Spinal Cord Injury 

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Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with spinal cord injury. This novel technology focuses beams of ultrasound energy precisely and accurately on targets in the spinal cord.

How it Works
Recent preclinical research is investigating focused ultrasound for temporary opening of the brain-spinal cord barrier to enhance delivery of genes, growth factors or other agents to improve recovery. 

Researchers at John’s Hopkins University are working to develop a Band-Aid–sized implantable device from concept to human use. If it detects decreased blood flow to the spinal cord, the device would be used to apply focused ultrasound at the proper parameters to improve blood flow, stop inflammation, and offer pain relief or other neuroprotective therapies to prevent further damage to the injured spinal cord tissue.

While significant preclinical work has been accomplished, there is still much to be done before this technology will be widely available.

Advantages
The primary options for treatment of spinal cord injury include structural stabilization of the bones of the spine, but little therapy for the damaged cord itself is currently available.

For certain patients, focused ultrasound could provide a noninvasive means of enhancing blood flow or enhancing the delivery of therapeutic agents to the injured cord to improve recovery.

Clinical Trials

At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of spinal cord injury.

Regulatory Approval and Reimbursement

Focused ultrasound treatment for spinal cord injury is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Wang B, Zhao H, Chen M, Chen S, Liao Y, Tang X, Ao L, Liu Y. Proteomics Reveals the Effect of Low-Intensity Focused Ultrasound on Spasticity After Spinal Cord Injury. Turk Neurosurg. 2022 Feb 8. doi: 10.5137/1019-5149.JTN.37469-21.2. Online ahead of print.

Liao YH, Chen MX, Chen SC, Luo KX, Wang B, Ao LJ, Liu Y. Low-Intensity Focused Ultrasound Alleviates Spasticity and Increases Expression of the Neuronal K-Cl Cotransporter in the L4-L5 Sections of Rats Following Spinal Cord Injury. Front Cell Neurosci. 2022 May 12;16:882127. doi: 10.3389/fncel.2022.882127. eCollection 2022.

Cross CG, Payne AH, Hawryluk GW, Haag-Roeger R, Cheeniyil R, Brady D, Odéen H, Minoshima S, Cross DJ, Anzai Y. Technical Note: Quantification of Blood Spinal Cord Barrier Permeability after Application of Magnetic Resonance Guided Focused Ultrasound in Spinal Cord Injury. Med Phys. 2021 May 17. doi: 10.1002/mp.14947.

Fletcher SP, Choi M, Ramesh R, O’Reilly MA. Focused Ultrasound-Induced Blood-Spinal Cord Barrier Opening Using Short-Burst Phase-Keying Exposures in Rats: A Parameter Study. Ultrasound Med Biol. 2021 Apr 17:S0301-5629(21)00128-9. doi: 10.1016/j.ultrasmedbio.2021.03.007.

Song Z, Ye Y, Zhang Z, et al. Noninvasive, targeted gene therapy for acute spinal cord injury using LIFU-mediated BDNF-loaded cationic nanobubble destruction. Biochem Biophys Res Commun. 2018;496(3):911-920. doi:10.1016/j.bbrc.2018.01.123.

Song Z, Wang Z, Shen J, Xu S, Hu Z. Nerve growth factor delivery by ultrasound-mediated nanobubble destruction as a treatment for acute spinal cord injury in rats. Int J Nanomedicine. 2017 Mar 2;12:1717-1729. doi: 10.2147/IJN.S128848. eCollection 2017.

Weber-Adrian D, Thévenot E, O’Reilly MA, Oakden W, Akens MK, Ellens N, Markham-Coultes K, Burgess A, Finkelstein J, Yee AJ, Whyne CM, Foust KD, Kaspar BK, Stanisz GJ, Chopra R, Hynynen K, Aubert I. Gene delivery to the spinal cord using MRI-guided focused ultrasound. Gene Ther. 2015 Jul;22(7):568-77.

Oakden W, Kwiecien JM, O’Reilly MA, Lake EM, Akens MK, Aubert I, Whyne C, Finkelstein J, Hynynen K, Stanisz GJ. A non-surgical model of cervical spinal cord injury induced with focused ultrasound and microbubbles. J Neurosci Methods. 2014 Sep 30;235:92-100. doi: 10.1016/j.jneumeth.2014.06.018.

Click here for additional references from PubMed.

Early Stage