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Sonogenetics is a non-invasive approach to activating neurons in Caenorhabditis elegans. Nat Commun 2015; 6:8264. [PMID: 26372413 PMCID: PMC4571289 DOI: 10.1038/ncomms9264] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 08/04/2015] [Indexed: 12/30/2022] Open
Abstract
A major challenge in neuroscience is to reliably activate individual neurons, particularly those in deeper brain regions. Current optogenetic approaches require invasive surgical procedures to deliver light of specific wavelengths to target cells to activate or silence them. Here, we demonstrate the use of low-pressure ultrasound as a non-invasive trigger to activate specific ultrasonically sensitized neurons in the nematode, Caenorhabditis elegans. We first show that wild-type animals are insensitive to low-pressure ultrasound and require gas-filled microbubbles to transduce the ultrasound wave. We find that neuron-specific misexpression of TRP-4, the pore-forming subunit of a mechanotransduction channel, sensitizes neurons to ultrasound stimulus, resulting in behavioural outputs. Furthermore, we use this approach to manipulate the function of sensory neurons and interneurons and identify a role for PVD sensory neurons in modifying locomotory behaviours. We suggest that this method can be broadly applied to manipulate cellular functions in vivo. Common optogenetic approaches require surgical procedures to deliver light of specific wavelengths to the target cells. Here the authors demonstrate the use of low-pressure ultrasound as a non-invasive trigger to activate specific neurons in Caenorhabditis elegans and find that the mechanotransduction channel TRP-4 sensitizes cells to the ultrasound stimulus.
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352
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Timbie KF, Mead BP, Price RJ. Drug and gene delivery across the blood-brain barrier with focused ultrasound. J Control Release 2015; 219:61-75. [PMID: 26362698 DOI: 10.1016/j.jconrel.2015.08.059] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/26/2015] [Accepted: 08/31/2015] [Indexed: 12/31/2022]
Abstract
The blood-brain barrier (BBB) remains one of the most significant limitations to treatments of central nervous system (CNS) disorders including brain tumors, neurodegenerative diseases and psychiatric disorders. It is now well-established that focused ultrasound (FUS) in conjunction with contrast agent microbubbles may be used to non-invasively and temporarily disrupt the BBB, allowing localized delivery of systemically administered therapeutic agents as large as 100nm in size to the CNS. Importantly, recent technological advances now permit FUS application through the intact human skull, obviating the need for invasive and risky surgical procedures. When used in combination with magnetic resonance imaging, FUS may be applied precisely to pre-selected CNS targets. Indeed, FUS devices capable of sub-millimeter precision are currently in several clinical trials. FUS mediated BBB disruption has the potential to fundamentally change how CNS diseases are treated, unlocking potential for combinatorial treatments with nanotechnology, markedly increasing the efficacy of existing therapeutics that otherwise do not cross the BBB effectively, and permitting safe repeated treatments. This article comprehensively reviews recent studies on the targeted delivery of therapeutics into the CNS with FUS and offers perspectives on the future of this technology.
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Affiliation(s)
- Kelsie F Timbie
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Brian P Mead
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Richard J Price
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
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353
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Kim HJ, Kim JH, Song YJ, Seo YK, Park JK, Kim CW. Overexpressed Calponin3 by Subsonic Vibration Induces Neural Differentiation of hUC-MSCs by Regulating the Ionotropic Glutamate Receptor. Appl Biochem Biotechnol 2015; 177:48-62. [PMID: 26175098 DOI: 10.1007/s12010-015-1726-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
In this study, we used proteomics to investigate the effects of sonic vibration (SV) on mesenchymal stem cells derived from human umbilical cords (hUC-MSCs) during neural differentiation to understand how SV enhances neural differentiation of hUC-MSCs. We investigated the levels of gene and protein related to neural differentiation after 3 or 5 days in a group treated with 40-Hz SV. In addition, protein expression patterns were compared between the control and the 40-Hz SV-treated hUC-MSC groups via a proteomic approach. Among these proteins, calponin3 (CNN3) was confirmed to have 299 % higher expression in the 40-Hz SV stimulated hUC-MSCs group than that in the control by Western blotting. Notably, overexpression of CNN3-GFP in Chinese hamster ovary (CHO)-K1 cells had positive effects on the stability and reorganization of F-actin compared with that in GFP-transfected cells. Moreover, CNN3 changed the morphology of the cells by making a neurite-like form. After being subjected to SV, messenger RNA (mRNA) levels of glutamate receptors such as PSD95, GluR1, and NR1 as well as intracellular calcium levels were upregulated. These results suggest that the activity of glutamate receptors increased because of CNN3 characteristics. Taken together, these results demonstrate that overexpressed CNN3 during SV increases expression of glutamate receptors and promotes functional neural differentiation of hUC-MSCs.
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Affiliation(s)
- Hyun-Jung Kim
- College of Life of Life Sciences and Biotechnology, Korea University, 1-5, Anam Dong, Seongbuk-Gu, Seoul, 136-701, Korea
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354
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Ghezzi D. Retinal prostheses: progress toward the next generation implants. Front Neurosci 2015; 9:290. [PMID: 26347602 PMCID: PMC4542462 DOI: 10.3389/fnins.2015.00290] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 07/30/2015] [Indexed: 12/18/2022] Open
Abstract
In the last decade, various clinical trials proved the capability of visual prostheses, in particular retinal implants, to restore a useful form of vision. These encouraging results promoted the emerging of several strategies for neuronal stimulation aiming at the restoration of sight. Besides the traditional approach based on electrical stimulation through metal electrodes in the different areas of the visual path (e.g., the visual cortex, the lateral geniculate nucleus, the optic nerve, and the retina), novel concepts for neuronal stimulation have been mostly exploited as building blocks of the next generation of retinal implants. This review is focused on critically discussing recent major advancements in the field of retinal stimulation with particular attention to the findings in the application of novel concepts and materials. Last, the major challenges in the field and their clinical implications will be outlined.
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Affiliation(s)
- Diego Ghezzi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics, Interfaculty Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
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355
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Hakimova H, Kim S, Chu K, Lee SK, Jeong B, Jeon D. Ultrasound stimulation inhibits recurrent seizures and improves behavioral outcome in an experimental model of mesial temporal lobe epilepsy. Epilepsy Behav 2015; 49:26-32. [PMID: 25940106 DOI: 10.1016/j.yebeh.2015.04.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 04/03/2015] [Indexed: 02/06/2023]
Abstract
Current therapies for epilepsy consist mostly of pharmacological agents or invasive surgery. Recently, ultrasound (US) stimulation has been considered a promising tool for the noninvasive treatment of brain diseases, including epilepsy. However, in temporal lobe epilepsy (TLE), a common form of epilepsy, neurophysiological and functional outcomes following US stimulation are not well defined. To address this, we developed a paradigm of transcranial pulsed US stimulation to efficiently suppress seizure activity in the initial/acute period in a kainate (KA)-induced mouse model of mesial TLE. Pulsed US stimulation inhibited acute seizure activity and either delayed the onset of or suppressed status epilepticus (SE). Kainate-treated mice that had received US stimulation in the initial period exhibited fewer spontaneous recurrent seizures (SRSs) and improved performance in behavioral tasks assessing sociability and depression in the chronic period of epilepsy. Our results demonstrate that US stimulation in the acute period of epilepsy can inhibit SRSs and improve behavioral outcomes in a mouse model of mesial TLE. The present study suggests that noninvasive transcranial pulsed US stimulation may be feasible as an adjuvant therapy in patients with epilepsy. This article is part of a Special Issue entitled "Status Epilepticus".
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Affiliation(s)
- Hilola Hakimova
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sangwoo Kim
- Department of Neurology, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Republic of Korea
| | - Kon Chu
- Department of Neurology, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Republic of Korea
| | - Sang Kun Lee
- Department of Neurology, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Republic of Korea
| | - Bumseok Jeong
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.
| | - Daejong Jeon
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea; Department of Neurology, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Republic of Korea.
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356
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Haji Hasani M, Gharibzadeh S, Farjami Y, Tavakkoli J. Investigating the effect of thermal stress on nerve action potential using the soliton model. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1668-1680. [PMID: 25952315 DOI: 10.1016/j.ultrasmedbio.2014.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 07/04/2014] [Accepted: 07/11/2014] [Indexed: 06/04/2023]
Abstract
The thermal mechanism of acoustic modulation of the reversible electrical activities of peripheral nerves is investigated using the soliton model, and a numerical solution is presented for its non-homogenous version. Our results indicate that heating a small segment of the nerve will increase the action potential conduction velocity and decrease its amplitude. Moreover, cooling the nerve will have the reverse effects, and cooling to temperatures below the nerve melting point can reflect back a significant portion of the action potentials. These results are consistent with the theory of the soliton model, as well as with the experimental findings. Although there exists a discrepancy between the results of the soliton model and experimental pulse amplitude data, from the free energy point of view, the experiments are compatible with Heimburg and Jackson theory. We conclude that the presented model accompanied by the free energy view is capable of simulating the effects of thermal energy on nerve function. One potential application of the developed theoretical model will be investigation of the reversible and irreversible effects of thermal energy induced by various energy modalities, including therapeutic ultrasound, on nerve function.
