Neuronavigated focused ultrasound for clinical bbb opening in Alzheimer’s and brain cancer patients

Abstract

Treatment of neurological diseases has been at the forefront of medical research for more than a century with limited success due partly to the blood-brain barrier (BBB) that impedes both delivery and biodistribution of the drug delivered. Focused ulltrasound methodologies in conjunction with systemically administered microbubbles have been shown capable of transcranially and transiently opening the BBB over the past two decades. More recently, those efforts have resulted into clinical translation in a variety of brain diseases such as brain tumors and neurodegenerative disease such as Alzheimer’s (AD) and Parkinson’s disease. Our group has been developing a neuronavigated system for opening the BBB at the patient’s bedside safely and efficiently, i.e., within 20–30 min with real-time cavitation mapping. The findings of two clinical studies are reported herein. In the first clinical study, five AD patients underwent FUS with microbubbles with successful BBB opening in their prefrontal cortex while 60% exhibited amyloid reduction in the sonicated hemisphere. In the second clinical study, four diffuse intrinsic pontine glioma (DIPG) subjects underwent BBB opening similar procedure with successful BBB opening in the pons. An overview of the aforementioned findings together with the most recent clinical outcomes will be presented.