News | Focused Ultrasound Therapy | May 09, 2019

Clinical Trial Explores Opening Blood-Brain Barrier in Fight Against Alzheimer's

MRI-guided imaging helps team identify amyloid buildup that is then targeted with focused ultrasound

Clinical Trial Explores Opening Blood-Brain Barrier in Fight Against Alzheimer's

Vibhor Krishna, M.D., (right) fits David Shorr with a helmet-like device used in a new clinical trial for Alzheimer’s disease at The Ohio State University Wexner Medical Center. The device uses MRI-guided imaging to deliver focused ultrasound to specific areas of the brain to open the blood-brain barrier. Image courtesy of Ohio State University Wexner Medical Center.

May 9, 2019 — A new clinical trial at The Ohio State University Wexner Medical Center and two other sites is testing an innovative procedure that may provide hope in the fight against Alzheimer’s disease.

The non-invasive procedure uses low-intensity focused ultrasound to open the blood-brain barrier, a protective layer that shields the brain from infections or pathogens in the blood. However, this barrier also makes it nearly impossible to deliver therapeutics to the brain to treat neurodegenerative diseases such as Alzheimer’s.

“While it’s protective and beneficial for day-to-day brain function, when we think about therapeutics, the blood-brain barrier poses a significant challenge,” said Vibhor Krishna, M.D., a neurosurgeon at Ohio State Wexner Medical Center. “The focused ultrasound procedure allows us to non-invasively access the brain tissue so treatment can be administered straight to the site of pathology.”

During the surgery in an intraoperative magnetic resonance imaging (MRI)-surgical suite, patient David Shorr of Bexley, Ohio, was awake and alert, giving real-time feedback to the treatment team of neurosurgeon, neurologist, neuropsychologist, researchers and nurses.

MRI-guided imaging allows doctors to target a specific area of the brain where there is a buildup of toxic proteins called amyloid. A head frame holds the patient’s head still during the treatment. The ultrasound transducer — essentially a helmet housing the ultrasound beams — is attached to the head frame. Surrounding the patient’s head is a water bath where cold, degassed water is circulated. This setup helps transmission of 1,000 focused ultrasound beams from the machine through intact skull, all converging  at the exact brain tissue that is being targeted.

During the procedure, the patient’s bloodstream is infused with microbubbles. The focused ultrasound waves are delivered through the helmet-like device, which causes microbubbles in the blood to oscillate and open the blood-brain barrier.

“In this research study, we are not delivering any medications. Our hypothesis is that, by opening the blood brain barrier, a patient’s own immune defense may clear some of those harmful amyloids,”  Krishna said. “If we determine this to be safe, in the next steps we would want to understand the effectiveness and the impact of opening the blood-brain barrier in improving cognitive decline.”

The procedure is performed three times at two-week intervals to allow for as much amyloid clearance as possible. In the future, this method of opening the blood-brain barrier may also be applicable in developing new treatments for brain tumors and epilepsy.

“With 5.8 million Americans living with Alzheimer’s, there’s a critical need to develop novel therapies to treat this devastating disease. With this innovative clinical trial, Ohio State researchers are pioneering potential new treatments,” said K. Craig Kent, M.D., dean of the Ohio State University College of Medicine.

The research team at Ohio State’s Center for Neuromodulation will monitor the patients closely, using neurological exams and neuro-psychological exams to assess language, memory and executive functioning at various intervals for one year following the surgery.

The clinical trial, sponsored by Insightec, will enroll up to 10 patients at Ohio State Wexner Medical Center, Weill Cornell Medicine and West Virginia University Rockefeller Neuroscience Center.

“We’re hopeful it can help him, but we also know maybe it will help somebody else,” said Shorr’s wife, Kim.

For more information: www.wexnermedical.osu.edu

Related Content

International Working Group Releases New Multiple Myeloma Imaging Guidelines

X-ray images such as the one on the left fail to indicate many cases of advanced bone destruction caused by multiple myeloma, says the author of new guidelines on imaging for patients with myeloma and related disorders. Image courtesy of Roswell Park Comprehensive Cancer Center.

News | Computed Tomography (CT) | June 17, 2019
An International Myeloma Working Group (IMWG) has developed the first set of new recommendations in 10 years for...
SyMRI Software Receives FDA Clearance for Use With Siemens MRI Systems
Technology | Magnetic Resonance Imaging (MRI) | June 14, 2019
SyntheticMR announced U.S. Food and Drug Administration (FDA) clearance for clinical use of its SyMRI Image and SyMRI...
A high-fidelity 3-D tractography of the left ventricle heart muscle fibers of a mouse

Figure 1. A high-fidelity 3-D tractography of the left ventricle heart muscle fibers of a mouse from Amsterdam Ph.D. researcher Gustav Strijkers.

News | Magnetic Resonance Imaging (MRI) | June 07, 2019
The Amsterdam University Medical Center has won MR Solutions’ Image of the Year 2019 award for the best molecular...
Study Identifies MRI-Guided Radiation Therapy as Growing Market Segment
News | Image Guided Radiation Therapy (IGRT) | June 06, 2019
Revenues from the magnetic resonance imaging (MRI)-guided radiation therapy systems market exceeded $220 million in...
Ann Arbor Startup Launches Augmented Reality MRI Simulator
Technology | Virtual and Augmented Reality | June 04, 2019
SpellBound, an Ann Arbor startup specializing in augmented reality (AR) tools for children in hospitals, has officially...

Photo courtesy of Philips Healthcare

Feature | Radiology Business | May 31, 2019 | By Arjen Radder
Change is a consistent theme in our world today, no matter where you look.
MRI Metal Artifact Reduction Poses Minimal Thermal Risk to Hip Arthroplasty Implants
News | Magnetic Resonance Imaging (MRI) | May 23, 2019
Clinical metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) protocols at 3 Tesla (3T) on hip...
Henry Ford Hospital's ViewRay MRIdian linear accelerator system allows real-time MRI-guided radiotherapy. Shown is the support staff for this system. In the center of the photo is Benjamin Movsas, M.D., chair of radiation oncology at Henry Ford Cancer Institute. Second from the right is Carrie Glide-Hurst, Ph.D., director of translational research, radiation oncology.

Henry Ford Hospital's ViewRay MRIdian linear accelerator system allows real-time MRI-guided radiotherapy. Shown is the support staff for this system. In the center of the photo is Benjamin Movsas, M.D., chair of radiation oncology at Henry Ford Cancer Institute. Second from the right is Carri Glide-Hurst, Ph.D., director of translational research, radiation oncology.

Feature | Henry Ford Hospital | May 21, 2019 | Dave Fornell, Editor
Henry Ford Hospital thought leaders regularly speak at the radiation oncology and radiology conferences about new res
Videos | Radiation Therapy | May 21, 2019
This is a walk through of the ViewRay MRIdian MRI-guided radiotherapy system installed at ...