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Affiliation(s)
- Mojtaba Haji Hasani
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Shahriar Gharibzadeh
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
| | - Yaghoub Farjami
- Department of Computer Engineering, Qom University, Qom, Iran
| | - Jahan Tavakkoli
- Department of Physics, Ryerson University, Toronto, ON, Canada
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357
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Guo T, Li H, Lv Y, Lu H, Niu J, Sun J, Yang GY, Ren C, Tong S. Pulsed Transcranial Ultrasound Stimulation Immediately After The Ischemic Brain Injury is Neuroprotective. IEEE Trans Biomed Eng 2015; 62:2352-7. [PMID: 25935023 DOI: 10.1109/tbme.2015.2427339] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
GOAL We applied a low-intensity pulsed transcranial ultrasound stimulation (pTUS) to the ischemic cortex after a distal middle cerebral artery occlusion (dMCAO) to study whether pTUS is capable of protecting brain from ischemic injury. METHODS Rats were randomly assigned to Sham (n = 6), Control (n = 16), and pTUS (n = 16) groups. The pTUS-treated rats were subjected to 60-min ultrasonic stimulation immediately after the ischemia. After 48 h, the sensorimotor-related behavioral outcomes were assessed by a neurological severity score (NSS), and the permanent brain injury was assessed by the histologic analysis of TTC staining of brain slices. RESULTS pTUS group showed significantly lower NSS (n = 10, 5.5 ± 2.5) than the Control group ( n = 10, 10.5 ±1.4) (p < 0.01). Concordantly, the ischemic lesion was significantly reduced after receiving pTUS immediately after dMCAO. The cortical infarct volume in the control group was more than threefold of the pTUS group (43.39% ± 2.33%, n = 16 versus 13.78% ± 8.18%, n = 16, p < 0.01). Immunohistochemical staining indicated reduction of neutrophils in the affected area, and laser speckle imaging showed significant increase of a cerebral blood flow after pTUS, which consistently supported the neuroprotection of pTUS in ischemic brain injury. CONCLUSION Both behavior and histological results suggested that pTUS on ischemic core immediately after ischemic stroke could be neuroprotective. SIGNIFICANCE The noninvasiveness and high spatiotemporal resolution of pTUS makes it a unique neuromodulation technique in comparison with the current TMS and tDCS.
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358
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Lin WT, Chen RC, Lu WW, Liu SH, Yang FY. Protective effects of low-intensity pulsed ultrasound on aluminum-induced cerebral damage in Alzheimer's disease rat model. Sci Rep 2015; 5:9671. [PMID: 25873429 PMCID: PMC4397698 DOI: 10.1038/srep09671] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/13/2015] [Indexed: 12/02/2022] Open
Abstract
The protein expressions of neurotrophic factors can be enhanced by low-intensity pulsed ultrasound (LIPUS) stimulation in the brain. The purpose of this study was to demonstrate the protective effect of LIPUS stimulation against aluminum-induced cerebral damage in Alzheimer's disease rat model. LIPUS was administered 7 days before each aluminum chloride (AlCl3) administration, and concomitantly given with AlCl3 daily for a period of 6 weeks. Neurotrophic factors in hippocampus were measured by western blot analysis. Behavioral changes in the Morris water maze and elevated plus maze were examined in rats after administration of AlCl3. Various biochemical analyses were performed to evaluate the extent of brain damages. LIPUS is capable of prompting levels of brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and vascular endothelial growth factor (VEGF) in rat brain. AlCl3 administration resulted in a significant increase in the aluminum concentration, acetylcholinesterase activity and beta-amyloid (Aβ) deposition in AlCl3 treated rats. LIPUS stimulation significantly attenuated aluminum concentration, acetylcholinesterase activity, Aβ deposition and karyopyknosis in AlCl3 treated rats. Furthermore, LIPUS significantly improved memory retention in AlCl3-induced memory impairment. These experimental results indicate that LIPUS has neuroprotective effects against AlCl3-induced cerebral damages and cognitive dysfunction.
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Affiliation(s)
- Wei-Ting Lin
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Ran-Chou Chen
- 1] Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan [2] Department of Radiology, Taipei City Hospital, Taipei, Taiwan
| | - Wen-Wei Lu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Hwa Liu
- Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Feng-Yi Yang
- 1] Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan [2] Biophotonics and Molecular Imaging Research Center, National Yang-Ming University, Taipei, Taiwan
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359
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Jung YJ, Kim R, Ham HJ, Park SI, Lee MY, Kim J, Hwang J, Park MS, Yoo SS, Maeng LS, Chang W, Chung YA. Focused low-intensity pulsed ultrasound enhances bone regeneration in rat calvarial bone defect through enhancement of cell proliferation. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:999-1007. [PMID: 25701528 DOI: 10.1016/j.ultrasmedbio.2014.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 09/25/2014] [Accepted: 11/11/2014] [Indexed: 06/04/2023]
Abstract
A number of studies have reported the therapeutic potential of low-intensity pulsed ultrasound (LIPUS) for induction of bone repair. This study investigated whether bone regeneration might be enhanced by application of focused LIPUS to selectively stimulate fractured calvarial bone. To accomplish this, bone defects were surgically created in the middle of the skull of rats that were subsequently exposed to focused LIPUS. Bone regeneration was assessed by repeated computed tomography imaging after the operation, as well as histologic analysis with calcein, hematoxylin and eosin and proliferating cell nuclear antigen assay. At 6 wk after surgery, bone formation in the focused LIPUS-treated group improved significantly relative to the control. Interestingly, new bone tissue sprouted from focused LIPUS target points. Histologic analysis after exposure to focused LIPUS revealed that proliferating cells were significantly increased relative to the control. Taken together, these results suggest that focused LIPUS can improve re-ossification through enhancement of cell proliferation in calvarial defect sites.
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Affiliation(s)
- Yu Jin Jung
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, Republic of Korea
| | - Ran Kim
- Department of Biology Education, College of Education, Pusan National University, Busan, Republic of Korea
| | - Hyun-Joo Ham
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, Republic of Korea
| | - Sang In Park
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, Republic of Korea
| | - Min Young Lee
- Department of Molecular Physiology, College of Pharmacy, Kyungpook National University, Daegu, Republic of Korea
| | - Jongmin Kim
- Department of Life Systems, Sookmyung Women's University, Yongsan-gu Seoul, Republic of Korea
| | - Jihwan Hwang
- Department of Microbiology, College of Natural Science, Pusan National University, Busan, Republic of Korea
| | - Moon-Seo Park
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, Republic of Korea
| | - Seung-Schik Yoo
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lee-So Maeng
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, Republic of Korea
| | - Woochul Chang
- Department of Biology Education, College of Education, Pusan National University, Busan, Republic of Korea.
| | - Yong-An Chung
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, Republic of Korea.
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360
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Abstract
Ultrasound therapy has been investigated for over half a century. Ultrasound can act on tissue through a variety of mechanisms, including thermal, shockwave and cavitation mechanisms, and through these can elicit different responses. Ultrasound therapy can provide a non-invasive or minimally invasive treatment option, and ultrasound technology has advanced to the point where devices can be developed to investigate a wide range of applications. This review focuses on non-cancer clinical applications of therapeutic ultrasound, with an emphasis on treatments that have recently reached clinical investigations, and preclinical research programmes that have great potential to impact patient care.
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361
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Bystritsky A, Korb AS. A Review of Low-Intensity Transcranial Focused Ultrasound for Clinical Applications. Curr Behav Neurosci Rep 2015. [DOI: 10.1007/s40473-015-0039-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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362
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Wang TR, Dallapiazza R, Elias WJ. Neurological applications of transcranial high intensity focused ultrasound. Int J Hyperthermia 2015; 31:285-91. [PMID: 25703389 DOI: 10.3109/02656736.2015.1007398] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Advances in transcranial MRI-guided focused ultrasound have renewed interest in lesioning procedures in functional neurosurgery with a potential role in the treatment of neurological conditions such as chronic pain, brain tumours, movement disorders and psychiatric diseases. While the use of transcranial MRI-guided focused ultrasound represents a new innovation in neurosurgery, ultrasound has been used in neurosurgery for almost 60 years. This paper reviews the major historical milestones that have led to modern transcranial focused ultrasound and discusses current and evolving applications of ultrasound in the brain.
