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

National Imaging Solutions, a recognized leader in medical imaging and radiology solutions, announced it has acquired DynaRad — the oldest manufacturer of portable X-ray systems in the US. This new investment will allow National Imaging Solutions to support its customers by supplying them with DynaRad portable X-ray machines, including a mobile field X-ray device using nanotube technology.
News | Radiology Business | May 11, 2021
May 11, 2021 — ...
New Module Creates a Warped MRI Scan that Matches Real-Time Ultrasound Results (Graphic: Business Wire)

New Module Creates a Warped MRI Scan that Matches Real-Time Ultrasound Results (Graphic: Business Wire)

News | Artificial Intelligence | May 07, 2021
3D aMRI not only provides a stunning look inside the "beating brain", but it can also measure this physiological motion in all directions. Here, the amplitude of brain motion is overlayed for each brain slice and orientation in 3D. Image credit: 3D aMRI method outlined in Abderezaei et al. Brain Multiphysics (2021); Terem et al. Magnetic Resonance in Medicine (2021).

3D aMRI not only provides a stunning look inside the "beating brain", but it can also measure this physiological motion in all directions. Here, the amplitude of brain motion is overlayed for each brain slice and orientation in 3D. Image credit: 3D aMRI method outlined in Abderezaei et al. Brain Multiphysics (2021); Terem et al. Magnetic Resonance in Medicine (2021).

News | Magnetic Resonance Imaging (MRI) | May 06, 2021
May 6, 2021 — Magnetic Resonance Imaging
After radiosurgery concurrent with nivolumab in 59-year-old patient with melanoma BM (patient 1; Supplemental Tables 3 and 5), F-18 FET PET at follow-up 12 weeks after treatment initiation (bottom row) shows significant decrease of metabolic activity (TBRmean, ?28%) compared with baseline (top row), although MRI changes were consistent with progression according to iRANO criteria. Reduction of metabolic activity was associated with stable clinical course over 10 mo. CE = contrast-enhanced. Image created by

After radiosurgery concurrent with nivolumab in 59-year-old patient with melanoma BM (patient 1; Supplemental Tables 3 and 5), F-18 FET PET at follow-up 12 weeks after treatment initiation (bottom row) shows significant decrease of metabolic activity (TBRmean, ?28%) compared with baseline (top row), although MRI changes were consistent with progression according to iRANO criteria. Reduction of metabolic activity was associated with stable clinical course over 10 mo. CE = contrast-enhanced. Image created by N. Galldiks et al., Research Center Juelich, Juelich, Germany.

News | PET Imaging | May 05, 2021
May 5, 2021 — For patients with brain metastases, amino acid ...
Asheville Radiology Associates announced the unveiling of a new brand including a name, logo and website. The adopted name of Asheville Radiology Associates is now ARA Health Specialists (ARAHS). The updated name more closely reflects ARAHS’ role in leading healthcare in Western North Carolina.
News | Radiology Business | May 03, 2021
May 3, 2021 — Asheville Radiology Associates announced the unveiling of a new brand including a name, logo and websit
News | Artificial Intelligence | April 30, 2021
April 30, 2021 — Canon Medical is bringing the power of accessible...
The Women’s Heart Attack Research Program (HARP) study shows combining OCT and cardiac MRI can help detect the underlying cause of heart attacks in women who did not have blocked arteries.

The Women’s Heart Attack Research Program (HARP) study shows combining OCT and cardiac MRI can help detect the underlying cause of heart attacks in women who did not have blocked arteries.

News | Cardiac Imaging | April 30, 2021
April 30, 2021 — In almost 10 percent of...
Using ultra-high field magnetic resonance imaging (MRI) to map the brains of people with #Down_syndrome (#DS), #researchers from #CaseWesternReserveUniversity, #ClevelandClinic, University Hospitals and other institutions detected subtle differences in the structure and function of the #hippocampus—a region of the #brain tied to memory and learning.

Using ultra-high field magnetic resonance imaging (MRI) to map the brains of people with Down syndrome (DS), researchers from Case Western Reserve University, Cleveland Clinic, University Hospitals and other institutions detected subtle differences in the structure and function of the hippocampus—a region of the brain tied to memory and learning.

News | Magnetic Resonance Imaging (MRI) | April 29, 2021
April 29, 2021 — Using...