Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with traumatic brain injury. 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 clinical mechanism involves neuromodulation, that is aimed a stimulation of desired neural activity. A preclinical mechanism is the temporary opening of the blood brain barrier, which can facilitate the entry of stem cell, where they can multiply and differentiate. While some progress has been made, much work remains before these approaches could be widely available.
The primary options for treatment of traumatic brain injury include initial stabilization measures, followed by specific treatment of the injuries involved. These may include medication and surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
A clinical trial in Los Angeles is looking to use thalamic low intensity focused ultrasound in acute brain injured patients.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for traumatic brain injury is not yet approved by regulatory bodies or covered by medical insurance companies.
Csaba Z, Vitalis T, Charriaut-Marlangue C, Margaill I, Coqueran B, Leger PL, Parente I, Jacquens A, Titomanlio L, Constans C, Demene C, Santin MD, Lehericy S, Perrière N, Glacial F, Auvin S, Tanter M, Ghersi-Egea JF, Adle-Biassette H, Aubry JF, Gressens P, Dournaud P. A simple novel approach for detecting blood-brain barrier permeability using GPCR internalization. Neuropathol Appl Neurobiol. 2021 Feb;47(2):297-315. doi: 10.1111/nan.12665. Epub 2020 Sep 27.
Cain JA, Spivak NM, Coetzee JP, Crone JS, Johnson MA, Lutkenhoff ES, N P CR, Buitrago-Blanco M, Vespa PM, Schnakers C, Monti MM. Ultrasonic Thalamic Stimulation in Chronic Disorders of Consciousness. Brain Stimul. 2021 Jan 16:S1935-861X(21)00009-7. doi: 10.1016/j.brs.2021.01.008.
Shen WB, Anastasiadis P, Nguyen B, Yarnell D, Yarowsky PJ, Frenkel V, Fishman PS. Magnetic Enhancement of Stem Cell-Targeted Delivery into the Brain Following MR-Guided Focused Ultrasound for Opening the Blood-Brain Barrier. Cell Transplant. 2017 Jul;26(7):1235-1246. doi: 10.1177/0963689717715824.
McCutcheon V, Park E, Liu E, Sobhebidari P, Tavakkoli J, Wen XY, Baker AJ. A Novel Model of Traumatic Brain Injury in Adult Zebrafish Demonstrates Response to Injury and Treatment Comparable with Mammalian Models. J Neurotrauma. 2017 Apr 1;34(7):1382-1393. doi: 10.1089/neu.2016.4497. Epub 2016 Dec 20.
McCutcheon V, Park E, Liu E, Sobhe Bidari P, Tavakkoli J, Wen XY, Baker AJ. A novel model of traumatic brain injury in adult zebrafish demonstrates response to injury and treatment comparable with mammalian models. J Neurotrauma. 2016 Sep 20.
Neren D, Johnson MD, Legon W, Bachour SP, Ling G, Divani AA. Vagus Nerve Stimulation and Other Neuromodulation Methods for Treatment of Traumatic Brain Injury. Neurocrit Care. 2016 Apr;24(2):308-19. doi: 10.1007/s12028-015-0203-0.
Fisher J, Huang S, Ye M, Nabili M, Wilent W, Krauthamer V, Myers M, Welle C. Real-Time Detection and Monitoring of Acute Brain Injury Utilizing Evoked Electroencephalographic Potentials. IEEE Trans Neural Syst Rehabil Eng. 2016 Mar 1.
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