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Affiliation(s)
- Tony R Wang
- Department of Neurological Surgery, University of Virginia Health Sciences Center , Charlottesville, Virginia , USA
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363
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Wright CJ, Rothwell J, Saffari N. Ultrasonic stimulation of peripheral nervous tissue: an investigation into mechanisms. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1742-6596/581/1/012003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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364
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Fitzgerald PB. Non-pharmacological biological treatment approaches to difficult-to-treat depression. Med J Aust 2014; 199:S48-51. [PMID: 25370288 DOI: 10.5694/mja12.10509] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There has been substantial recent interest in novel brain stimulation treatments for difficult-to-treat depression. Electroconvulsive therapy (ECT) is a well established, effective treatment for severe depression. ECT's problematic side-effect profile and questions regarding optimal administration methods continue to be investigated. Magnetic seizure therapy, although very early in development, shows promise, with potentially similar efficacy to ECT but fewer side effects. Vagus nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (rTMS) are clinically available in some countries. Limited research suggests VNS has potentially long-lasting antidepressant effects in a small group of patients. Considerable research supports the efficacy of rTMS. Both techniques require further study of optimal treatment parameters. Transcranial direct current stimulation may provide a low-cost antidepressant option if its efficacy is substantiated in larger samples. Deep brain stimulation is likely to remain reserved for patients with the most severe and difficult-to-treat depression, requiring further exploration of administration methods and its role in depression therapy. New and innovative forms of brain stimulation, including low-intensity ultrasound, low-field magnetic stimulation and epidural stimulation of the cortical surface, are in early stages of exploration and are yet to move into the clinical domain. Ongoing work is required to define which brain stimulation treatments are likely to be most useful, and in which patient groups. Clinical service development of brain stimulation treatments will likely be inconsistent and variable.
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Affiliation(s)
- Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University and Alfred Health, Melbourne, VIC, Australia.
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365
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Estimation of the spatial profile of neuromodulation and the temporal latency in motor responses induced by focused ultrasound brain stimulation. Neuroreport 2014; 25:475-9. [PMID: 24384503 PMCID: PMC3979873 DOI: 10.1097/wnr.0000000000000118] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This study investigates the spatial profile and the temporal latency of the brain stimulation induced by the transcranial application of pulsed focused ultrasound (FUS). The site of neuromodulation was detected using 2-deoxy-2-[18F]fluoro-d-glucose PET immediately after FUS sonication on the unilateral thalamic area of Sprague–Dawley rats. The latency of the stimulation was estimated by measuring the time taken from the onset of the stimulation of the appropriate brain motor area to the corresponding tail motor response. The brain area showing elevated glucose uptake from the PET image was much smaller (56±10% in diameter, 24±6% in length) than the size of the acoustic focus, which is conventionally defined by the full-width at half-maximum of the acoustic intensity field. The spatial dimension of the FUS-mediated neuromodulatory area was more localized, approximated to be full-width at 90%-maximum of the acoustic intensity field. In addition, the time delay of motor responses elicited by the FUS sonication was 171±63 (SD) ms from the onset of sonication. When compared with latencies of other nonultrasonic neurostimulation techniques, the longer time delay associated with FUS-mediated motor responses is suggestive of the nonelectrical modes of neuromodulation, making it a distinctive brain stimulation method.
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366
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Luo D, Yu H, Garfield RE, Shi SQ, Towe B. Treatment with focused ultrasound waves softens the rat cervix during pregnancy. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:2107-2112. [PMID: 24972500 DOI: 10.1016/j.ultrasmedbio.2014.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 02/07/2014] [Accepted: 02/20/2014] [Indexed: 06/03/2023]
Abstract
Application of focused ultrasound stimulation (FUS) to the rat cervix during pregnancy has significant physiologic effects. One-millisecond-long pulses of 680-kHz ultrasound with a repetition frequency of 25 Hz, at ISPTA (spatial-peak, temporal-average intensity) of 1, 2 and 4W/cm(2), were applied to the rat abdomen over the cervix. FUS produced a significant change in cervical elasticity known as softening, which is part of the ripening process, comparable to the degree seen just before delivery. Timed-pregnant Sprague-Dawley rats (n = 40) were used. During gestation, the FUS system was applied to the cervix for variable times up to 1 h. Daily measurements of cervix light-induced florescence were made to estimate changes in softening. In addition, cervical stretch estimates of softening were made of isolated cervices of control and FUS-treated rats to measure distensiblity. The ultrasound power with ISPPA (spatial-peak, pulse-average intensity) of 40 W/cm(2) was considered tolerable; the U.S. Food and Drug Administration regulatory limit is 190 W/cm(2) for both the body periphery and the fetus. This is the first report of alterations induced by ultrasound in the connective tissue of the cervix and suggests the therapeutic application of ultrasound for the facilitation of labor and delivery.
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Affiliation(s)
- Daishen Luo
- Harrington Biomedical Engineering, School of Biological Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Heng Yu
- Harrington Biomedical Engineering, School of Biological Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Robert E Garfield
- Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Shao-Qing Shi
- Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Bruce Towe
- Harrington Biomedical Engineering, School of Biological Health Systems Engineering, Arizona State University, Tempe, Arizona, USA.
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367
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McCabe JT, Moratz C, Liu Y, Burton E, Morgan A, Budinich C, Lowe D, Rosenberger J, Chen H, Liu J, Myers M. Application of high-intensity focused ultrasound to the study of mild traumatic brain injury. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:965-978. [PMID: 24462152 DOI: 10.1016/j.ultrasmedbio.2013.11.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 11/13/2013] [Accepted: 11/16/2013] [Indexed: 06/03/2023]
Abstract
Though intrinsically of much higher frequency than open-field blast overpressures, high-intensity focused ultrasound (HIFU) pulse trains can be frequency modulated to produce a radiation pressure having a similar form. In this study, 1.5-MHz HIFU pulse trains of 1-ms duration were applied to intact skulls of mice in vivo and resulted in blood-brain barrier disruption and immune responses (astrocyte reactivity and microglial activation). Analyses of variance indicated that 24 h after HIFU exposure, staining density for glial fibrillary acidic protein was elevated in the parietal and temporal regions of the cerebral cortex, corpus callosum and hippocampus, and staining density for the microglial marker, ionized calcium binding adaptor molecule, was elevated 2 and 24 h after exposure in the corpus callosum and hippocampus (all statistical test results, p < 0.05). HIFU shows promise for the study of some bio-effect aspects of blast-related, non-impact mild traumatic brain injuries in animals.
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Affiliation(s)
- Joseph T McCabe
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA; Graduate Program in Neuroscience, USUHS, Bethesda, Maryland, USA; The Center for Neuroscience and Regenerative Medicine, USUHS, Bethesda, Maryland, USA.
| | - Chantal Moratz
- Graduate Program in Neuroscience, USUHS, Bethesda, Maryland, USA; The Center for Neuroscience and Regenerative Medicine, USUHS, Bethesda, Maryland, USA; Department of Medicine, USUHS, Bethesda, Maryland, USA
| | - Yunbo Liu
- Center for Devices and Radiological Health, Food and Drug Administration, White Oak, Maryland, USA
| | - Ellen Burton
- The Center for Neuroscience and Regenerative Medicine, USUHS, Bethesda, Maryland, USA; Department of Medicine, USUHS, Bethesda, Maryland, USA
| | - Amy Morgan
- The Center for Neuroscience and Regenerative Medicine, USUHS, Bethesda, Maryland, USA; Department of Medicine, USUHS, Bethesda, Maryland, USA
| | - Craig Budinich
- Graduate Program in Neuroscience, USUHS, Bethesda, Maryland, USA
| | - Dennell Lowe
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA
| | - John Rosenberger
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA
| | - HuaZhen Chen
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA
| | - Jiong Liu
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA
| | - Matthew Myers
- Center for Devices and Radiological Health, Food and Drug Administration, White Oak, Maryland, USA
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Abstract
INTRODUCTION The presence of the blood-brain barrier (BBB) is a significant impediment to the delivery of therapeutic agents to the brain for treatment of brain diseases. Focused ultrasound (FUS) has been developed as a noninvasive method for transiently increasing the permeability of the BBB to promote drug delivery to targeted regions of the brain. AREAS COVERED The present review briefly compares the methods used to promote drug delivery to the brain and describes the benefits and limitations of FUS technology. We summarize the experimental data which shows that FUS, combined with intravascular microbubbles, increases therapeutic agent delivery into the brain leading to significant reductions in pathology in preclinical models of disease. The potential for translation of this technology to the clinic is also discussed. EXPERT OPINION The introduction of magnetic resonance imaging guidance and intravascular administration of microbubbles to FUS treatments permits the consistent, transient and targeted opening of the BBB. The development of feedback systems and real-time monitoring techniques improve the safety of BBB opening. Successful clinical translation of FUS has the potential to revolutionize the treatment of brain disease resulting in effective, less-invasive treatments without the need for expensive drug development.
