Current clinical investigations of focused ultrasound blood-brain barrier disruption: A review

Abstract

The blood-brain barrier (BBB) presents a formidable challenge in delivering therapeutic agents to the central nervous system. Ultrasound-mediated BBB disruption has emerged as a promising non-invasive technique to enhance drug delivery to the brain. This manuscript reviews fundamental principles of ultrasound-based techniques and their mechanisms of action in temporarily permeabilizing the BBB. Clinical trials employing ultrasound for BBB disruption are discussed, summarizing diverse applications ranging from the treatment of neurodegenerative diseases to targeted drug delivery for brain tumors. The review also addresses safety considerations, outlining the current understanding of potential risks and mitigation strategies associated with ultrasound exposure, including real-time monitoring and assessment of treatment efficacy. Among the large number of studies, significant successes are highlighted thus providing perspective on the future direction of the field.

Keywords: Alzheimer's; Blood-brain barrier; Neuro-oncology; Ultrasound.

Fig. 1

The cumulative number of clinical trials registered on clinicaltrials.gov by year for studies related to ultrasound blood-brain barrier disruption for cancer applications (Cancer), neurodegenerative diseases (NDD), or other applications. Trials found by searching clinicaltrials.gov for the keywords “ultrasound” and “blood-brain barrier” were included and unrelated trials were removed.