Trained as a neurologist, Thilo Hoelscher, M.D., has travelled a long way from his native Germany and his early clinical experiences at that country’s first stroke unit. Now an assistant professor in the Departments of Radiology and Neurosciences at the University of California San Diego, he is Director of its Brain Ultrasound Research Laboratory and working once again on the forefront of medicine.

As a researcher and clinician, Hoelscher has extensive experience in using transcranial ultrasound as a diagnostic tool. In 2007, he learned about high intensity focused ultrasound and became intrigued with its potential to treat the human brain. Since then, he has completed hundreds of preclinical experiments with FUS and concentrated on developing therapies based on a clot-busting technique, transcranial sonothrombolysis. He recently received a multi-million dollar grant from the National Institutes of Health to study sonothrombolysis as a treatment for ischemic stroke.

Hoelscher, who received a FUSF fellowship in 2009, expects to begin pilot clinical trials in 2011 using FUS to treat stroke and believes success is inevitable. “Once it is approved for use in patients, FUS will be without equal – it will have no competition. In treating ischemic stroke, for example, it will dissolve blood clots and restore blood flow within seconds. Drugs like tPA won’t be necessary,” he says.

Hoelscher’s work has moved beyond exploring the thermal ablative capabilities of FUS to assessing its use in precise drug delivery and its ability to induce cellular mechanisms.

Noting that the pace of FUS research is accelerating, he says. “Our work has been booming during the last six to eight months. Everything has started to progress rapidly. Researchers from all over the place are interested in focused ultrasound. Ideas and new collaborations are popping up everywhere.”

Matt Eames - Brain Program Senior Project Engineer

Matt Eames, PhD, is supporting the development of technical infrastructure for clinical FUS.

Eames earned his doctorate in Biomedical Engineering at the University of Virginia in ultrasound. Funding for his position was made possible by an anonymous $1 million donation to the FUSF Brain Program.

Thilo Hölscher M.D.,Visiting Professor at UVA and the Foundation in January

Dr. Thilo Hölscher, Assistant Professor in both Radiology and Neurosciences at the University of California at San Diego, was a guest of the Focused Ultrasound Surgery Foundation and the University of Virginia Department of Neurosurgery on January 13-14, 2010.  Dr. Hölscher attended medical school at the University of Essen in Germany, and did his neurology residency training both there and at the University of Regensburg.  He began a research fellowship in transcranial ultrasound as a Co-Investigator on a P50 NIH grant at the University of California at San Diego in the summer of 2002, where he became an assistant professor in 2004.

Dr. Hölscher is one of the world’s foremost authorities on the use of focused ultrasound in the dissolution of intravascular clot in the treatment of stroke.  He has been instrumental in assisting the Brain Program of the Foundation in developing a comprehensive road map for the pre-clinical studies necessary to complete before beginning pilot clinical trials in patients.

The Foundation has funded Dr. Hölscher in several ways, including work he proposed to generate a skull data base of sound absorption coefficients in 150 skulls of a wide variety of shapes and thicknesses. Shear waves and significant acoustic characteristics are much more significant at lower frequencies (those used for certain transcranial FUS). This is important in offering the possibility of expeditious treatment of stroke patients by omitting the time-consuming process of calculating the correction algorithms for each individual patient.

The combined CT and sound field data acquired will be important to another ongoing FUSF study involving simulations to investigate the possible generation of standing waves or hot spots due to natural focusing within the skull (intracranial reflection). These studies are critical to the overall safety of FUS in the brain.

Dr. Hölscher presented his work to a multidisciplinary audience at UVA Medical Center on January 13, 2010.  He discussed the optimal power range for sonothrombolysis, the potential role of microbubble enhancement and even the possibility of replacing tPA (tissue Plasminogen Activator, a significant cause of hemorrhagic risk as currently employed with stroke patients) with microbubbles, greatly decreasing the risks of treatment.

Illustrating the global nature of his research interests, he finished his talk with a provocative review of the possibilities of inducing heat shock proteins, eradicating Lewy bodies in the treatment of Parkinson’s disease, and even vagal nerve stimulation using FUS to treat the gastrointestinal complications of traumatic brain injury.

Dr. Hölscher was recently awarded NIH RO1 funding as a multi-million dollar grant to study sonothrombolysis in the treatment of stroke.

Discussions about Comparative Effectiveness Research (CER) were not commonplace conversation just over a year ago, but as the Health Care Reform initiative has progressed, it seems that nearly every single day we hear something about CER. Just last week Medical Devices Today published a piece about the amount of NIH Comparative Effectiveness Research funding dollars committed solely to medical-device-focused CER in 2009, and the number was significant at $40 Million. While some of these monies were directed to the establishment of CER centers at different universities, the majority involved short-term (2 year) studies in CER with funding totals for each project approximately $500,000. These short-term projects were funded through the American Recovery and Reinvestment Act of 2009 as part of the economic stimulus package.

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