Electroporation-based Therapies Research Articles

Modeling methods in overlapping electroporation treatments: Pulse number effects on tissue conductivity and ablation area

Irreversible electroporation (IRE) is a non-thermal tissue ablation technique that utilizes high-voltage pulses between electrode pairs to destroy tissue. Numerical models are essential for predicting treatment outcomes and aiding in treatment planning. This paper studies a nonlinear conductivity model (NC) and a multiparametric nonlinear conductivity model (MPNC) to investigate overlapping electroporation treatments using a three-needle electrode configuration. The NC model accounts for the effects of the electric field and temperature on tissue conductivity during multiple pulsed electric field applications. The MPNC model incorporates the influence of pulse number, alongside electric field and temperature, on tissue conductivity. Results indicate that in the MPNC model, tissue conductivity is significantly higher in regions where the electric field intensity is below the threshold for irreversible electroporation, with the maximum difference reaching 0.4S/m. In contrast, tissue conductivity is slightly lower in regions where the electric field intensity exceeds the IRE threshold. Additionally, the MPNC model predicts a smaller area of irreversible electroporation and a larger area of reversible electroporation, with these differences becoming more pronounced as the distance between electrode needles increases. These findings underscore the importance of considering pulse number effects in numerical models to enhance the accuracy of treatment planning for irreversible electroporation-based therapies.

How Impedance Measurements and Imaging Can Be Used to Characterize the Conductivity of Tissues During the Workflow of an Electroporation-Based Therapy.

In this article we investigate the possibility of using needles, which the interventional radiologist inserts near a deep-seated tumor during an electroporation-based therapy, to characterize the electrical conductivity of patient's tissues. Specifically, we propose to exploit voltage/current measurements and imaging that are performed prior to the application of electroporation pulses. The approach is partly based on the concepts of electrical impedance tomography; however, imaging is used to build a specific geometric model and compensate for the lack of information resulting from the small number of electrodes available. 3D canonical and clinical examples, where a few electrodes surround a tumor, demonstrate the feasibility of this method: solving the inverse problem to estimate tissues conductivity converges in a few iterations. For a given error on the measurement, it is also possible to calculate the error on the estimated conductivities. The uncertainty error with clinical data is at best 5% for one of the tissues identified, due to the limitations of the clinical device used. Various improvements to clinical devices are discussed to make the conductivity estimation more accurate but also to extract more information.

The Effects of Interphase and Interpulse Delays and Pulse Widths on Induced Muscle Contractions, Pain and Therapeutic Efficacy in Electroporation-Based Therapies.

Electroporation is used in medicine for drug and gene delivery, and as a nonthermal ablation method in tumor treatment and cardiac ablation. Electroporation involves delivering high-voltage electric pulses to target tissue; however, this can cause effects beyond the intended target tissue like nerve stimulation, muscle contractions and pain, requiring use of sedatives or anesthetics. It was previously shown that adjusting pulse parameters may mitigate some of these effects, but not how these adjustments would affect electroporation's efficacy. We investigated the effect of varying pulse parameters such as interphase and interpulse delay while keeping the duration and number of pulses constant on nerve stimulation, muscle contraction and assessing pain and electroporation efficacy, conducting experiments on human volunteers, tissue samples and cell lines in vitro. Our results show that using specific pulse parameters, particularly short high-frequency biphasic pulses with short interphase and long interpulse delays, reduces muscle contractions and pain sensations in healthy individuals. Higher stimulation thresholds were also observed in experiments on isolated swine phrenic nerves and human esophagus tissues. However, changes in the interphase and interpulse delays did not affect the cell permeability and survival, suggesting that modifying the pulse parameters could minimize adverse effects while preserving therapeutic goals in electroporation.

Harnessing the Electrochemical Effects of Electroporation-Based Therapies to Enhance Anti-tumor Immune Responses

This study introduces a new method of targeting acidosis (low pH) within the tumor microenvironment (TME) through the use of cathodic electrochemical reactions (CER). Low pH is oncogenic by supporting immunosuppression. Electrochemical reactions create local pH effects when a current passes through an electrolytic substrate such as biological tissue. Electrolysis has been used with electroporation (destabilization of the lipid bilayer via an applied electric potential) to increase cell death areas. However, the regulated increase of pH through only the cathode electrode has been ignored as a possible method to alleviate TME acidosis, which could provide substantial immunotherapeutic benefits. Here, we show through ex vivo modeling that CERs can intentionally elevate pH to an anti-tumor level and that increased alkalinity promotes activation of naïve macrophages. This study shows the potential of CERs to improve acidity within the TME and that it has the potential to be paired with existing electric field-based cancer therapies or as a stand-alone therapy.

PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies.

We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies. The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters. Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation (3D Slicer) and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93. A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform. This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.

Immunogenic Cell Death in Electroporation-Based Therapies Depends on Pulse Waveform Characteristics.

Traditionally, electroporation-based therapies such as electrochemotherapy (ECT), gene electrotransfer (GET) and irreversible electroporation (IRE) are performed with different but typical pulse durations-100 microseconds and 1-50 milliseconds. However, recent in vitro studies have shown that ECT, GET and IRE can be achieved with virtually any pulse duration (millisecond, microsecond, nanosecond) and pulse type (monopolar, bipolar-HFIRE), although with different efficiency. In electroporation-based therapies, immune response activation can affect treatment outcome, and the possibility of controlling and predicting immune response could improve the treatment. In this study, we investigated if different pulse durations and pulse types cause different or similar activations of the immune system by assessing DAMP release (ATP, HMGB1, calreticulin). Results show that DAMP release can be different when different pulse durations and pulse types are used. Nanosecond pulses seems to be the most immunogenic, as they can induce the release of all three main DAMP molecules-ATP, HMGB1 and calreticulin. The least immunogenic seem to be millisecond pulses, as only ATP release was detected and even that assumingly occurs due to increased permeability of the cell membrane. Overall, it seems that DAMP release and immune response in electroporation-based therapies can be controlled though pulse duration.

Pulse Parameters and Thresholds for (ir)Reversible Electroporation on Hepatocellular Carcinoma Cells in Vitro.

Hepatocellular carcinoma is a leading cause of cancer-related death in many parts of the world. Traditional treatment options are not always effective. During the promising minimally invasive electroporation-based therapies, biological cell membranes are exposed to an external, sufficiently high, pulsed electric field which creates so-called nanopores into the lipid bilayer of the cell membrane. These pores can either be permanent (irreversible electroporation (IRE)), leading to apoptosis, or repairable (reversible electroporation (RE)), with continued cell function. In tumor therapy, RE is used to increase the diffusion of a chemotherapeutic drug during electrochemotherapy. For both IRE and RE, the success of the treatment is dependent on application of the appropriate electric field. Therefore, this study aims to define the pulse parameters and thresholds for IRE and RE on hepatocellular carcinoma (HepG2) cells in-vitro.In a custom-made in-vitro setup, HepG2 cell viability (0, 5, 10, and 15 min), and the peak temperature were measured after electroporation with the different IRE and RE pulsing protocols, to determine the most successful settings for IRE and RE. A CAM/PI flow cytometric assay was performed to confirm cell permeabilization for the RE pulsing protocols with the highest cell viability.The results indicated that an IRE pulsing protocol (70 pulses, 100 µs pulse length, and 100 ms interval) with an electric field strength of 4000 V/cm was needed as threshold for almost complete cell death of HepG2 cells. A RE pulsing protocol (8 pulses, 100 µs pulse length, and 1000 ms interval) with an electric field strength of 1000 V/cm was needed as threshold for viable and permeabilized HepG2 cells. The low peak temperatures (max 30.1°C for IRE, max 23.1°C for RE) within this study indicated that the reduction in HepG2 cell viability was caused by the applied electric field and was not a result of Joule heating.

Real-Time Temperature Rise Estimation during Irreversible Electroporation Treatment through State-Space Modeling

To evaluate the feasibility of real-time temperature monitoring during an electroporation-based therapy procedure, a data-driven state-space model was developed. Agar phantoms mimicking low conductivity (LC) and high conductivity (HC) tissues were tested under the influences of high (HV) and low (LV) applied voltages. Real-time changes in impedance, measured by Fourier Analysis SpecTroscopy (FAST) along with the known tissue conductivity and applied voltages, were used to train the model. A theoretical finite element model was used for external validation of the model, producing model fits of 95.8, 88.4, 90.7, and 93.7% at 4 mm and 93.2, 58.9, 90.0, and 90.1% at 10 mm for the HV-HC, LV-LC, HV-LC, and LV-HC groups, respectively. The proposed model suggests that real-time temperature monitoring may be achieved with good accuracy through the use of real-time impedance monitoring.

