Focus Feature: Neuromodulation

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FOCUS FEATURE: NEUROMODULATION
 
 
 

This special report highlights the impact of focused ultrasound in the field of neuromodulation.

Researchers are studying its potential for brain mapping, diagnosing and monitoring medical conditions, and treating multiple disorders.

Current techniques to induce neuromodulation include deep brain stimulation, transcranial magnetic stimulation, and other methods. Can FUS join the crowd? Researchers will soon find out. Read about:

Neuromodulation Workshop Creates Roadmap, Eyes Clinical Use

UCLA Researchers Investigate Neuromodulation for Treating Epilepsy

Worldwide Neuromodulation Research

Research Prize Will Advance the Field

BRAIN Initiative May Provide Funding Opportunities

A Neuromodulation Start-up Company: BrainSonix

Gavrilov Book Describes Techniques


 
Is Focused Ultrasound the Future of Neuromodulation?
 
 

Neuromodulation is the reversible stimulation or suppression of neural (brain) activity. Focused ultrasound (FUS) may induce neuromodulation in one of two ways depending on the desired outcome:

  • The mechanical effects of pulsed sequences can reversibly inhibit or stimulate targeted neurons
  • The thermal effects of FUS can temporarily decrease neural function
According to a 2012 report by NeuroInsights, “Nearly 2 billion people worldwide and 100 million people in the United States are affected by a brain or nervous system disorder…Diagnosis of these disorders is rapidly changing as new tools are developed for more objective and personalized assessment and treatment.”

FUS-induced neuromodulation is one of these new tools, and scientists are brainstorming ways to make an impact. Potential applications include:

"If I had to pick one thing that will turn the functional neurosurgery field  around, it would be neuromodulation using focused ultrasound."

– Walter J. Koroshetz, MD, Deputy Director of the National Institute of Neurological Disorders and Stroke.

Brain Mapping

  • Verifying targets for lesioning
  • Mapping both deep and shallow functional areas in the brain and determining how they are interrelated
  • Mapping the eloquent areas of the brain (speech, language, sensory, and motor functions) prior to resection
  • Discovering neurodiagnostic biomarkers for conditions like autism, schizophrenia, bipolar disorder, and attention deficit hyperactivity disorder (ADHD)

Monitoring and Diagnosis

Treating

  • Suppressing epileptic seizures by lowering tissue excitability
  • Suppressing the symptoms of psychiatric conditions like obsessive compulsive disorder, depression, anxiety, and obesity
  • Controlling cancer pain using reversible nerve blocks or thalamic neuromodulation
 
 
 
 
 

Neuromodulation workshop participants

 
Workshop Participants Create Neuromodulation Roadmap, Set Sights on Clinical Use

“This is a very important field that can benefit from the unique model and atmosphere driven by the Foundation's vision for collaboration between clinicians, academia, and industry.”

Eyal Zadicario, PhD, Director of Neuro Programs at InSightec

A group of 24 researchers from 14 organizations met March 3-4 in Charlottesville to inventory the current state of the field, identify important applications, and chart a course for the first clinical use of FUS–induced neuromodulation. Participants represented academia, industry, government, and the Foundation.

The workshop produced several important outcomes, including a White Paper that outlines a roadmap with timelines, milestones, and the responsibilities necessary to achieve first clinical use.

READ MORE ABOUT THE OUTCOMES OF THE WORKSHOP ►

 

John Stern, MD

Alexander Bystritsky, MD, PhD and Alex Korb, PhD

 
UCLA Researchers Investigate the Use of Neuromodulation to Treat Epilepsy


Can neuromodulation reduce the excitability of neurons and therefore reduce seizures in epilepsy patients? That is the question that scientists at the University of California Los Angeles (UCLA) Semel Institute are asking.