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Affiliation(s)
- Alison Burgess
- Sunnybrook Research Institute, Physical Sciences , 2075 Bayview Avenue, S665, Toronto, ON M4N 3M5 , Canada +1 416 480 5765 ;
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369
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Schlesinger D, Benedict S, Diederich C, Gedroyc W, Klibanov A, Larner J. MR-guided focused ultrasound surgery, present and future. Med Phys 2014; 40:080901. [PMID: 23927296 DOI: 10.1118/1.4811136] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
MR-guided focused ultrasound surgery (MRgFUS) is a quickly developing technology with potential applications across a spectrum of indications traditionally within the domain of radiation oncology. Especially for applications where focal treatment is the preferred technique (for example, radiosurgery), MRgFUS has the potential to be a disruptive technology that could shift traditional patterns of care. While currently cleared in the United States for the noninvasive treatment of uterine fibroids and bone metastases, a wide range of clinical trials are currently underway, and the number of publications describing advances in MRgFUS is increasing. However, for MRgFUS to make the transition from a research curiosity to a clinical standard of care, a variety of challenges, technical, financial, clinical, and practical, must be overcome. This installment of the Vision 20∕20 series examines the current status of MRgFUS, focusing on the hurdles the technology faces before it can cross over from a research technique to a standard fixture in the clinic. It then reviews current and near-term technical developments which may overcome these hurdles and allow MRgFUS to break through into clinical practice.
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Affiliation(s)
- David Schlesinger
- Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia 22908, USA.
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370
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Younan Y, Deffieux T, Larrat B, Fink M, Tanter M, Aubry JF. Influence of the pressure field distribution in transcranial ultrasonic neurostimulation. Med Phys 2014; 40:082902. [PMID: 23927357 DOI: 10.1118/1.4812423] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Low-intensity focused ultrasound has been shown to stimulate the brain noninvasively and without noticeable tissue damage. Such a noninvasive and localized neurostimulation is expected to have a major impact in neuroscience in the coming years. This emerging field will require many animal experiments to fully understand the link between ultrasound and stimulation. The primary goal of this paper is to investigate transcranial ultrasonic neurostimulation at low frequency (320 kHz) on anesthetized rats for different acoustic pressures and estimate the in situ pressure field distribution and the corresponding motor threshold, if any. The corresponding acoustic pressure distribution inside the brain, which cannot be measured in vivo, is investigated based on numerical simulations of the ultrasound propagation inside the head cavity, reproducing at best the experiments conducted in the first part, both in terms of transducer and head geometry and in terms of acoustic parameters. METHODS In this study, 37 ultrasonic neurostimulation sessions were achieved in rats (N=8) using a 320 kHz transducer. The corresponding beam profile in the entire head was simulated in order to investigate the in situ pressure and intensity level as well as the spatial pressure distribution, thanks to a rat microcomputed tomography scan (CT)-based 3D finite differences time domain solver. RESULTS Ultrasound pulse evoked a motor response in more than 60% of the experimental sessions. In those sessions, the stimulation was always present, repeatable with a pressure threshold under which no motor response occurred. This average acoustic pressure threshold was found to be 0.68±0.1 MPa (corresponding mechanical index, MI=1.2 and spatial peak, pulse averaged intensity, Isppa=7.5 W cm(-2)), as calibrated in free water. A slight variation was observed between deep anesthesia stage (0.77±0.04 MPa) and light anesthesia stage (0.61±0.03 MPa), assessed from the pedal reflex. Several kinds of motor responses were observed: movements of the tail, the hind legs, the forelimbs, the eye, and even a single whisker were induced separately. Numerical simulations of an equivalent experiment with identical acoustic parameters showed that the acoustic field was spread over the whole rat brain with the presence of several secondary pressure peaks. Due to reverberations, a 1.8-fold increase of the spatial peak, temporal peak acoustic pressure (Psptp) (±0.4 standard deviation), a 3.6-fold increase (±1.8) for the spatial peak, temporal peak acoustic intensity (Isptp), and 2.3 for the spatial peak, pulse averaged acoustic intensity (Isppa), were found compared to simulations of the beam in free water. Applying such corrections due to reverberations on the experimental results would yield a higher estimation for the average acoustic pressure threshold for motor neurostimulation at 320 KHz at 1.2±0.3 MPa (MI=2.2±0.5 and Isppa=17.5±7.5 W cm(-2)). CONCLUSIONS Transcranial ultrasonic stimulation is pressure- and anesthesia-dependent in the rat model. Numerical simulations have shown that the acoustic pattern can be complex inside the rat head and that special care must be taken for small animal studies relating acoustic parameters to neurostimulation effects, especially at a low frequency.
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Affiliation(s)
- Youliana Younan
- Institut Langevin, ESPCI-ParisTech, CNRS UMR7587, INSERM U979, 1 rue Jussieu, Paris 75005, France
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371
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Juan EJ, González R, Albors G, Ward MP, Irazoqui P. Vagus Nerve Modulation Using Focused Pulsed Ultrasound: Potential Applications and Preliminary Observations in a Rat. INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY 2014; 24:67-71. [PMID: 25165410 PMCID: PMC4142523 DOI: 10.1002/ima.22080] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The use of focused ultrasonic waves to modulate neural structures has gained recent interest due to its potential in treating neurological disorders non-invasively. While several papers have focused on the use of ultrasound neuromodulation on peripheral nerves, none of these studies have been performed on the vagus nerve. We present preliminary observations on the effects of focused pulsed ultrasound (FPUS) on the conduction of the left cervical vagus nerve of a Long Evans rat. Ultrasound energy was applied at a frequency of 1.1 MHz, and at spatial-peak, temporal average intensities that ranged from 13.6 to 93.4 W/cm2. Vagus nerve inhibition was observed in most cases. Results of this preliminary study suggested that there is a proportional relationship between acoustic intensity and the level of nerve inhibition.
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Affiliation(s)
- Eduardo J Juan
- Electrical Engineering, University of Puerto Rico at Mayagüez, Mayagüez, Puerto Rico
| | - Rafael González
- Electrical Engineering, University of Puerto Rico at Mayagüez, Mayagüez, Puerto Rico
| | - Gabriel Albors
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Matthew P Ward
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Pedro Irazoqui
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
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372
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Transcranial focused ultrasound modulates the activity of primary somatosensory cortex in humans. Nat Neurosci 2014; 17:322-9. [PMID: 24413698 DOI: 10.1038/nn.3620] [Citation(s) in RCA: 518] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 12/04/2013] [Indexed: 01/26/2023]
Abstract
Improved methods of noninvasively modulating human brain function are needed. Here we probed the influence of transcranial focused ultrasound (tFUS) targeted to the human primary somatosensory cortex (S1) on sensory-evoked brain activity and sensory discrimination abilities. The lateral and axial spatial resolution of the tFUS beam implemented were 4.9 mm and 18 mm, respectively. Electroencephalographic recordings showed that tFUS significantly attenuated the amplitudes of somatosensory evoked potentials elicited by median nerve stimulation. We also found that tFUS significantly modulated the spectral content of sensory-evoked brain oscillations. The changes produced by tFUS on sensory-evoked brain activity were abolished when the acoustic beam was focused 1 cm anterior or posterior to S1. Behavioral investigations showed that tFUS targeted to S1 enhanced performance on sensory discrimination tasks without affecting task attention or response bias. We conclude that tFUS can be used to focally modulate human cortical function.
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373
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374
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Deffieux T, Younan Y, Wattiez N, Tanter M, Pouget P, Aubry JF. Low-Intensity Focused Ultrasound Modulates Monkey Visuomotor Behavior. Curr Biol 2013; 23:2430-3. [DOI: 10.1016/j.cub.2013.10.029] [Citation(s) in RCA: 264] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/18/2013] [Accepted: 10/10/2013] [Indexed: 11/24/2022]
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375
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Dervishi E, Aubry JF, Delattre JY, Boch AL. [Focused ultrasound therapy: current status and potential applications in neurosurgery]. Neurochirurgie 2013; 59:201-9. [PMID: 24210288 DOI: 10.1016/j.neuchi.2013.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 05/19/2013] [Accepted: 06/09/2013] [Indexed: 01/26/2023]
Abstract
High Intensity Focused Ultrasound (HIFU) therapy is an innovative approach for tissue ablation, based on high intensity focused ultrasound beams. At the focus, HIFU induces a temperature elevation and the tissue can be thermally destroyed. In fact, this approach has been tested in a number of clinical studies for the treatment of several tumors, primarily the prostate, uterine, breast, bone, liver, kidney and pancreas. For transcranial brain therapy, the skull bone is a major limitation, however, new adaptive techniques of phase correction for focusing ultrasound through the skull have recently been implemented by research systems, paving the way for HIFU therapy to become an interesting alternative to brain surgery and radiotherapy.
