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.
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)
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.
Along with Principal Investigator and neurologistDr. John Stern, UCLA researchers Alexander Bystritsky and Alex Korb have been awarded a partial grant from theFriedman 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
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.
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.
BRAIN Initiative May Provide Funding Opportunities
FUS researchers may be in a position to gain funding for their neuromodulation research based on aJune 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
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:
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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