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

 Many patients with severe coronavirus disease 2019 (COVID-19) remain unresponsive after surviving critical illness. Investigators led by a team at Massachusetts General Hospital (MGH) now describe a patient with severe COVID-19 who, despite prolonged unresponsiveness and structural brain abnormalities, demonstrated functionally intact brain connections and weeks later he recovered the ability to follow commands

Getty Images

News | Coronavirus (COVID-19) | July 08, 2020
July 8, 2020 — Many patients with severe coronavirus disease 2019 (...
A patient implanted with the Axonics System can undergo MRI examinations safely with radio frequency (RF) Transmit Body or Head Coil under the conditions outlined in the Axonics MRI Conditional Guidelines.

A patient implanted with the Axonics System can undergo MRI examinations safely with radio frequency (RF) Transmit Body or Head Coil under the conditions outlined in the Axonics MRI Conditional Guidelines.

News | Magnetic Resonance Imaging (MRI) | July 02, 2020
July 2, 2020 — Axonics Modulation Technologies, Inc., a medical technology company that has developed and is commerci
This data represents wave 2 of a QuickPoLL survey conducted in partnership with an imagePRO panel created by The MarkeTech Group (TMTG), regarding the effects of COVID-19 on their business

Getty Images

Feature | Coronavirus (COVID-19) | July 01, 2020 | By Melinda Taschetta-Millane
Researchers reviewed results of prostate biopsies on over 3,400 men who had targets identified on prostate MRI and found that the positive predictive value of the test for prostate cancer was highly variable at different sites
News | Prostate Cancer | July 01, 2020
July 1, 2020 — Prostate MRI is an emerging technology used to identify and guide treatment for...
R2* maps of healthy control participants and participants with Alzheimer disease. R2* maps are windowed between 10 and 50 sec21. Differences in iron concentration in basal ganglia are too small to allow visual separation between patients with Alzheimer disease and control participants, and iron levels strongly depend on anatomic structure and subject age. Image courtesy of Radiological Society of North America

R2* maps of healthy control participants and participants with Alzheimer disease. R2* maps are windowed between 10 and 50 sec21. Differences in iron concentration in basal ganglia are too small to allow visual separation between patients with Alzheimer disease and control participants, and iron levels strongly depend on anatomic structure and subject age. Image courtesy of Radiological Society of North America

News | Magnetic Resonance Imaging (MRI) | July 01, 2020
July 1, 2020 — Researchers using magnetic...
In new QuickPoLL survey on imaging during the pandemic, responses were tallied from around 170 radiology administrators and business managers, who are part of an imagePRO panel created by The MarkeTech Group (TMTG), regarding the effects of COVID-19 on their business. TMTG is a research firm specializing in the medical device, healthcare and pharmaceutical industries.
Feature | Coronavirus (COVID-19) | June 30, 2020 | By Melinda Taschetta-Millane
Cardiac MR can offer data above and beyond anatomical imaging, which is the main reason why this system was installed at Baylor Scott White Heart Hospital in Dallas. The system is a dedicated heart MRI scanner.

Cardiac MR can offer data above and beyond anatomical imaging, which is the main reason why this system was installed at Baylor Scott White Heart Hospital in Dallas. The system is a dedicated heart MRI scanner.

News | Pediatric Imaging | June 29, 2020
June 29, 2020 — A type of smart magnetic r...
Neurosurgeon Jason Sheehan, M.D., Ph.D., of UVA Health, is pioneering the use of focused ultrasound to treat glioblastoma, the deadliest brain tumor. Image courtesy of UVA Health

Neurosurgeon Jason Sheehan, M.D., Ph.D., of UVA Health, is pioneering the use of focused ultrasound to treat glioblastoma, the deadliest brain tumor. Image courtesy of UVA Health

News | Focused Ultrasound Therapy | June 23, 2020
June 23, 2020 — An innovativ...
This image of DCE-MRI reveals persistent blood brain barrier disorder in American football players. Using brain imaging techniques and analytical methods, researchers can determine whether football players have CTE by measuring leakage of the blood-brain barrier. Image courtesy of Ben-Gurion University

This image of DCE-MRI reveals persistent blood brain barrier disorder in American football players. Using brain imaging techniques and analytical methods, researchers can determine whether football players have CTE by measuring leakage of the blood-brain barrier. Image courtesy of Ben-Gurion University

News | Magnetic Resonance Imaging (MRI) | June 22, 2020
June 22, 2020 — Chronic traumatic encephalopathy (CTE), a neurodegenerative disease caused by repeated...