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Affiliation(s)
- E Dervishi
- Équipe de neuro-oncologie expérimentale, Inserm, UMRS 975, CNRS 7225, institut du cerveau et de la moelle épinière, groupe hospitalier La Pitié Salpêtrière-Charles-Foix, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75651 Paris, France.
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376
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Abstract
Transcranial MRI-guided focused ultrasound (TcMRgFUS) is an old idea but a new technology that may change the entire clinical field of the neurosciences. TcMRgFUS has no cumulative effect, and it is applicable for repeatable treatments, controlled by real-time dosimetry, and capable of immediate tissue destruction. Most importantly, it has extremely accurate targeting and constant monitoring. It is potentially more precise than proton beam therapy and definitely more cost effective. Neuro-oncology may be the most promising area of future TcMRgFUS applications.
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377
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Dynamic response of model lipid membranes to ultrasonic radiation force. PLoS One 2013; 8:e77115. [PMID: 24194863 PMCID: PMC3806737 DOI: 10.1371/journal.pone.0077115] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/29/2013] [Indexed: 12/14/2022] Open
Abstract
Low-intensity ultrasound can modulate action potential firing in neurons in vitro and in vivo. It has been suggested that this effect is mediated by mechanical interactions of ultrasound with neural cell membranes. We investigated whether these proposed interactions could be reproduced for further study in a synthetic lipid bilayer system. We measured the response of protein-free model membranes to low-intensity ultrasound using electrophysiology and laser Doppler vibrometry. We find that ultrasonic radiation force causes oscillation and displacement of lipid membranes, resulting in small (<1%) changes in membrane area and capacitance. Under voltage-clamp, the changes in capacitance manifest as capacitive currents with an exponentially decaying sinusoidal time course. The membrane oscillation can be modeled as a fluid dynamic response to a step change in pressure caused by ultrasonic radiation force, which disrupts the balance of forces between bilayer tension and hydrostatic pressure. We also investigated the origin of the radiation force acting on the bilayer. Part of the radiation force results from the reflection of the ultrasound from the solution/air interface above the bilayer (an effect that is specific to our experimental configuration) but part appears to reflect a direct interaction of ultrasound with the bilayer, related to either acoustic streaming or scattering of sound by the bilayer. Based on these results, we conclude that synthetic lipid bilayers can be used to study the effects of ultrasound on cell membranes and membrane proteins.
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378
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Kim H, Park MA, Wang S, Chiu A, Fischer K, Yoo SS. PET∕CT imaging evidence of FUS-mediated (18)F-FDG uptake changes in rat brain. Med Phys 2013; 40:033501. [PMID: 23464343 DOI: 10.1118/1.4789916] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Transcranial focused ultrasound (FUS) delivers highly focused acoustic energy to a small region of the brain in a noninvasive manner. Recent studies have revealed that FUS, which is administered either in pulsed or continuous waves, can elicit or suppress neural tissue excitability. This neuromodulatory property of FUS has been demonstrated via direct motion detection, electrophysiological recordings, functional magnetic resonance imaging (fMRI), confocal imaging, and microdialysis sampling of neurotransmitters. This study presents new evidence of local increase in glucose metabolism induced by FUS to the rat brain using FDG (18-fludeoxyglucose) positron emission tomography (PET). METHODS Sprague-Dawley rats underwent sonication to a unilateral hemispheric area of the brain prior to PET scan. The pulsed sonication (350 kHz, tone burst duration of 0.5 ms, pulse repetition frequency of 1 kHz, and duration of 300 ms) was applied in 2 s intervals for 40 min immediately after the FDG injection via tail vein. Subsequently, the PET was acquired in dynamic list-mode to image FDG activity for an hour, and reconstructed into a single volume representing standardized uptake value (SUV). The raw SUV as well as its asymmetry index (AI) were measured from five different volume-of-interests (VOIs) of the brain for both hemispheres, and compared between sonicated and unsonicated groups. RESULTS Statistically significant hemispheric changes in SUV were observed only at the center of sonication focus within the FUS group [paired t-test; t(7) = 3.57, p < 0.05]. There were no significant hemispheric differences in SUV within the control group in any of the VOIs. A statistically significant elevation in AI (t-test; t(7) = 3.40, p < 0.05) was observed at the center of sonication focus (7.9 ± 2.5%, the deviations are in standard error) among the FUS group when compared to the control group (-0.8 ± 1.2%). CONCLUSIONS Spatially distinct increases in the glucose metabolic activity in the rat brain is present only at the center of sonication focus, suggesting localized functional neuromodulation mediated by the sonication.
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Affiliation(s)
- Hyungmin Kim
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
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379
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Gigliotti JC, Huang L, Ye H, Bajwa A, Chattrabhuti K, Lee S, Klibanov AL, Kalantari K, Rosin DL, Okusa MD. Ultrasound prevents renal ischemia-reperfusion injury by stimulating the splenic cholinergic anti-inflammatory pathway. J Am Soc Nephrol 2013; 24:1451-60. [PMID: 23907510 DOI: 10.1681/asn.2013010084] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AKI affects both quality of life and health care costs and is an independent risk factor for mortality. At present, there are few effective treatment options for AKI. Here, we describe a nonpharmacologic, noninvasive, ultrasound-based method to prevent renal ischemia-reperfusion injury in mice, which is a model for human AKI. We exposed anesthetized mice to an ultrasound protocol 24 hours before renal ischemia. After 24 hours of reperfusion, ultrasound-treated mice exhibited preserved kidney morphology and function compared with sham-treated mice. Ultrasound exposure before renal ischemia reduced the accumulation of CD11b(+)Ly6G(high) neutrophils and CD11b(+)F4/80(high) myeloid cells in kidney tissue. Furthermore, splenectomy and adoptive transfer studies revealed that the spleen and CD4(+) T cells mediated the protective effects of ultrasound. Last, blockade or genetic deficiency of the α7 nicotinic acetylcholine receptor abrogated the protective effect of ultrasound, suggesting the involvement of the cholinergic anti-inflammatory pathway. Taken together, these results suggest that an ultrasound-based treatment could have therapeutic potential for the prevention of AKI, possibly by stimulating a splenic anti-inflammatory pathway.
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Affiliation(s)
- Joseph C Gigliotti
- Department of Medicine, Division of Nephrology, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daeheungdong, Chungku, South Korea
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380
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Farah N, Zoubi A, Matar S, Golan L, Marom A, Butson CR, Brosh I, Shoham S. Holographically patterned activation using photo-absorber induced neural-thermal stimulation. J Neural Eng 2013; 10:056004. [PMID: 23902876 DOI: 10.1088/1741-2560/10/5/056004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Patterned photo-stimulation offers a promising path towards the effective control of distributed neuronal circuits. Here, we demonstrate the feasibility and governing principles of spatiotemporally patterned microscopic photo-absorber induced neural-thermal stimulation (PAINTS) based on light absorption by exogenous extracellular photo-absorbers. APPROACH We projected holographic light patterns from a green continuous-wave (CW) or an IR femtosecond laser onto exogenous photo-absorbing particles dispersed in the vicinity of cultured rat cortical cells. Experimental results are compared to predictions of a temperature-rate model (where membrane currents follow I ∝ dT/dt). MAIN RESULTS The induced microscopic photo-thermal transients have sub-millisecond thermal relaxation times and stimulate adjacent cells. PAINTS activation thresholds for different laser pulse durations (0.02 to 1 ms) follow the Lapicque strength-duration formula, but with different chronaxies and minimal threshold energy levels for the two excitation lasers (an order of magnitude lower for the IR system <50 nJ). Moreover, the empirical thresholds for the CW system are found to be in good agreement with detailed simulations of the temperature-rate model, but are generally lower for the IR system, suggesting an auxiliary excitation mechanism. SIGNIFICANCE Holographically patterned PAINTS could potentially provide a means for minimally intrusive control over neuronal dynamics with a high level of spatial and temporal selectivity.