Abstract 3314: Glioblastoma treatment using epigenetic modification induced by microsecond pulsed electric field (µsPEF) exposure

Abstract Epigenetic modifications derived from changes in sub-cellular localization and activity of the post-translational histone modifying enzymes, histone deacetylases (HDACs) are one of the strategies to treat various types of cancer. Aberrant HDAC activity is an indicator of glioblastoma multiforme (GBM), generally leading to hypoacetylation of histones and a transcriptionally repressed chromatin state. Most noticeably, HDAC4 expression increases 61,000% in brain tumors!1 Upregulation of HDAC4 in human glioma cells (U87-MG) stimulates proliferation and invasiveness, making HDAC4 a therapeutic target. The effectiveness of pharmacological HDAC inhibitors is hampered by non-specific targeting and low selectivity, especially in solid tumors like GBM, and by side-effects with systemic delivery, e.g. cardiac toxicity.2 Existing electroporation-based approaches to GBM aim to induce cell death either directly3 or in combination with adjuvants such as excess extracellular calcium4 or chemotherapy drugs5.A cytostatic approach is introduced in which the initial electroporation from non-thermal, localized µsPEF exposure elicits downstream epigenetic responses that decrease cell proliferation, circumventing obstacles experienced by pharmacological agents. Accumulation of HDAC4 in the nucleus of U87-MG cells following exposure to µsPEF is hypothesized to lead in a dose-dependent manner to cell death via apoptosis and decreased proliferation.A BTX GeminiX2 electroporator delivered square-wave µsPEF of 100 µs and 1.45 kV/cm, while the number of pulses (0, 1, 10, 20 pulses, delivered at 1 Hz) were varied to determine thresholds for HDAC4 translocation and proliferation reduction of U87-MG cells. For immunofluorescence assay to track HDAC4 location at 3 h after exposure, cells were cultured and exposed on glass-bottom dishes. For MTT and ATP kinase assays, cells were exposed in electroporation cuvettes and transferred to 96-well plates to measure proliferation at 6, 24 and 72 h after exposure. The ratio of HDAC4 in the nucleus compared to the cytoplasm (N/C ratio) more than doubles after 20 pulses, compared to sham control with no µsPEF exposure. Cell concentration relative to control drops over 90% given 20 pulses. Our data reflect the inhibition of cell proliferation and HDAC4 accumulation in nuclei. Although electroporation-based therapies for GBM have been studied pre-clinically, this study delves further into fundamental mechanisms and optimization of the energy delivered by µsPEF exposure that induces cell death with respect to epigenetic modification. 1. Lee P. et al. Anticancer Res, 35:615, 2015.2. Slingerland M. et al. Anticancer Drugs, 25:140, 2014.3. Rossmeisl J.H. et al. J Neurosurg, 123:1008, 2015.4. Wasson E.M. et al. Ann Biomed Eng, 45:2535, 2017.5. Sharabi S. et al. Sci Rep, 10:2178, 2020. Citation Format: Zahra Safaei, Gary L Thompson. Glioblastoma treatment using epigenetic modification induced by microsecond pulsed electric field (µsPEF) exposure [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3314.

The Evidence of the Bystander Effect after Bleomycin Electrotransfer and Irreversible Electroporation.

One of current applications of electroporation is electrochemotherapy and electroablation for local cancer treatment. Both of these electroporation modalities share some similarities with radiation therapy, one of which could be the bystander effect. In this study, we aimed to investigate the role of the bystander effect following these electroporation-based treatments. During direct CHO-K1 cell treatment, cells were electroporated using one 100 µs duration square wave electric pulse at 1400 V/cm (for bleomycin electrotransfer) or 2800 V/cm (for irreversible electroporation). To evaluate the bystander effect, the medium was taken from directly treated cells after 24 h incubation and applied on unaffected cells. Six days after the treatment, cell viability and colony sizes were evaluated using the cell colony formation assay. The results showed that the bystander effect after bleomycin electrotransfer had a strong negative impact on cell viability and cell colony size, which decreased to 2.8% and 23.1%, respectively. On the contrary, irreversible electroporation induced a strong positive bystander effect on cell viability, which increased to 149.3%. In conclusion, the results presented may serve as a platform for further analysis of the bystander effect after electroporation-based therapies and may ultimately lead to refined application of these therapies in clinics.

