Focused Ultrasound Therapy
Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with multiple sclerosis (MS). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound may produce a variety of therapeutic effects to treat multiple sclerosis without surgery. While significant preclinical work has been accomplished, clinical trials must be performed before this technology could be available for patients.
There are at least three mechanisms by which focused ultrasound may help patients with MS.
The first approach is to treat motor symptoms such as tremor by thermal ablation of a target nucleus in the brain, similar to how focused ultrasound treats tremors from other diseases such as essential tremor and Parkinson’s disease. Up to 50% of patients with multiple sclerosis may also suffer from motor symptoms such as tremors. One anecdotal treatment was accomplished in a patient with a disabling hand and upper extremity tremor from multiple sclerosis. It is important to remember that this approach treats the symptoms of movement disorder only and does not treat the underlying cause of the patient’s multiple sclerosis. Other applications of thermal ablation in preclinical rat studies has reported that killing or degrading lymphocytes in cervical lymph nodes may decrease autoimmune attacks that these lymphocytes exert in the brain.
The second mechanism utilizing focused ultrasound can potentially treat the actual underlying cause of multiple sclerosis and preserve the myelin sheath (insulation around nerves) which allows nerves to transmit signals quickly and efficiently. Preclinical work in mouse models have shown that focused ultrasound accelerates remyelinization of nerves.
The third area of research takes advantage of the ability of focused ultrasound to open the blood brain barrier. Focused ultrasound can reversibly and safely allow the blood vessels in the brain to partially “open” the otherwise tight junctions, allowing certain therapies (genes, stem cells, neuroprotective and/or neurorestorative drugs, and medications) to enter the brain in specific areas. Current avenues of research involve delivering these therapies directly from the bloodstream itself or even within or attached to microbubbles.
- Noninvasive–no surgery or implantable devices
- Precision targeting–treatment to affected areas minimize damage to healthy tissue
- Opens BBB safely–enhanced drug delivery and immune effects
- Can be repeated – no radiation
A clinical trial has begun in Canada treating patients with multiple sclerosis induced hand tremor with focused ultrasound. This trial is only open to citizens of Canada.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for multiple sclerosis is not yet approved by regulatory bodies or covered by medical insurance companies.
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