Safety Study Using Transcranial MR Guided Focused Ultrasound in the Treatment of Neuropathic Pain

Inclusion Criteria: 1. Male and female patients 18 years and older 2. Clinical indication for a medial thalamotomy 3. Stereotactic targets within thalamus, subthalamus and pallidum 4. All targets supposedly accessible by TcMRgFUS 5. Physically and mentally able to understand the risks of participating in this study and to give written informed consent based on the patient information provided 6. Sufficient proficiency in one of the languages German, French, Italian or English to al-low for verbal communication during all phases of the study 7. Physically and mentally able to communicate the personal condition and all feelings during the TcMRgFUS treatment 8. Physically and mentally able to undergo the TcMRgFUS treatment Exclusion Criteria: 1. Anomalies of brain anatomy, especially in or around thalamus or pallidum that will in-fluence the atlas-based navigation 2. Existing lesions in close proximity (\<5mm) to planned ablation targets 3. Extended anomalies of scalp such as scars, inflammations, etc. 4. Clips or other implanted objects close to (\< 3cm) target 5. Non-MRI-compatible cardiac pacemaker 6. Previous hemorrhages in the brain 7. Uncontrolled arterial hypertension 8. Any coagulopathy or patient under anticoagulant therapy 9. Sensitivity to MRI contrast agents 10. Contraindications to MRI such as non-MRI-compatible implanted devices 11. Large patients not fitting comfortably into the MRI unit (generally \>110kg) 12. Difficulty to lie supine and still for up to 4 hours in the MRI unit or claustrophobia 13. Other known life-threatening systemic disease 14. Patients currently participating or participated in another clinical trial in the last 30 days