Clinical Applications and Immunological Aspects of Electroporation-Based Therapies.

Reversible electropermeabilization (RE) is an ultrastructural phenomenon that transiently increases the permeability of the cell membrane upon application of electrical pulses. The technique was described in 1972 by Neumann and Rosenheck and is currently used in a variety of applications, from medicine to food processing. In oncology, RE is applied for the intracellular transport of chemotherapeutic drugs as well as the delivery of genetic material in gene therapies and vaccinations. This review summarizes the physical changes of the membrane, the particularities of bleomycin, and the immunological aspects involved in electrochemotherapy and gene electrotransfer, two important EP-based cancer therapies in human and veterinary oncology.

Electroporation-Based Therapy for Brain Tumors: A Review.

Electroporation-based therapy (EBT), as a high-voltage-pulse technology has been prevalent with favorable clinical outcomes in the treatment of various solid tumors. This review paper aims to promote the clinical translation of EBT for brain tumors. First, we briefly introduced the mechanism of pore formation in a cell membrane activated by external electric fields using a single cell model. Then, we summarized and discussed the current in vitro and in vivo preclinical studies, in terms of (1) the safety and effectiveness of EBT for brain tumors in animal models, and (2) the blood-brain barrier (BBB) disruption induced by EBT. Two therapeutic effects could be achieved in EBT for brain tumors simultaneously, i.e., the tumor ablation induced by irreversible electroporation (IRE) and transient BBB disruption induced by reversible electroporation (RE). The BBB disruption could potentially improve the uptake of antitumor drugs thereby enhancing brain tumor treatment. The challenges that hinder the application of EBT in the treatment of human brain tumors are discussed in the review paper as well.

Multi-Tissue Analysis on the Impact of Electroporation on Electrical and Thermal Properties.

Tissue electroporation is achieved by applying a series of electric pulses to destabilize cell membranes within the target tissue. The treatment volume is dictated by the electric field distribution, which depends on the pulse parameters and tissue type and can be readily predicted using numerical methods. These models require the relevant tissue properties to be known beforehand. This study aims to quantify electrical and thermal properties for three different tissue types relevant to current clinical electroporation. Pancreatic, brain, and liver tissue were harvested from pigs, then treated with IRE pulses in a parallel-plate configuration. Resulting current and temperature readings were used to calculate the conductivity and its temperature dependence for each tissue type. Finally, a computational model was constructed to examine the impact of differences between tissue types. Baseline conductivity values (mean 0.11, 0.14, and 0.12S/m) and temperature coefficients of conductivity (mean 2.0, 2.3, and 1.2 % per degree Celsius) were calculated for pancreas, brain, and liver, respectively. The accompanying computational models suggest field distribution and thermal damage volumes are dependent on tissue type. The three tissue types show similar electrical and thermal responses to IRE, though brain tissue exhibits the greatest differences. The results also show that tissue type plays a role in the expected ablation and thermal damage volumes. The conductivity and its changes due to heating are expected to have a marked impact on the ablation volume. Incorporating these tissue properties aids in the prediction and optimization of electroporation-based therapies.

Investigation of safety for electrochemotherapy and irreversible electroporation ablation therapies in patients with cardiac pacemakers

BackgroundThe effectiveness of electrochemotherapy of tumors (ECT) and of irreversible electroporation ablation (IRE) depends on different mechanisms and delivery protocols. Both therapies exploit the phenomenon of electroporation of the cell membrane achieved by the exposure of the cells to a series of high-voltage electric pulses. Electroporation can be fine-tuned to be either reversible or irreversible, causing the cells to either survive the exposure (in ECT) or not (in IRE), respectively. For treatment of tissues located close to the heart (e.g., in the liver), the safety of electroporation-based therapies is ensured by synchronizing the electric pulses with the electrocardiogram. However, the use of ECT and IRE remains contraindicated for patients with implanted cardiac pacemakers if the treated tissues are located close to the heart or the pacemaker. In this study, two questions are addressed: can the electroporation pulses interfere with the pacemaker; and, can the metallic housing of the pacemaker modify the distribution of electric field in the tissue sufficiently to affect the effectiveness and safety of the therapy?ResultsThe electroporation pulses induced significant changes in the pacemaker ventricular pacing pulse only for the electroporation pulses delivered during the pacing pulse itself. No residual effects were observed on the pacing pulses following the electroporation pulses for all tested experimental conditions. The results of numerical modeling indicate that the presence of metal-encased pacemaker in immediate vicinity of the treatment zone should not impair the intended effectiveness of ECT or IRE even when the casing is in direct contact with one of the active electrodes. Nevertheless, the contact between the casing and the active electrode should be avoided due to significant tissue heating at the site of the other active electrode for the IRE protocol and may cause the pulse generator to fail to deliver the pulses due to excessive current draw.ConclusionsThe observed effects of electroporation pulses delivered in close vicinity of the pacemaker or its electrodes do not indicate adverse consequences for either the function of the pacemaker or the treatment outcome. These findings should contribute to making electroporation-based treatments accessible also to patients with implanted cardiac pacemakers.

