Noninvasive ultrasound safely switches the blood-brain barrier in alzheimer's patients

Journal:
Nir Lipsman et al
Published: 2018/07/25
Digital Identification Number: 10.1038/s41467-018-04529-6
Original Link:
WeChat Link:Nature-Communication Paper
published in a clinical trial
. The results showed that the procedure was safe, but the effect of focused ultrasound on improving the clinical symptoms of Alzheimer's disease was inconclusive.1: MRI shows the opening and closing of the blood-brain barrier. Photo: Lipsman et al.
blood-brain barrier (BBB) prevents therapeutic drugs from reaching the brain, and focusing on ultrasound combined microbuses can effectively open the blood-brain barrier to remove amyloid protein from the brains of animal models of Alzheimer's disease. In addition, focused ultrasound can also be implanted to act on patients with brain tumors.
Nir Lipsman of the Sunnybrook Health Science Center in Canada and colleagues used an invasive device to perform
on amyloid aggregation areas in the right frontallobe of the brain in five mild to moderate Alzheimer's patients (three men and two women). The results show that
. However, no significant clinical changes were detected in the patient's amyloid imaging markers or cognitive function.2: s18F- Florbetaben electron emission fault scan. a indicates the baseline, b indicates the scanning status of the sonic degradation method a week later, and c indicates that the target area is shown after the blood-brain barrier is broken. Source: Alfonso Castro
show that the procedure is safe, but whether it can effectively remove amyloid and improve cognitive function still needs to be confirmed by large-scale studies.
summary: Magnetic resonance-guided ultrasound in combine with intravenously injected microbubbles has been shown to transiently open blood-brain barrier, and reduce beta-amyloid and tau pathology in animal models of Alzheimer's disease. Here, we used focused ultrasound to open the blood–brain barrier in five patients with early to moderate Alzheimer's disease in a phase I safety trial. In all patients, the blood–brain barrier within the target volume was safely, reversibly, and repeatedly opened. Opening the blood–brain barrier did not result in serious clinical or radiographic adverse events, as well as no clinically significant worsening on cognitive scores at three months compared to baseline. Beta-amyloid levels were measured before treatment using [18F]-florbetaben PET to confirm amyloid deposition at the target site. Exploratory analysis suggested no group-wise changes in amyloid post-sonication. The results of this safety and feasibility study support the continued investigation of focused ultrasound as a potential novel treatment and delivery strategy for patients with Alzheimer's disease.(Source: Science.com)