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Affiliation(s)
- Nairouz Farah
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa 32000, Israel
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381
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Schwalb JM. Magnetic resonance-guided focused ultrasound surgery. J Neurosurg 2013; 119:531. [PMID: 23790116 DOI: 10.3171/2013.2.jns13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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382
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Korb AS, Shellock FG, Cohen MS, Bystritsky A. Low-Intensity Focused Ultrasound Pulsation Device Used During Magnetic Resonance Imaging: Evaluation of Magnetic Resonance Imaging-Related Heating at 3 Tesla/128 MHz. Neuromodulation 2013; 17:236-41; discussion 241. [DOI: 10.1111/ner.12075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 03/22/2013] [Accepted: 04/02/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Alexander S. Korb
- Department of Psychiatry and Biobehavioral Sciences; University of California; Los Angeles CA USA
| | - Frank G. Shellock
- Department of Radiology; University of Southern California; Los Angeles CA USA
| | - Mark S. Cohen
- Department of Psychiatry and Biobehavioral Sciences; University of California; Los Angeles CA USA
- Departments of Neurology, Radiology, Psychology, Biomedical Physics, and Bioengineering; University of California; Los Angeles CA USA
| | - Alexander Bystritsky
- Department of Psychiatry and Biobehavioral Sciences; University of California; Los Angeles CA USA
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383
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Hu Y, Zhong W, Wan JMF, Yu ACH. Ultrasound can modulate neuronal development: impact on neurite growth and cell body morphology. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:915-25. [PMID: 23415289 DOI: 10.1016/j.ultrasmedbio.2012.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 12/06/2012] [Accepted: 12/08/2012] [Indexed: 05/21/2023]
Abstract
Neuronal development is known to be a dynamic process that can be modulated by presenting guidance cues to neuronal cells. We show that ultrasound, when applied at pulsed settings and with intensities slightly greater than clinical diagnosis levels, can potentially act as a repulsive cue for modulating neuronal growth dynamics. Using differentiated Neuro-2a cells as the model, we have examined in vitro how neuronal development can change during and after exposure to 1-MHz ultrasound for different acoustic settings. Neurite retraction and cell body shrinkage were found in neuronal cells over a 10-min exposure period with 1.168 W/cm(2) spatial-peak, time-averaged intensity (based on 0.84 MPa peak acoustic pressure, 100-cycle pulse duration, and 500-Hz pulse repetition frequency). These effects were found to result in instances of neuronal cell body displacement. The extent of the effects was dependent on acoustic intensity, with peak acoustic pressure being a more important contributing factor compared with pulse duration. The morphological changes were found to be non-destructive, in that post-exposure neurite outgrowth and neuritogenesis were respectively observed in neurite-bearing and neurite-less neuronal cells. Our results also showed that mechanotransduction might be involved in mediating ultrasound-neuron interactions, as the morphological changes were suppressed if stretch-activated ion channels were blocked or if calcium messenger ions were chelated. Overall, these findings suggest that ultrasound can potentially influence how neuronal cells develop through modifying their cytomechanical characteristics.
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Affiliation(s)
- Yaxin Hu
- Medical Engineering Program, The University of Hong Kong, Pokfulam, Hong Kong SAR
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384
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Abstract
Focused ultrasound is a promising noninvasive technology for neural stimulation. Here we use the isolated salamander retina to characterize the effect of ultrasound on an intact neural circuit and compared these effects with those of visual stimulation of the same retinal ganglion cells. Ultrasound stimuli at an acoustic frequency of 43 MHz and a focal spot diameter of 90 μm delivered from a piezoelectric transducer evoked stable responses with a temporal precision equal to strong visual responses but with shorter latency. By presenting ultrasound and visual stimulation together, we found that ultrasonic stimulation rapidly modulated visual sensitivity but did not change visual temporal filtering. By combining pharmacology with ultrasound stimulation, we found that ultrasound did not directly activate retinal ganglion cells but did in part activate interneurons beyond photoreceptors. These results suggest that, under conditions of strong localized stimulation, timing variability is largely influenced by cells beyond photoreceptors. We conclude that ultrasonic stimulation is an effective and spatiotemporally precise method to activate the retina. Because the retina is the most accessible part of the CNS in vivo, ultrasonic stimulation may have diagnostic potential to probe remaining retinal function in cases of photoreceptor degeneration, and therapeutic potential for use in a retinal prosthesis. In addition, because of its noninvasive properties and spatiotemporal resolution, ultrasound neurostimulation promises to be a useful tool to understand dynamic activity in pharmacologically defined neural pathways in the retina.
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385
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Yoo SS, Kim H, Filandrianos E, Taghados SJ, Park S. Non-invasive brain-to-brain interface (BBI): establishing functional links between two brains. PLoS One 2013; 8:e60410. [PMID: 23573251 PMCID: PMC3616031 DOI: 10.1371/journal.pone.0060410] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 02/26/2013] [Indexed: 02/02/2023] Open
Abstract
Transcranial focused ultrasound (FUS) is capable of modulating the neural activity of specific brain regions, with a potential role as a non-invasive computer-to-brain interface (CBI). In conjunction with the use of brain-to-computer interface (BCI) techniques that translate brain function to generate computer commands, we investigated the feasibility of using the FUS-based CBI to non-invasively establish a functional link between the brains of different species (i.e. human and Sprague-Dawley rat), thus creating a brain-to-brain interface (BBI). The implementation was aimed to non-invasively translate the human volunteer’s intention to stimulate a rat’s brain motor area that is responsible for the tail movement. The volunteer initiated the intention by looking at a strobe light flicker on a computer display, and the degree of synchronization in the electroencephalographic steady-state-visual-evoked-potentials (SSVEP) with respect to the strobe frequency was analyzed using a computer. Increased signal amplitude in the SSVEP, indicating the volunteer’s intention, triggered the delivery of a burst-mode FUS (350 kHz ultrasound frequency, tone burst duration of 0.5 ms, pulse repetition frequency of 1 kHz, given for 300 msec duration) to excite the motor area of an anesthetized rat transcranially. The successful excitation subsequently elicited the tail movement, which was detected by a motion sensor. The interface was achieved at 94.0±3.0% accuracy, with a time delay of 1.59±1.07 sec from the thought-initiation to the creation of the tail movement. Our results demonstrate the feasibility of a computer-mediated BBI that links central neural functions between two biological entities, which may confer unexplored opportunities in the study of neuroscience with potential implications for therapeutic applications.
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Affiliation(s)
- Seung-Schik Yoo
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
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386
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King RL, Brown JR, Newsome WT, Pauly KB. Effective parameters for ultrasound-induced in vivo neurostimulation. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:312-31. [PMID: 23219040 DOI: 10.1016/j.ultrasmedbio.2012.09.009] [Citation(s) in RCA: 288] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 08/01/2012] [Accepted: 09/11/2012] [Indexed: 05/13/2023]
Abstract
Ultrasound-induced neurostimulation has recently gained increasing attention, but little is known about the mechanisms by which it affects neural activity or about the range of acoustic parameters and stimulation protocols that elicit responses. We have established conditions for transcranial stimulation of the nervous system in vivo, using the mouse somatomotor response. We report that (1) continuous-wave stimuli are as effective as or more effective than pulsed stimuli in eliciting responses, and responses are elicited with stimulus onset rather than stimulus offset; (2) stimulation success increases as a function of both acoustic intensity and acoustic duration; (3) interactions of intensity and duration suggest that successful stimulation results from the integration of stimulus amplitude over a time interval of 50 to 150 ms; and (4) the motor response elicited appears to be an all-or-nothing phenomenon, meaning stronger stimulus intensities and durations increase the probability of a motor response without affecting the duration or strength of the response.
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Affiliation(s)
- Randy L King
- Department of Bioengineering, Stanford University, Stanford, CA, USA.
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387
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Abstract
OBJECTIVE To review novel techniques of noninvasive brain stimulation (NBS), which may have value in assessment and treatment of traumatic brain injury (TBI). METHODS Review of the following techniques: transcranial magnetic stimulation, transcranial direct current stimulation, low-level laser therapy, and transcranial Doppler sonography. Furthermore, we provide a brief overview of TMS studies to date. MAIN FINDINGS We describe the rationale for the use of these techniques in TBI, discuss their possible mechanisms of action, and raise a number of considerations relevant to translation of these methods to clinical use. Depending on the stimulation parameters, NBS may enable suppression of the acute glutamatergic hyperexcitability following TBI and/or counter the excessive GABAergic effects in the subacute stage. In the chronic stage, brain stimulation coupled to rehabilitation may enhance behavioral recovery, learning of new skills, and cortical plasticity. Correlative animal models and comprehensive safety trials seem critical to establish the use of these modalities in TBI. CONCLUSIONS Different forms of NBS techniques harbor the promise of diagnostic and therapeutic utility, particularly to guide processes of cortical reorganization and enable functional restoration in TBI. Future lines of safety research and well-designed clinical trials in TBI are warranted to determine the capability of NBS to promote recovery and minimize disability.