Rapid Impedance Spectroscopy for Monitoring Tissue Impedance, Temperature, and Treatment Outcome During Electroporation-Based Therapies.

Electroporation-based therapies (EBTs) employ high voltage pulsed electric fields (PEFs) to permeabilize tumor tissue; this results in changes in electrical properties detectable using electrical impedance spectroscopy (EIS). Currently, commercial potentiostats for EIS are limited by impedance spectrum acquisition time ( ∼10s); this timeframe is much larger than pulse periods used with EBTs ( ∼1s). In this study, we utilize rapid EIS techniques to develop a methodology for characterizing electroporation (EP) and thermal effects associated with high-frequency irreversible EP (H-FIRE) in real-time by monitoring inter-burst impedance changes. A charge-balanced, bipolar rectangular chirp signal is proposed for rapid EIS. Validation of rapid EIS measurements against a commercial potentiostat was conducted in potato tissue using flat-plate electrodes and thereafter for the measurement of impedance changes throughout IRE treatment. Flat-plate electrodes were then utilized to uniformly heat potato tissue; throughout high-voltage H-FIRE treatment, low-voltage inter-burst impedance measurements were used to continually monitor impedance change and to identify a frequency at which thermal effects are delineated from EP effects. Inter-burst impedance measurements (1.8 kHz - 4.93 MHz) were accomplished at 216 discrete frequencies. Impedance measurements at frequencies above ∼1MHz served to delineate thermal and EP effects in measured impedance. We demonstrate rapid-capture ( 1s) EIS which enables monitoring of inter-burst impedance in real-time. For the first time, we show impedance analysis at high frequencies can delineate thermal effects from EP effects in measured impedance. The proposed waveform demonstrates the potential to perform inter-burst EIS using PEFs compatible with existing pulse generator topologies.

Development of an endothermic electrode for electroporation-based therapies: A simulation study

Cell death mediated by non-thermal mechanisms is an essential characteristic of irreversible electroporation for tumor ablation. However, needle electrodes inherently promote thermal damage immediately adjacent to the electrode/tissue interface, especially in cases when intensive pulsed electric fields are applied to get a large ablation. In this study, we propose utilization of endothermic reactions in the core of clinically used needle electrodes to absorb the heat generated during electroporation, thereby accentuating the nonthermal aspect of irreversible electroporation. In this study, numerical models were developed to determine temperature profiles resulting from a typical irreversible electroporation (IRE) protocol in clinic using either conventional solid electrodes or hollow electrodes filled with NH4NO3 to facilitate an endothermic reaction in the electrode core. The results indicate that the endothermic electrodes can reduce the temperature rise and thermal damage during IRE treatment.

EView: An electric field visualization web platform for electroporation-based therapies

