Researchers have developed a noninvasive way to remove faulty brain circuits that could allow doctors to treat debilitating neurological diseases without the need for conventional brain surgery.
From:
University of Virginia Health System
December 3, 2021 -- The UVA team,
together with colleagues at Stanford University, indicate that the approach, if
successfully translated to the operating room, could revolutionize the
treatment of some of the most challenging and complex neurological diseases,
including epilepsy, movement disorders and more. The approach uses
low-intensity focused ultrasound waves combined with microbubbles to briefly
penetrate the brain's natural defenses and allow the targeted delivery of a
neurotoxin. This neurotoxin kills the culprit brain cells while sparing other
healthy cells and preserving the surrounding brain architecture.
"This novel surgical strategy has
the potential to supplant existing neurosurgical procedures used for the
treatment of neurological disorders that don't respond to medication,"
said researcher Kevin S. Lee, PhD, of UVA's Departments of Neuroscience and
Neurosurgery and the Center for Brain Immunology and Glia (BIG). "This
unique approach eliminates the diseased brain cells, spares adjacent healthy
cells and achieves these outcomes without even having to cut into the
scalp."
The Power of PING
The new approach is called PING, and it
has already demonstrated exciting potential in laboratory studies. For
instance, one of the promising applications for PING could be for the surgical
treatment of epilepsies that do not respond to medication. Approximately a
third of patients with epilepsy do not respond to anti-seizure drugs, and
surgery can reduce or eliminate seizures for some of them. Lee and his team,
along with their collaborators at Stanford, have shown that PING can reduce or
eliminate seizures in two research models of epilepsy. The findings raise the
possibility of treating epilepsy in a carefully-targeted and noninvasive manner
without the need for traditional brain surgery.
Another important potential advantage of
PING is that it could encourage the surgical treatment of appropriate patients
with epilepsy who are reluctant to undergo conventional invasive or ablative
surgery.
In a new scientific paper in the Journal
of Neurosurgery, Lee and his collaborators detail the ability of PING to
focally eliminate neurons in a brain region, while sparing non-target cells in
the same area. In contrast, currently available surgical approaches damage all
cells in a treated brain region.
A key advantage of the approach is its
incredible precision. PING harnesses the power of magnetic-resonance imaging
(MRI) to let scientists peer inside the skull so that they can precisely guide
sound waves to open the body's natural blood-brain barrier exactly where
needed. This barrier is designed to keep harmful cells and molecules out of the
brain, but it also prevents the delivery of potentially beneficial treatments.
The UVA group's new paper concludes that
PING allows the delivery of a highly targeted neurotoxin, cleanly wiping out
problematic neurons, a type of brain cell, without causing collateral damage.
Another key advantage of the precision
of this approach is that it can be used on irregularly shaped targets in areas
that would be extremely difficult or impossible to reach through regular brain
surgery. "If this strategy translates to the clinic," the researchers
write in their new paper, "the noninvasive nature and specificity of the
procedure could positively influence both physician referrals for and patient
confidence in surgery for medically intractable neurological disorders."
"Our hope is that the PING strategy
will become a key element in the next generation of very precise, noninvasive,
neurosurgical approaches to treat major neurological disorders," said Lee,
who is part of the UVA Brain Institute.
https://www.sciencedaily.com/releases/2021/12/211203095804.htm
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