Neurolase: Laser Neurotherapy

While high-intensity lasers are best known in their applications as precision surgical tools, Laser Neurotherapy Development Labs has discovered the biostimulative value of high energy laser radiation. The Neurolase™ direct high level, monochromatic, continuous-wave optical radiation to pathological tissue to restore and improve function.

I recently had an opportunity to witness my first laser neurotherapy treatment at the Rady Children's Hospital in San Diego. Essentially, this procedure uses controlled delivery of laser light through a diffuse-tip optical fiber to burn away parts of the brain. The special tip allows the laser light to scatter, heating the immediate surround area. With enough heat, the brain matter is destroyed, all without having to cut out large parts of the skull / brain.

The outline of the procedure was as follows:

  1. Patient standard of care (imaging, functional mapping, therapy, etc)
  2. Plan patient treatment and surgery through epilepsy conference
  3. Prep patient for neurosurgery
  4. Calibrate ROSA surgical robot
  5. Drill hole(s) into patient skull and attach skull screw guides
  6. Clear path to inner-most brain region and insert Neurolase optical fiber
  7. Move patient (w/ cables) to MRI scanner
    • The MRI is used to image the cable and track the progress of treatment
  8. Calibrate Neurolase guiding/imaging system
  9. Turn laser on for a few seconds, and assess
  10. Pull optical fiber slightly out to cover a new area
  11. Repeat (9,10) until target area is completely treated

The laser treatment itself lasted at most half an hour. However, the surgery took half a day (neurosurgeons are very careful), and calibrating the Neurolase system took another few hours.

Observing this procedure was interesting in part because of two amazing pieces of technology. First was the ROSA surgical robot, which coregisters high-resolution images of the patient's brain to create a 3D map that surgeons can use to guide their operations. It's a really useful tool for accurately matching their surgical plans to the real world:

Second was the Neurolase system. Both the hardware (a cart with 2 monitors, a laser generator, and a computer) and software (co-registers with MRI to track fiber and heating; even allows warning markers that shut off system if key areas reach dangerous temperatures):

So before I close things out, let's talk about why this therapy was necessary. The patient in question had previously been treated for their epilepsy. Specifically, they already experienced more than one craniotomy (surgical removal of part of the skull, for access to the brain). This probability of complications arising from this procedure increases with each attempt, due to scarring and the strain it places on the body. Furthermore, the part of the brain needed to be treated was difficult to access even with part of the skull removed. Instead, pushing a fiber into the brain through a small drill hole reduces the amount of damage to the skull and is a minimally invasive means of getting into the brain. The controlled heating provided by Neurolase is very tight, allowing removal of mm-sized regions of the brain with very little side-effects.

I think it's pretty neat! Do you? Let me know if you or a loved one has experienced this type of treatment before!