Neuro-navigation Systems Find Application in Treatment of Movement Disorders Such As Parkinson's disease and Dystonia
Neuro-navigation systems are used in open cranial surgeries to make precise resection of individual nerves. Neuronavigation involves the use of a hand crank arm that delivers special ultrasonic vibrations to damage areas of interest, as opposed to a drill like an instrument used during open cranial surgeries. It gained popularity during the 1940s, particularly in Germany, France and the U.S., with the development of surgery for the treatment of movement disorders such as Parkinson's disease and dystonia. Increasing investment in neuronavigation has further increased its adoption. In December 2020, ClearPoint Neuro, Inc., a global therapy-enabling platform company providing navigation and delivery to the brain, announced an amendment to its January 2020 secured convertible note financing agreement with Petrichor Healthcare Capital Management and PTC Therapeutics, Inc. The amendment provided for an additional US$ 7.5 million strategic investment from Petrichor.
Neuro-navigation has become widely used due to the fact that it is a much less invasive procedure than traditional open cranial surgeries. The benefit of neuronavigation over other methods is that it can be performed on an outpatient basis. Neuro-navigation systems involve the use of radio frequency transducers, which are attached to the scalp, to deliver ultrasound waves that are able to penetrate the skull and deliver precise excimer laser pulses to the target area. Neuronavigation is an advanced form of open cranial surgical procedure that uses non-surgical and interventional techniques for the purpose of removing or cutting out, particular brain cells. Neuronavigation is often used in association with other diagnostic imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and neuro-imaging technologies. The combined results from these imaging modalities help to determine the location and function of a particular nerve.
There are two basic methods of performing neuronavigation. One method is done with the use of high precision instruments. Neuro-navigation using high precision tumescent technique is done with the assistance of a precision rotor with a headgear containing a phototube. Neurons are immobilized using a solution that includes an amino acid such as Glycine and Magnesium. The high precision equipment is then used to perform the desired action on the targeted area with the use of pulses of light and high-frequency sound waves.
Neuro-navigation can also be performed with the use of non-high precision equipments called cochlear implants. These cochlear implants contain non-intrusive miniature acoustic devices (cmets) made from silicon designed to deliver ultrasound energy to the auditory nerve. Neurons in the human body respond to sound with the aid of acoustic transducers. These cmets are inserted in the auditory canal, so that the electrical current flowing in the direction of the nerve is transformed into sound vibrations that reach the cochlea. The size and location of the cochlea affect the type and intensity of the energy delivered by the ultrasound waves to the auditory nerve.
Neuronavigation can be done using two different methods. Single Shot Neuronavigation, or SPN, wherein a single shot of the ultrasound beam is used to perform the desired procedure and is ideal for cases where the procedure is performed on an outpatient basis, while Single Intravenous Neuromuscular Neuromyeliopsy (SIVN), where a larger quantity of anesthetic fluid is injected into the cranial cavity for neuronavigation, is more suitable for patients undergoing surgery. Single shot Neuronavigation involves the use of a cannula that is inserted into the cranial cavity by the surgeon so as to deliver the ultrasound pulses, which passes through the skull and into the nervous tissue. In Single Intravenous Neuromuscular Neuromyeliopsy, or SIVN, the cochlea is preloaded with an anesthetic solution. The procedure requires fewer tools and the recovery period are relatively shorter.
Neuronavigation is highly beneficial for persons who are paralyzed or have limited range of motion and are left with the option of walking, but need help to perform everyday activities. As the technology advances, the number of patients opting for neuronavigation will rise and it is predicted that in the next ten years, more than two million people will undergo this minimally invasive surgery worldwide. The procedure is minimally invasive, minimally evasive and has the advantages of minimal postoperative pain, less bruising and scarring and faster recovery.
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