Background and objectivesElectroporation is the phenomenon by which cell membrane permeability to ions and macromolecules is increased when the cell is briefly exposed to high electric fields. In electroporation-based treatments, such exposure is typically performed by delivering high voltage pulses across needle electrodes in tissue. For a given tissue and pulsing protocol, an electric field magnitude threshold exists that must be overreached for treatment efficacy. However, it is hard to preoperatively infer the treatment volume because the electric field distribution intricately depends on the electrodes’ positioning and length, the applied voltage, and the electric conductivity of the treated tissues. For illustrating such dependencies, we have created EView (https://eview.upf.edu), a web platform that estimates the electric field distribution for arbitrary needle electrode locations and orientations and overlays it on 3D medical images. MethodsA client-server approach has been implemented to let the user set the electrode configuration easily on the web browser, whereas the simulation is computed on a dedicated server. By means of the finite element method, the electric field is solved in a 3D volume. For the sake of simplicity, only a homogeneous tissue is modeled, assuming the same properties for healthy and pathologic tissues. The non-linear dependence of tissue conductivity on the electric field due to the electroporation effect is modeled. The implemented model has been validated against a state of the art finite element solver, and the server has undergone a heavy load test to ensure reliability and to report execution times. ResultsThe electric field is rapidly computed for any electrode and tissue configuration, and alternative setups can be easily compared. The platform provides the same results as the state of the art finite element solver (Dice = 98.3 ± 0.4%). During the high load test, the server remained responsive. Simulations are computed in less than 2 min for simple cases consisting of two electrodes and take up to 40 min for complex scenarios consisting of 6 electrodes. ConclusionsWith this free platform we provide expert and non-expert electroporation users a way to rapidly model the electric field distribution for arbitrary electrode configurations.

Towards standardization of electroporation devices and protocols

Cell exposure to high-voltage, short-duration electric pulses can lead to temporary formation of hydrophilic pores in the plasma membrane and an increase in the membrane's permeability which consequently increases the transmembrane transport of molecules that are otherwise unable to cross the membrane. This phenomenon, termed membrane electroporation, is currently an applicable technique in different areas such as biomedicine, biotechnology, food technology and environmental applications. Electroporation pulses are generated by pulse power generators known as electroporators and delivered to the cells (in tissue) via electrodes. The objective of this paper is to review and compare characteristics of electroporation applications and equipment described in the literature and/or present on the market. Since there are no specific standards or regulations that specifically refer to the safety of medical devices with intended medical uses for electroporation, we propose guidelines for the design of clinical electroporators and define minimal requirements for their safe and efficient use which can be incorporated within the particular standards in the future. In order to facilitate the comparison of data obtained by different research groups and to enable reproduction of results under the same conditions, we want to stress the necessity of defining the electroporator's output parameters and tolerances of electroporation parameters for electroporation-based therapies.

Functional Requirements and Quality Assurance Necessary for Successful Incorporation of Electroporation-Based Therapies Into Clinical Practice

Abstract Electroporation-based therapies have a huge potential for implementation into clinical practice in socioeconomically disadvantaged populations. Currently, the price of electroporators and electrodes is relatively high, but custom low budget devices can be developed. In the paper, we describe three most established applications in medicine, with the focus on the basic mechanisms, which should be taken into account during the development process of a clinical electroporator. Also, typical pulse parameters used in each of the described applications are defined. In the second part of the paper, we describe technical functional requirements for a clinical electroporator and safety guidelines, with the focus on medical device standard. At the end of the paper, the focus moves to a more general problematic, such as quality assurance and the importance of measurement during the pulse delivery, which we firmly believe is necessary for successful electroporation.

Temporal Characterization of Blood-Brain Barrier Disruption with High-Frequency Electroporation.

Treatment of intracranial disorders suffers from the inability to accumulate therapeutic drug concentrations due to protection from the blood–brain barrier (BBB). Electroporation-based therapies have demonstrated the capability of permeating the BBB, but knowledge of the longevity of BBB disruption (BBBD) is limited. In this study, we quantify the temporal, high-frequency electroporation (HFE)-mediated BBBD in an in vivo healthy rat brain model. 40 male Fisher rats underwent HFE treatment; two blunt tipped monopolar electrodes were advanced into the brain and 200 bursts of HFE were delivered at a voltage-to-distance ratio of 600 V/cm. BBBD was verified with contrast enhanced T1W MRI (gadopentetate dimeglumine) and pathologically (Evans blue dye) at time points of 1, 24, 48, 72, and 96 h after HFE. Contrast enhanced T1W scans demonstrated BBBD for 1 to 72 h after HFE but intact BBB at 96 h. Histologically, tissue damage was restricted to electrode insertion tracks. BBBD was induced with minimal muscle contractions and minimal cell death attributed to HFE. Numerical modeling indicated that brief BBBD was induced with low magnitude electric fields, and BBBD duration increased with field strength. These data suggest the spatiotemporal characteristics of HFE-mediated BBBD may be modulated with the locally applied electric field.