University of Virginia School of Medicine researchers have created a noninvasive way to remove brain circuits that are not functioning properly that could enable doctors to treat neurological disorders that are debilitating without the need for traditional brain surgery.
UVA has created a novel method of brain surgery that removes neuronal problems without causing collateral damage. Image Credit: UVA Health
The UVA team and Stanford University colleagues indicate that this approach could revolutionize the treatment for certain of the most difficult neurological diseases , including epilepsy and movement disorders. The approach uses low-intensity focused ultrasound waves and microbubbles to temporarily attack the brain’s defenses to allow the targeted delivery of a neurotoxin. This neurotoxin kills the culprit brain cells, while preserving other healthy cells, and preserving the brain’s structure.
This new surgical technique has the potential to supplant existing neurosurgical procedures used for treating neurological disorders that aren’t responding to medications. This unique approach eliminates brain cells that are damaged, and spares adjacent healthy cells and achieves these outcomes without having to cut into the scalp.”
Kevin S. Lee, PhD, Researcher, UVA’s Departments of Neuroscience and Neurosurgery and Center for Brain Immunology and Glia (BIG)
The potential and power of PING
The new method is referred to as “PING” and has already produced promising results in laboratory research. For instance, one of the promising applications of PING is for the surgical treatment of epilepsies that don’t respond to medications. About a third of epilepsy patients do not respond to antiseizure drugs. Surgery may reduce or eliminate seizures in certain instances. Lee and his team, along with their collaborators from Stanford, have shown that PING can decrease or eliminate seizures in two epilepsy research models. The results raise the possibility of treating epilepsy in a targeted and noninvasive manner without the need for traditional brain surgery.
Another benefit that could be derived from PING is that it could help in the treatment of patients suffering from epilepsy who are hesitant to undergo traditional surgical procedures, such as ablative or invasive.
Lee and his coworkers discuss the power of PING in a region of the brain to selectively kill neurons while protecting other cells. This is based on a new scientific paper published in the Journal of Neurosurgery. Contrary to this, all current surgical procedures cause damage to the brain’s entire region.
The method’s remarkable precision is an important benefit. PING harnesses the power of magnetic resonance imaging (MRI) to let researchers look into the skull so that they can precisely guide sound waves to let the body’s blood-brain barrier precisely where it is needed. This barrier is designed to keep harmful cells and molecules out of the brain however, it also blocks the delivery of potentially beneficial treatments.
The UVA group’s latest research concludes that PING allows the delivery of a precisely targeted neurotoxin, cleanly wiping out the problematic neurons, a kind of brain cell, but without causing collateral harm.
Another benefit of the precision of this approach is that it can be used on targets with irregular shapes in areas that would be extremely difficult or impossible to reach by regular brain surgery. “If this approach is applied to the clinic,” the researchers write in their new paper, “the noninvasive nature and specificity of the procedure can positively impact the physician referrals for and patient confidence in surgery for medically intractable neurological diseases.”
Lee who is a part of the UVA Brain Institute, said, “Our hope is, that the PING strategy will become a key component in the next generation very precise, noninvasive neurosurgical strategies to treat major neurological disorders.”
University of Virginia Health System
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