Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with dementia. (Please note that Alzheimer’s disease is a specific type of dementia, and it is covered under Alzheimer’s disease). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One mechanism is the temporary loosening of the blood-brain barrier (BBB), which may improve the ability of toxic materials to exit and allow dementia to be treated without surgery. Opening the BBB can also enhance the delivery of therapeutic intravenous exosomes. Another mechanism is to use focused ultrasound to stimulate portions of the brain to have higher activity. While significant work has been accomplished, there is still much to be done before this technology will be widely available.
The primary options for treatment of dementia include medication, but this is of limited effectiveness.
For certain patients, focused ultrasound might provide a more effective alternative to current treatments. Focused ultrasound can reach the desired target without damaging surrounding tissue, and it can be repeated, if necessary.
A clinical trial for patients with mild cognitive impairment or early Alzheimer’s disease is recruiting patients in West Virginia.
A clinical trial is treating patients with neurodegenerative dementia in Los Angeles, California. This study is only recruiting patients by invitation.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for dementia is not yet approved by regulatory bodies or covered by medical insurance companies.
Suggested Reading: Focused Ultrasound: Transforming treatment of Neurodegenerative Diseases August 2022
Yoo SS, Kim E, Kowsari K, Van Reet J, Kim HC, Yoon K. Non-invasive enhancement of intracortical solute clearance using transcranial focused ultrasound. Sci Rep. 2023 Jul 31;13(1):12339. doi: 10.1038/s41598-023-39640-2. PMID: 37524783
Kuo YY, Chen WT, Lin GB, Chen YM, Liu HH, Chao CY. Thermal cycling-hyperthermia ameliorates Aβ25-35-induced cognitive impairment in C57BL/6 mice. Neurosci Lett. 2023 Jun 12;810:137337. doi: 10.1016/j.neulet.2023.137337. PMID: 37315732
Kim E, Van Reet J, Kim HC, Kowsari K, Yoo SS. High Incidence of Intracerebral Hemorrhaging Associated with the Application of Low-Intensity Focused Ultrasound Following Acute Cerebrovascular Injury by Intracortical Injection. Pharmaceutics. 2022 Oct 6;14(10):2120. doi: 10.3390/pharmaceutics14102120.
Pineda-Pardo JA, Gasca-Salas C, Fernández-Rodríguez B, Rodríguez-Rojas R, Del Álamo M, Obeso I, Hernández-Fernández F, Trompeta C, Martínez-Fernández R, Matarazzo M, Mata-Marín D, Guida P, Duque A, Albillo D, Plaza de Las Heras I, Montero JI, Foffani G, Toltsis G, Rachmilevitch I, Blesa J, Obeso JA. Striatal Blood-Brain Barrier Opening in Parkinson’s Disease Dementia: A Pilot Exploratory Study. Mov Disord. 2022 Jun 28. doi: 10.1002/mds.29134.
Gasca-Salas C, Fernández-Rodríguez B, Pineda-Pardo JA, Rodríguez-Rojas R, Obeso I, Hernández-Fernández F, Del Álamo M, Mata D, Guida P, Ordás-Bandera C, Montero-Roblas JI, Martínez-Fernández R, Foffani G, Rachmilevitch I, Obeso JA. Blood-brain barrier opening with focused ultrasound in Parkinson’s disease dementia. Nat Commun. 2021 Feb 3;12(1):779. doi: 10.1038/s41467-021-21022-9.
Lee J, Chang WS, Shin J, Seo Y, Kong C, Song BW, Na YC, Kim BS, Chang JW. Non-invasively enhanced intracranial transplantation of mesenchymal stem cells using focused ultrasound mediated by overexpression of cell-adhesion molecules. Stem Cell Res. 2020 Jan 30;43:101726. doi: 10.1016/j.scr.2020.101726.
Shin J, Kong C, Lee J, Choi BY, Sim J, Koh CS, Park M, Na YC, Suh SW, Chang WS, Chang JW. Focused ultrasound-induced blood-brain barrier opening improves adult hippocampal neurogenesis and cognitive function in a cholinergic degeneration dementia rat model. Alzheimers Res Ther. 2019 Dec 27;11(1):110. doi: 10.1186/s13195-019-0569-x.
Nicodemus NE, Becerra S, Kuhn TP, Packham HR, Duncan J, Mahdavi K, Iovine J, Kesari S, Pereles S, Whitney M, Mamoun M, Franc D, Bystritsky A, Jordan S. Focused transcranial ultrasound for treatment of neurodegenerative dementia. Alzheimers Dement (N Y). 2019 Aug 8;5:374-381. doi: 10.1016/j.trci.2019.06.007. eCollection 2019.
Blackmore DG, Turpin F, Mohamed AZ, Zong F, Pandit R, Pelekanos M, Nasrallah F, Sah P, Bartlett PF, Götz J. Multimodal analysis of aged wild-type mice exposed to repeated scanning ultrasound treatments demonstrates long-term safety. Theranostics. 2018 Nov 29;8(22):6233-6247. doi: 10.7150/thno.27941. eCollection 2018.
Hsu PH, Lin YT, Chung YH, Lin KJ, Yang LY, Yen TC, Liu HL. Focused Ultrasound-Induced Blood-Brain Barrier Opening Enhances GSK-3 Inhibitor Delivery for Amyloid-Beta Plaque Reduction. Sci Rep. 2018 Aug 27;8(1):12882. doi: 10.1038/s41598-018-31071-8.
Eguchi K, Shindo T, Ito K, Ogata T, Kurosawa R, Kagaya Y, Monma Y, Ichijo S, Kasukabe S, Miyata S, Yoshikawa T, Yanai K, Taki H, Kanai H, Osumi N, Shimokawa H. Whole-brain low-intensity pulsed ultrasound therapy markedly improves cognitive dysfunctions in mouse models of dementia – Crucial roles of endothelial nitric oxide synthase. Brain Stimul. 2018 Sep – Oct;11(5):959-973. doi: 10.1016/j.brs.2018.05.012. Epub 2018 May 22.
Nisbet RM, Götz J. Amyloid-β and Tau in Alzheimer’s Disease: Novel Pathomechanisms and Non-Pharmacological Treatment Strategies. J Alzheimers Dis. 2018;64(s1):S517-S527. doi: 10.3233/JAD-179907.
Click here for additional references from PubMed.