New radiology research shows promising results for focused u
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Scientists used MRI scans to show what happens when ultrasound waves target a specific area of Alzheimer's patient's brains. They concluded that this treatment may induce an immunological healing response, a potential breakthrough for a disease that accounts for up to 80% of all dementia cases.

This study by Radiology was aimed to assess imaging effects of focused ultrasound–induced BBB opening in the hippocampus of human participants with early AD and to evaluate fluid flow patterns after BBB opening by using serial contrast-enhanced MRI.

Study participants with early AD recruited to a Health Insurance Portability and Accountability Act–compliant, prospective, ongoing phase II clinical trial underwent three separate focused ultrasound-induced BBB opening procedures that used a 220-kHz transducer with a concomitant intravenous microbubble contrast agent administered at 2-week intervals targeting the hippocampus and entorhinal cortex. Posttreatment effects and gadolinium-based contrast agent enhancement patterns were evaluated by using 3.0-T MRI.

Three women consecutively enrolled in the trial successfully completed repeated focused ultrasound–induced BBB opening of the hippocampus and entorhinal cortex.

--Post-procedure contrast enhancement was clearly identified within the targeted brain volumes, indicating immediate spatially precise BBB opening.

--Parenchymal enhancement resolved within 24 hours after all treatments, confirming BBB closure.

--Transient perivenous enhancement was consistently observed during the acute phase after BBB opening.

--Notably, contrast enhancement reappeared in the perivenular regions after BBB closure.

--This imaging marker is consistent with blood-meningeal barrier permeability and persisted for 24–48 hours before spontaneous resolution. No evidence of intracranial hemorrhage or other adverse effects was identified.

Conclusively, MRI-guided focused ultrasound–induced blood-brain barrier opening was safely performed in the hippocampi of three participants with Alzheimer's disease without any adverse effects. Posttreatment MRI reveals a unique spatiotemporal contrast enhancement pattern that suggests a perivenular immunologic healing response downstream from targeted sites.

Source: https://doi.org/10.1148/radiol.2021200643
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