Focused transcranial ultrasound for treatment of neurodegenerative dementia

Abstract

Introduction: Preclinical studies support investigation of focused ultrasound for breakdown of cerebral pathologies in neurodegenerative conditions including Alzheimer's disease (AD) and Parkinson's disease (PD).

Methods: A focused transcranial Doppler device with probes (2 MHz, 520 mW/cm²) affixed bilaterally was used to target the hippocampus (AD) or substantia nigra (PD) with functional magnetic resonance imaging navigation for enhanced plaque removal. A total of 22 patients (n = 11 AD, n = 11 PD) underwent 8 consecutive, weekly, 1-hour treatments wherein sleep was encouraged naturally or pharmacologically. Cognitive and motor functioning assessment was carried out using standardized evaluations at baseline and conclusion.

Results: Of all, 62.5% of patients had one or more improved cognitive scores without data incongruence, 87% had stable or improved fine motor scores, and 87.5% had stable or improved gross motor scores. No adverse events were reported.

Discussion: The safety of focused transcranial Doppler and possible enhancement in patient functioning were suggested by outcome data.

Keywords: ASL; Alzheimer's; Cognition; Dementia; Parkinson's; Sleep; Ultrasound.

Fig. 1

Pre– and post– ultrasound arterial spin labeling (ASL) sequences demonstrating a color map of relative blood flow perfusion with red (lower) to yellow (higher) perfusion values, which was registered and superimposed over a T1-weighted MRI of the brain. Four three-panel images demonstrate the results of 2 patients (A and B) (1) immediately before and (2) immediately after one-hour of ultrasound treatment.