Modern medicine continues to make significant strides in treating neurodegenerative diseases. Recent clinical trials using focused ultrasound and microbubbles to enhance drug delivery to the brain in patients with Alzheimer’s and Parkinson’s diseases have shown high efficacy in mice. This innovative approach opens new horizons in the fight against such complex diseases.

What is the blood-brain barrier and why is it important?

The blood-brain barrier is a thin membrane that separates the central nervous system (brain and spinal cord) from the circulatory system. It prevents the penetration of molecules with a diameter greater than 400, which protects the brain from toxins but also limits the delivery of medications. This has become one of the key challenges in developing effective treatments for patients with Parkinson’s and Alzheimer’s diseases.

How do microbubbles work?

Microbubbles are synthesized substances the size of a human erythrocyte, which are administered intravenously. They safely circulate in the circulatory system and interact with focused ultrasound, creating temporary openings in the walls of blood vessels. These openings allow medicinal substances to penetrate the brain, which was previously impossible.

Restoration of the Dopaminergic Pathway After Drug Delivery Using Focused Ultrasound

MRI-guideded focused ultrasound and treatment of Parkinson’s disease

Researchers from Columbia Engineering conducted a groundbreaking study using transcranial focused ultrasound in combination with microbubbles They administered neurotrophic factors—molecules that support the growth and survival of neurons, such as glial cell line-derived neurotrophic factor and neurturin These substances previously showed a positive effect in animal models of Parkinson’s disease

Scientists used an early-stage Parkinson’s disease model in mice to test whether the delivery of neurotrophic factors improves in key brain areas such as the substantia nigra and dorsal striatum. The results showed that the combination of focused ultrasound and microbubbles significantly increased drug penetration into the brain, leading to an increase in the number of nerve cells and fibers, as well as elevated dopamine levels.

Opening of the blood-brain barrier using focused ultrasound in the mouse brain

Breakthrough in the Treatment of Neurodegenerative Diseases

«This is the first case where anyone has been able to restore the dopaminergic pathway using available drugs in the early stages of Parkinson’s disease,” noted E. Konofagou, the lead author of the study. This research demonstrates that the use of focused ultrasound in the early stages of Parkinson’s disease not only slows the progression of neurodegeneration but also improves neuronal functions.

The results also open new therapeutic opportunities for treating other central nervous system diseases, such as Alzheimer’s disease. The use of focused ultrasound and microbubbles may become the key to creating effective methods for drug delivery to the brain.

From Past to Future: The Evolution of Treatment

Until recently, patients with Parkinson’s disease did not have such effective treatment methods as levodopa or deep brain stimulation. Today, we actively use MRI-guided focused ultrasound for treating tremor and rigidity. In the near future, this method may become the basis for improving drug delivery in Parkinson’s disease, opening new horizons in the fight against this ailment.

Conclusion

Research using focused ultrasound and microbubbles offers hope to millions of patients worldwide. This innovative method not only improves drug delivery but may also become the foundation for treating the most complex neurodegenerative diseases. We live in an era where research and medicine unite to change patients’ lives for the better.

Sources:

https://www.bme.columbia.edu/news/konofagou-ultrasound-dopaminergic-pathway

Karakatsani, M.E., Wang, S., Samiotaki, G., Kugelman, T., Olumolade, O.O., Acosta, C., Sun, T., Han, Y., Kamimura, H.A., Jackson-Lewis, V. and Przedborski, S., 2019. Amelioration of the nigrostriatal pathway facilitated by ultrasound-mediated neurotrophic delivery in early Parkinson’s disease. Journal of Controlled Release, 303, pp.289-301. https://www.sciencedirect.com/science/article/abs/pii/S0168365919301907

Aleksej Savelev

PhD in Medicine

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