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388
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Legon W, Rowlands A, Opitz A, Sato TF, Tyler WJ. Pulsed ultrasound differentially stimulates somatosensory circuits in humans as indicated by EEG and FMRI. PLoS One 2012; 7:e51177. [PMID: 23226567 PMCID: PMC3514181 DOI: 10.1371/journal.pone.0051177] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 10/30/2012] [Indexed: 11/19/2022] Open
Abstract
Peripheral somatosensory circuits are known to respond to diverse stimulus modalities. The energy modalities capable of eliciting somatosensory responses traditionally belong to mechanical, thermal, electromagnetic, and photonic domains. Ultrasound (US) applied to the periphery has also been reported to evoke diverse somatosensations. These observations however have been based primarily on subjective reports and lack neurophysiological descriptions. To investigate the effects of peripherally applied US on human somatosensory brain circuit activity we recorded evoked potentials using electroencephalography and conducted functional magnetic resonance imaging of blood oxygen level-dependent (BOLD) responses to fingertip stimulation with pulsed US. We found a pulsed US waveform designed to elicit a mild vibration sensation reliably triggered evoked potentials having distinct waveform morphologies including a large double-peaked vertex potential. Fingertip stimulation with this pulsed US waveform also led to the appearance of BOLD signals in brain regions responsible for somatosensory discrimination including the primary somatosensory cortex and parietal operculum, as well as brain regions involved in hierarchical somatosensory processing, such as the insula, anterior middle cingulate cortex, and supramarginal gyrus. By changing the energy profile of the pulsed US stimulus waveform we observed pulsed US can differentially activate somatosensory circuits and alter subjective reports that are concomitant with changes in evoked potential morphology and BOLD response patterns. Based on these observations we conclude pulsed US can functionally stimulate different somatosensory fibers and receptors, which may permit new approaches to the study and diagnosis of peripheral nerve injury, dysfunction, and disease.
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Affiliation(s)
- Wynn Legon
- Virginia Tech Carilion Research Institute and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, Virginia, United States of America
| | - Abby Rowlands
- Virginia Tech Carilion Research Institute and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, Virginia, United States of America
| | - Alexander Opitz
- Virginia Tech Carilion Research Institute and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, Virginia, United States of America
| | - Tomokazu F. Sato
- Virginia Tech Carilion Research Institute and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, Virginia, United States of America
| | - William J. Tyler
- Virginia Tech Carilion Research Institute and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, Virginia, United States of America
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389
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Al-Harbi KS, Qureshi NA. Neuromodulation therapies and treatment-resistant depression. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2012; 5:53-65. [PMID: 23152710 PMCID: PMC3496963 DOI: 10.2147/mder.s33198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Patients with treatment-resistant depression (TRD) who showed partial response to pharmacological and psychotherapeutic interventions need a trial of neuromodulation therapies (NTs). Objective This paper aims to review evidence-based data on the use of NTs in TRD. Method Using keywords and combined-word strategy, multiple computer searches of PubMed, Google Scholar, Quertle(R), and Medline were conducted for retrieving relevant articles published in English-language peer-reviewed journals (2000–2012). Those papers that addressed NTs in TRD were retained for extensive review. Results Despite methodological challenges, a range of 30%–93% of TRD patients showed substantial improvement to one of the NTs. One hundred–percent improvement was reported in two single-case studies on deep brain stimulation. Some studies reported no benefits from transcranial direct current stimulation. NTs were reported to have good clinical efficacy, better safety margin, and benign side-effect profile. Data are limited regarding randomized clinical trials, long-term efficacy, and cost-effectiveness of these approaches. Both modified electroconvulsive therapy and magnetic seizure therapy were associated with reversible but disturbing neurocognitive adverse effects. Besides clinical utility, NTs including approaches on the horizon may unlock the biological basis underlying mood disorders including TRD. Conclusion NTs are promising in patients with TRD, as the majority of them show good clinical response measured by standardized depression scales. NTs need further technological refinements and optimization together with continuing well-designed studies that recruit larger numbers of participants with TRD.
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390
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Abstract
High-intensity focused ultrasound (HIFU) provides focal delivery of mechanical energy deep into the body. This energy can be used to elevate the tissue temperature to such a degree that ablation is achieved. The elevated temperature can also be used to release drugs from temperature-sensitive carriers or activate therapeutic molecules using mechanical or thermal energy. Lower dose exposures modify the vasculature to allow large molecules to diffuse from blood in the surrounding tissue for local drug delivery. The energy delivery can be targeted and monitored using magnetic resonance imaging (MRI). The online image guidance and monitoring provides treatment delivery that is customized to each patient such that optimal, effective treatment can be achieved. This ability to localize and customize treatment delivery may further enhance the future potential of targeted drugs that are personalized for each patient. This review examines the rapid development of MRI-guided HIFU (MRIgHIFU) methods over the past few years and discuss their future potential.
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Affiliation(s)
- Kullervo Hynynen
- Imaging Research, Sunnybrook Health Sciences Centre, and Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
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391
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Yao JP, Hou WS, Yin ZQ. Optogenetics: a novel optical manipulation tool for medical investigation. Int J Ophthalmol 2012; 5:517-22. [PMID: 22937517 DOI: 10.3980/j.issn.2222-3959.2012.04.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 07/25/2012] [Indexed: 11/02/2022] Open
Abstract
Optogenetics is a new and rapidly evolving gene and neuroengineering technology that allows optical control of specific populations of neurons without affecting other neurons in the brain at high temporal and spatial resolution. By heterologous expression of the light-sensitive membrane proteins, cell type-specific depolarization or hyperpolarization can be optically induced on a millisecond time scale. Optogenetics has the higher selectivity and specificity compared to traditional electrophysiological techniques and pharmaceutical methods. It has been a novel promising tool for medical research. Because of easy handling, high temporal and spatial precision, optogenetics has been applied to many aspects of nervous system research, such as tactual neural circuit, visual neural circuit, auditory neural circuit and olfactory neural circuit, as well as research of some neurological diseases. The review highlights the recent advances of optogenetics in medical study.
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Affiliation(s)
- Jun-Ping Yao
- College of Biology Engineering, Chongqing University, Chongqing 400044, China
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392
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Kim H, Chiu A, Park S, Yoo SS. Image-guided Navigation of Single-element Focused Ultrasound Transducer. INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY 2012; 22:177-184. [PMID: 25232203 PMCID: PMC4163919 DOI: 10.1002/ima.22020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The spatial specificity and controllability of focused ultrasound (FUS), in addition to its ability to modify the excitability of neural tissue, allows for the selective and reversible neuromodulation of the brain function, with great potential in neurotherapeutics. Intra-operative magnetic resonance imaging (MRI) guidance (in short, MRg) has limitations due to its complicated examination logistics, such as fixation through skull screws to mount the stereotactic frame, simultaneous sonication in the MRI environment, and restrictions in choosing MR-compatible materials. In order to overcome these limitations, an image-guidance system based on optical tracking and pre-operative imaging data is developed, separating the imaging acquisition for guidance and sonication procedure for treatment. Techniques to define the local coordinates of the focal point of sonication are presented. First, mechanical calibration detects the concentric rotational motion of a rigid-body optical tracker, attached to a straight rod mimicking the sonication path, pivoted at the virtual FUS focus. The spatial error presented in the mechanical calibration was compensated further by MRI-based calibration, which estimates the spatial offset between the navigated focal point and the ground-truth location of the sonication focus obtained from a temperature-sensitive MR sequence. MRI-based calibration offered a significant decrease in spatial errors (1.9±0.8 mm; 57% reduction) compared to the mechanical calibration method alone (4.4±0.9 mm). Using the presented method, pulse-mode FUS was applied to the motor area of the rat brain, and successfully stimulated the motor cortex. The presented techniques can be readily adapted for the transcranial application of FUS to intact human brain.
