR-766-3p and miR-30d-5p in GB patients’ MVs was restored to control-like levels after surgery: miR-106b-5p, miR-486-3p and miR-766-3p were upregulated, while miR-30d-5p levels were downregulated after surgical resection. MiR-625-5p was only identified in MVs isolated from GB patients before surgery and was not detected in plasma. Target prediction and pathway analysis showed that the selected miRNAs regulate genes involved in cancer pathways, including glioma. In conclusion, miR-625-5p shows potential as a biomarker for GB regression or recurrence, but further in-depth studies are needed