Focused ultrasound shows promise in treating Alzheimer’s disease by reducing amyloid plaques

A new study published in the Journal of Neurosurgery highlights the potential of focused ultrasound technology in the treatment of Alzheimer’s disease. The clinical trial demonstrated that repeatedly opening the blood-brain barrier using focused ultrasound reduced amyloid plaques (protein buildups linked to Alzheimer’s disease) without using anti-Alzheimer’s disease medications. Alzheimer’s. In addition to clearing plaques, the treatment led to improvement in neuropsychiatric symptoms, such as anxiety and irritability, in the majority of participants, which showed promise as a new approach to managing this condition. debilitating.

Jin Woo Chang, a neurosurgeon at Korea University Anam Hospital, led the study alongside neurologists from Yonsei University. The researchers aimed to explore the potential of focused ultrasound to fight Alzheimer’s disease more effectively.

Alzheimer’s disease, a progressive neurodegenerative disorder, is marked by cognitive decline and the buildup of harmful beta-amyloid plaques in the brain. These plaques have been a primary target for therapies, but existing treatments often struggle to effectively deliver drugs to the brain due to the protective blood-brain barrier. Focused ultrasound offers a way to temporarily open this barrier, allowing access to deeper brain regions.

The study recruited six women aged 50 to 85 with Alzheimer’s disease. Participants underwent three blood-brain barrier opening sessions at two-month intervals using the ExAblate Neuro 220 kHz low-intensity focused ultrasound system. A microbubble agent, DEFINITY®, was injected intravenously during the procedure to enhance the effect of ultrasound. This treatment targeted both frontal lobes, focusing on areas of the brain commonly affected by Alzheimer’s disease. Before and after the sessions, researchers used advanced imaging techniques and neuropsychiatric assessments to assess changes in amyloid levels and mental health symptoms.

The study reached an important milestone by safely opening a blood-brain barrier volume of 43.1 cubic centimeters, double the volume of previous trials. Importantly, this approach reduced amyloid plaques in four of six participants. Neuropsychiatric symptoms, measured by the caregiver-administered Neuropsychiatric Inventory, improved in five participants, with a reduction in problems such as agitation, delusions and anxiety. No serious side effects were reported and participants tolerated the procedure well, despite its duration and the need to remain still.

Chang and colleagues pointed out that the study design isolated the effects of opening the blood-brain barrier alone, without combining it with drugs. This allowed them to evaluate whether focused ultrasound could independently reduce amyloid plaques and improve symptoms. The findings suggest that even without medication, plaque removal could have a positive impact on Alzheimer’s symptoms, particularly those related to behavior and mood.

“We developed this protocol to provide optimal benefit and test the technology in larger regions of the brain affected by Alzheimer’s disease,” Chang said. “This study begins to provide a more complete understanding of the effects of opening the blood-brain barrier alone. This will serve as the basis for future trials comparing the potential benefits of adding drugs to affected areas of the brain.

The research was funded by the Focused Ultrasound Foundation.

“This study is critical to the field as a whole,” said Foundation President Neal F. Kassell, MD. “Knowing what happens with the opening of the blood-brain barrier in the absence of medications in patients with Alzheimer’s disease adds a considerable amount of knowledge to the field and lays the foundation for further exploration.” in-depth with multiple mechanisms of action of targeted ultrasound. Focused ultrasound is a new technology currently being explored in patients with Alzheimer’s disease, an area that has remained stagnant in terms of treatment options over the past several decades.

However, the study’s small sample size limits the generalizability of its results. With only six participants, further research with larger groups is needed to confirm these results. Additionally, although neuropsychiatric symptoms improved, the study did not observe significant cognitive improvements, such as better memory or problem-solving skills. This may be because the treatment focused only on the frontal lobes, while regions like the hippocampus, essential for memory, were not targeted.

Moving forward, the researchers plan to build on these results by conducting larger-scale trials. Future studies will explore the effects of opening even larger brain regions and combining focused ultrasound with Alzheimer’s drugs to improve treatment outcomes. These efforts aim to refine the technique and maximize its potential benefits for patients at different stages of the disease.

The study, “Bilateral opening of the frontal blood-brain barrier mediated by repetitive and extended targeted ultrasound for Alzheimer’s disease,” was authored by Byoung Seok Ye, Kyung Won Chang, Sungwoo Kang, Seun Jeon and Jin Woo Chang.