0 11

Cited 0 times in

Repetitive and extensive focused ultrasound-mediated bilateral frontal blood-brain barrier opening for Alzheimer's disease

Authors
 Byoung Seok Ye  ;  Kyung Won Chang  ;  Sungwoo Kang  ;  Seun Jeon  ;  Jin Woo Chang 
Citation
 JOURNAL OF NEUROSURGERY, Vol.142(5) : 1263-1270, 2025-01 
Journal Title
JOURNAL OF NEUROSURGERY
ISSN
 0022-3085 
Issue Date
2025-01
MeSH
Aged ; Aged, 80 and over ; Alzheimer Disease* / diagnostic imaging ; Alzheimer Disease* / therapy ; Blood-Brain Barrier* / diagnostic imaging ; Female ; Frontal Lobe* / diagnostic imaging ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; Prospective Studies ; Treatment Outcome ; Ultrasonic Therapy* / methods
Keywords
Alzheimer’s disease ; blood-brain barrier opening ; focused ultrasound ; functional neurosurgery
Abstract
Objective: Focused ultrasound (FUS)-mediated blood-brain barrier (BBB) opening is safe and potentially beneficial in patients with Alzheimer's disease (AD) for the removal of amyloid-beta (Aβ) plaques. However, the optimal BBB opening intervals and number of treatment sessions for clinical improvement remain undefined. Therefore, the aim of this study was to evaluate the safety and benefits of repeated and more extensive BBB opening alone.

Methods: In this open-label prospective study, 6 patients with AD were enrolled from June 2022 to July 2023. FUS-mediated BBB opening was performed three times at 2-month intervals targeting the bilateral frontal lobes. 18F-florbetaben positron emission tomography (FBB-PET) was performed before the first procedure and after the third procedure. Patients were administered neuropsychological and neuropsychiatric evaluations.

Results: All 6 participants completed the study without any acute treatment-related adverse events. An extensive area of BBB opening (mean 43.1 cm3), more than twice as large as the opening volume (mean 20 cm3) in the authors' previous study, was confirmed by contrast-enhanced MRI. FBB-PET scans demonstrated a 14.9-Centiloid average decrease in Aβ plaques in 4 of the 6 participants (67%), but the Aβ plaques increased in 2 participants after BBB opening, compared with baseline. No significant changes were observed in the Korean version of the Mini-Mental State Examination in either group. Caregiver-Administered Neuropsychiatric Inventory scores improved in 5 of 6 participants (83%), indicating an improvement in neuropsychiatric symptoms.

Conclusions: This study confirmed the safety and efficacy of more frequent and extensive bilateral frontal BBB opening over multiple sessions in patients with AD. Furthermore, this is the first clinical trial to demonstrate improvement in neuropsychiatric symptoms through BBB opening alone, without concurrent administration of antibody medications.
Full Text
https://thejns.org/view/journals/j-neurosurg/142/5/article-p1263.xml
DOI
10.3171/2024.8.jns24989
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
Yonsei Authors
Kang, Sung Woo(강성우)
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Jeon, Seun(전세운) ORCID logo https://orcid.org/0000-0003-2817-3352
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/206064
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links