Along with Principal Investigator and neurologist Dr. John Stern, UCLA researchers Alexander Bystritsky and Alex Korb have been awarded a partial grant from the Friedman Foundation to study the use of the BrainSonix neuromodulation system in the treatment of medication resistant temporal lobe epilepsy (TLE). TLE is the most common form of epilepsy and often does not fully respond to medications. When medications are not effective, temporal lobe surgical resection is the standard treatment; however, surgery is not always fully effective and not all patients are candidates for surgery.

BrainSonix received FDA approval to test their low-intensity focused ultrasound pulsation (LIFUP) device to noninvasively treat TLE. The study aims to:

  • test the safety and feasibility of the LIFUP device
  • determine whether FUS can be used to stimulate or suppress brain activity in patients with epilepsy
  • test the hypothesis that FUS brain stimulation or suppression will be visible with fMRI

Patients who are interested in this study can find complete information on www.clinicaltrials.gov.

READ MORE ABOUT THE DEVELOPMENT OF LIFUP ►

 

 
Worldwide Neuromodulation Research

While UCLA is starting a clinical trial with FUS-induced neuromodulation, the field is growing, with at least 16 centers around the world active in laboratory research. These investigators are advancing the field on several fronts -- from clinical targeting to neurodiagnostics to treating pain and psychiatric disorders.

READ STUDY BRIEFS ►

 
 
 

 
Clinical Research Prize Encourages Progress

The Focused Ultrasound Foundation will award a clinical neuromodulation research prize to the first investigator or team of investigators to elicit transient sensory symptoms or tremor suppression using non-thermal FUS neuromodulation during a patient treatment.

The cash prize for determining sonication parameters in humans will be $25,000 if achieved before October 1, 2014 or $15,000 if achieved before January 1, 2015.

ABOUT THE PRIZE AND HOW TO APPLY ►

 
 
 

 
BRAIN Initiative May Provide Funding Opportunities

FUS researchers may be in a position to gain funding for their neuromodulation research based on a June 2014 announcement from the NIH that they intend to increase federal funding to $4.5 billion between 2016-2026 for research that will:

  • map the circuits of the brain
  • measure the fluctuating patterns of electrical and chemical activity flowing within those circuits
  • understand how their interplay creates our unique cognitive and behavioral capabilities

The Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative invested $40 million in 2014, and $100 million has been requested for NIH’s component of the initiative in the 2015 budget. Funding opportunities are announced on their website.

 
 
 

 

 

 
A Neuromodulation Start-up Company: BrainSonix

BrainSonix, Inc. is a privately held California company that is developing therapeutic FUS neuromodulation for the treatment of mental and neurological disorders. Their proprietary and noninvasive medical device uses low-intensity focused ultrasound pulsations to therapeutically modulate brain function to treat brain disorders.

Through collaboration with Harvard Medical School and UCLA, BrainSonix designed their single transducer, 450-watt system and performed preclinical feasibility studies. The company believes its technology and associated services can be developed for the treatment of:

  • psychiatric disorders (depression, anxiety disorder, obsessive compulsive disorder, autism)
  • neurological targets (epilepsy, Parkinson's disease, essential tremor, Huntington's disease)
  • medical problems (pain, obesity, endocrine illnesses)
  • research (scientific devices for brain mapping, animal and in-vitro experiments)

The company was founded by Dr. Alexander Bystritsky, and is managed by Dr. Bystritsky along with John Marlow.

 
 
 

Leonid R. Gavrilov, DSc, PhD

 
Gavrilov Book Describes Techniques

 
 

A newly published book entitled the Use of Focused Ultrasound for Stimulation of Various Neural Structures and written by Leonid R. Gavrilov, DSc, PhD, describes the use of FUS for neuromodulation of neural structures. Dr. Gavrilov is an internationally recognized ultrasound specialist and a pioneer in the use of this technique.

A Principal Research Scientist at the N.N. Andreyev Acoustics Institute in Moscow, Russia, Dr. Gavrilov has authored five books, 150 papers, and 18 patents related to this field. In 1988, he received the History of Medical Ultrasound Pioneer Award. The new text is published by Nova Science Publishers.
 
 
 
 
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