Focused Ultrasound Therapy

Clinical Trials SquareFocused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with multiple sclerosis (MS). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound may produce a variety of therapeutic effects to treat multiple sclerosis without surgery. While significant preclinical work has been accomplished, clinical trials must be performed before this technology could be available for patients.

There are at least three mechanisms by which focused ultrasound may help patients with MS.

The first approach is to treat motor symptoms such as tremor by thermal ablation of a target nucleus in the brain, similar to how focused ultrasound treats tremors from other diseases such as essential tremor and Parkinson’s disease. Up to 50% of patients with multiple sclerosis may also suffer from motor symptoms such as tremors. One anecdotal treatment was accomplished in a patient with a disabling hand and upper extremity tremor from multiple sclerosis. It is important to remember that this approach treats the symptoms of movement disorder only and does not treat the underlying cause of the patient’s multiple sclerosis. Other applications of thermal ablation in preclinical rat studies has reported that killing or degrading lymphocytes in cervical lymph nodes may decrease autoimmune attacks that these lymphocytes exert in the brain.

The second mechanism utilizing focused ultrasound can potentially treat the actual underlying cause of multiple sclerosis and preserve the myelin sheath (insulation around nerves) which allows nerves to transmit signals quickly and efficiently. Preclinical work in mouse models have shown that focused ultrasound accelerates remyelinization of nerves.

The third area of research takes advantage of the ability of focused ultrasound to open the blood brain barrier. Focused ultrasound can reversibly and safely allow the blood vessels in the brain to partially “open” the otherwise tight junctions, allowing certain therapies (genes, stem cells, neuroprotective and/or neurorestorative drugs, and medications) to enter the brain in specific areas. Current avenues of research involve delivering these therapies directly from the bloodstream itself or even within or attached to microbubbles.

Advantages:

  • Noninvasive–no surgery or implantable devices
  • Precision targeting–treatment to affected areas minimize damage to healthy tissue
  • Opens BBB safely–enhanced drug delivery and immune effects
  • Can be repeated – no radiation

Clinical Trials

At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of multiple sclerosis.

See a list of laboratory research sites >

Regulatory Approval and Reimbursement

Focused ultrasound treatment for multiple sclerosis is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Máñez-Miró JU, Martínez-Fernández R, Del Alamo M, Pineda-Pardo JA, Fernández-Rodríguez B, Alonso-Frech F, Álvarez-Cermeño JC, Obeso JA. Focused ultrasound thalamotomy for multiple sclerosis-associated tremor. Mult Scler. 2019 Oct 16:1352458519861597. doi: 10.1177/1352458519861597.

B. Fernández-Rodríguez, D. Urso, M. Monje, JA. Pineda-Pardo, M. del Álamo, R. Blazquez-Navarro, F. Hernández-Fernández, L. Vela, F. Alonso-Frech, R. Martínez-Fernández, J. Obeso. MRI-guided Focused Ultrasound thalamotomy for Multiple Sclerosis-associated tremor: A case report [abstract]. Mov Disord.2018; 33 (suppl 2).

Olmstead TA, Chiarelli PA, Griggs DJ, McClintic AM, Myroniv AN, Mourad PD. Transcranial and pulsed focused ultrasound that activates brain can accelerate remyelination in a mouse model of multiple sclerosis. J Ther Ultrasound. 2018 Dec 10;6:11. doi: 10.1186/s40349-018-0119-1. eCollection 2018.

Robert J Motl, Anthony Podkowa, Rita J Miller, Michael L. Oelze. Focused ultrasound therapy of cercial lymph nodes in rats for alleviating EAE. Journal of Cerebral Blood Flow & Metabolism 2017, Vol. 37(4) 1236–1250

Sierra, C, Acosta, A, Chen C, Shih-Ying, W, Karakatsani, M, Bernal M, Konofagou, E. Lipid microbubbles as a vehicle for targeted drug delivery using focused ultrasound- induced blood brain barrier opening. Journal of Cerebral Blood Flow & Metabolism. 2017, Vol. 37(4) 1236–1250

Iodice R, Manganelli F, Dubbioso R. The therapeutic use of non-invasive brain stimulation in multiple sclerosis - a review. Restor Neurol Neurosci. 2017;35(5):497-509. doi: 10.3233/RNN-170735.

Yoo SH, Croce P, Margolin RW, Lee SD, Lee W. Pulsed focused ultrasound changes nerve conduction of earthworm giant axonal fibers. Neuroreport. 2017 Mar 1;28(4):229-233. doi: 10.1097/WNR.0000000000000745.

Darvas F1, Mehić E1, Caler CJ2, Ojemann JG1, Mourad PD3. Toward Deep Brain Monitoring with Superficial EEG Sensors Plus Neuromodulatory Focused Ultrasound. Ultrasound Med Biol. 2016 Aug;42(8):1834-47. doi: 10.1016/j.ultrasmedbio.2016.02.020. Epub 2016 May 13.

Click here for additional references from PubMed.

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