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Affiliation(s)
- Hyungmin Kim
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Mechanical Engineering, Korea University, Seoul, Korea
| | - Alan Chiu
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Shinsuk Park
- Department of Mechanical Engineering, Korea University, Seoul, Korea
| | - Seung-Schik Yoo
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- School of Nano-Bioscience and Chemical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Korea
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393
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Kim H, Taghados SJ, Fischer K, Maeng LS, Park S, Yoo SS. Noninvasive transcranial stimulation of rat abducens nerve by focused ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:1568-75. [PMID: 22763009 PMCID: PMC3428140 DOI: 10.1016/j.ultrasmedbio.2012.04.023] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 03/27/2012] [Accepted: 04/30/2012] [Indexed: 05/09/2023]
Abstract
Nonpharmacologic and nonsurgical transcranial modulation of the nerve function may provide new opportunities in evaluation and treatment of cranial nerve diseases. This study investigates the possibility of using low-intensity transcranial focused ultrasound (FUS) to selectively stimulate the rat abducens nerve located above the base of the skull. FUS (frequencies of 350 kHz and 650 kHz) operating in a pulsed mode was applied to the abducens nerve of Sprague-Dawley rats under stereotactic guidance. The abductive eyeball movement ipsilateral to the side of sonication was observed at 350 kHz, using the 0.36-msec tone burst duration (TBD), 1.5-kHz pulse repetition frequency (PRF), and the overall sonication duration of 200 msec. Histologic and behavioral monitoring showed no signs of disruption in the blood brain barrier (BBB), as well as no damage to the nerves and adjacent brain tissue resulting from the sonication. As a novel functional neuro-modulatory modality, the pulsed application of FUS has potential for diagnostic and therapeutic applications in diseases of the peripheral nervous system.
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Affiliation(s)
- Hyungmin Kim
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Mechanical Engineering, Korea University, Seoul, Korea
| | | | - Krisztina Fischer
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Lee-So Maeng
- Institute of Catholic Integrative Medicine (ICIM), Incheon Saint Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
| | - Shinsuk Park
- Department of Mechanical Engineering, Korea University, Seoul, Korea
| | - Seung-Schik Yoo
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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394
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395
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Cognitive effects of NSAIDs in cerebral ischemia: a hypothesis exploring mechanical action mediated pharmacotherapy. Med Hypotheses 2012; 79:393-5. [PMID: 22771072 DOI: 10.1016/j.mehy.2012.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 05/26/2012] [Accepted: 06/03/2012] [Indexed: 12/19/2022]
Abstract
Cerebral ischemia is associated with altered neuronal mechanics leading to dynamic reshaping of neuronal structures, giving rise to a cascade of biological pathways leading to many deleterious consequences and cognitive deficits. Memory and learning specifically are mediated by neurotransmitter release from vesicles clustered at the synapse. Mechanical tension is an important factor governing the amount of vesicular neurotransmitter release in response to an action potential. Neuroinflammation in cerebral ischemia leads to altered mechanical/physical forces on neurons which gives rise to abnormal mechanical tension along the neuron resulting in neurotransmitter imbalance leading to cognitive dysfunction. We consider the possibility that modulation of mechanical forces on neurons may be a therapeutic strategy to help prevent cognitive deficit in cerebral ischemia. Here we show how NSAIDs may act as candidate pharmacological molecules which have the ability to inhibit neuroinflammation and which can alter neuronal mechanics by their COX-2 inhibiting property.
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396
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Hameroff S, Trakas M, Duffield C, Annabi E, Gerace MB, Boyle P, Lucas A, Amos Q, Buadu A, Badal JJ. Transcranial ultrasound (TUS) effects on mental states: a pilot study. Brain Stimul 2012; 6:409-15. [PMID: 22664271 DOI: 10.1016/j.brs.2012.05.002] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 02/19/2012] [Accepted: 05/06/2012] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND/OBJECTIVE Transcranial ultrasound (TUS) can modulate brain function. To assess possible TUS modulation of mental states, we investigated effects on subjective reports of pain and mood of sub-thermal TUS versus placebo applied to frontal scalp and brain of chronic pain patient volunteers. METHODS With IRB approval and informed consent, subjects with chronic pain completed two visual analog scales for pain (NRS) and mood (VAMS/Global Affect), and their vital signs were recorded 10 min prior to, and 10 min and 40 min following exposure to either subthermal TUS (8 MHz) or placebo (in a double blind crossover study) using the 12L-RS probe of a LOGIQe ultrasound imaging machine (General Electric, USA). A physician, also blinded for TUS versus placebo, applied the probe (with gel) to scalp over posterior frontal cortex, contralateral to maximal pain, for 15 seconds. A second investigator operated the ultrasound machine, randomizing TUS versus placebo. The process was then repeated, applying the opposite modality (TUS or placebo). RESULTS Subjective reports of Mood/Global Affect were improved 10 min (P = 0.03) and 40 min (P = 0.04) following TUS compared with placebo. NRS pain reports slightly improved following TUS (P = 0.07) at 40 min. CONCLUSION We found improvement in subjective mood 10 min and 40 min after TUS compared to placebo. TUS can have safe neurophysiological effects on brain function, and is a promising noninvasive therapy for modulating conscious and unconscious mental states and disorders. We suggest TUS acts via intra-neuronal microtubules, which apparently resonate in TUS megahertz range.
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Affiliation(s)
- Stuart Hameroff
- Department of Anesthesiology, The University of Arizona Health Sciences Center, Tucson, AZ 85718, USA.
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397
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398
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Rosa MA, Lisanby SH. Somatic treatments for mood disorders. Neuropsychopharmacology 2012; 37:102-16. [PMID: 21976043 PMCID: PMC3238088 DOI: 10.1038/npp.2011.225] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 08/18/2011] [Accepted: 08/18/2011] [Indexed: 12/22/2022]
Abstract
Somatic treatments for mood disorders represent a class of interventions available either as a stand-alone option, or in combination with psychopharmacology and/or psychotherapy. Here, we review the currently available techniques, including those already in clinical use and those still under research. Techniques are grouped into the following categories: (1) seizure therapies, including electroconvulsive therapy and magnetic seizure therapy, (2) noninvasive techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and cranial electric stimulation, (3) surgical approaches, including vagus nerve stimulation, epidural electrical stimulation, and deep brain stimulation, and (4) technologies on the horizon. Additionally, we discuss novel approaches to the optimization of each treatment, and new techniques that are under active investigation.
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Affiliation(s)
- Moacyr A Rosa
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Sarah H Lisanby
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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399
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Tsukamoto A, Higashiyama S, Yoshida K, Watanabe Y, Furukawa KS, Ushida T. Stable cavitation induces increased cytoplasmic calcium in L929 fibroblasts exposed to 1-MHz pulsed ultrasound. ULTRASONICS 2011; 51:982-990. [PMID: 21689836 DOI: 10.1016/j.ultras.2011.05.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 05/23/2011] [Accepted: 05/27/2011] [Indexed: 05/30/2023]
Abstract
An increase in cytoplasmic calcium (Ca(2+) increase) is a second messenger that is often observed under ultrasound irradiation. We hypothesize that cavitation is a physical mechanism that underlies the increase in Ca(2+) in these experiments. To control the presence of cavitation, the wave type was controlled in a sonication chamber. One wave type largely contained a traveling wave (wave type A) while the other wave type largely contained a standing wave (wave type B). Fast Fourier transform (FFT) analysis of a sound field produced by the wave types ascertained that stable cavitation was present only under wave type A ultrasound irradiation. Under the two controlled wave types, the increase in Ca(2+) in L929 fibroblasts was observed with fluorescence imaging. Under wave type A ultrasound irradiation, an increase in Ca(2+) was observed; however, no increase in Ca(2+) was observed under wave type B ultrasound irradiation. We conclude that stable cavitation is involved in the increase of Ca(2+) in cells subjected to pulsed ultrasound.
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Affiliation(s)
- Akira Tsukamoto
- Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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400
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Abstract
OBJECTIVE The aim of this study was to review the current state of development and application of a wide range of brain stimulation approaches in the treatment of psychiatric disorders. METHOD The approaches reviewed include forms of minimally invasive magnetic and electrical stimulation, seizure induction, implanted devices and several highly novel approaches in early development. RESULTS An extensive range of brain stimulation approaches are now being widely used in the treatment of patients with psychiatric disorders, or actively investigated for this use. Both vagal nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (rTMS) have been introduced into clinical practice in some countries. A small body of research suggests that VNS has some potentially long-lasting antidepressant effects in a minority of patients treated. rTMS has now been extensively investigated for over 15 years, with a large body of research now supporting its antidepressant effects. Further rTMS research needs to focus on defining the most appropriate stimulation methods and exploring its longer term use in maintenance protocols. Very early data suggest that magnetic seizure therapy (MST) has promise in the treatment of patients referred for electroconvulsive therapy: MST appears to have fewer side effects and may have similar efficacy. A number of other approaches including surgical and alternative forms of electrical stimulation appear to alter brain activity in a promising manner, but are in need of evaluation in more substantive patient samples. CONCLUSIONS It appears likely that the range of psychiatric treatments available for patients will grow over the coming years to progressively include a number of novel brain stimulation techniques.
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Affiliation(s)
- Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia. paul.fi
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