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Zhang Y, Buckmaster PS, Qiu L, Wang J, Keunen O, Ghobadi SN, Huang A, Hou Q, Li N, Narang S, Habte FG, Bertram EH, Lee KS, Wintermark M. Non-invasive, neurotoxic surgery reduces seizures in a rat model of temporal lobe epilepsy. Exp Neurol 2021; 343:113761. [PMID: 33991523 DOI: 10.1016/j.expneurol.2021.113761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/05/2021] [Accepted: 05/10/2021] [Indexed: 12/22/2022]
Abstract
Surgery can be highly effective for treating certain cases of drug resistant epilepsy. The current study tested a novel, non-invasive, surgical strategy for treating seizures in a rat model of temporal lobe epilepsy. The surgical approach uses magnetic resonance-guided, low-intensity focused ultrasound (MRgFUS) in combination with intravenous microbubbles to open the blood-brain barrier (BBB) in a transient and focal manner. During the period of BBB opening, a systemically administered neurotoxin (Quinolinic Acid: QA) that is normally impermeable to the BBB gains access to a targeted area in the brain, destroying neurons where the BBB has been opened. This strategy is termed Precise Intracerebral Non-invasive Guided Surgery (PING). Spontaneous recurrent seizures induced by pilocarpine were monitored behaviorally prior to and after PING or under control conditions. Seizure frequency in untreated animals or animals treated with MRgFUS without QA exhibited expected seizure rate fluctuations frequencies between the monitoring periods. In contrast, animals treated with PING targeting the intermediate-temporal aspect of the hippocampus exhibited substantial reductions in seizure frequency, with convulsive seizures being eliminated entirely in two animals. These findings suggest that PING could provide a useful alternative to invasive surgical interventions for treating drug resistant epilepsy, and perhaps for treating other neurological disorders in which aberrant neural circuitries play a role.
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Affiliation(s)
- Yanrong Zhang
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA
| | - Paul S Buckmaster
- Stanford University, Department of Comparative Medicine, Stanford, CA, USA
| | - Lexuan Qiu
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA
| | - Jing Wang
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA; Department of Radiology, Shandong Medical Imaging Research Institute, Jinan, Shandong 250021, China
| | - Olivier Keunen
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA; Translational Radiomics, Quantitative Biology Unit, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Ai Huang
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA; Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Qingyi Hou
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA; Nuclear Medicine Department, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Ningrui Li
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Shivek Narang
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA
| | - Frezghi G Habte
- Department of Radiology, Molecular Imaging Program at Stanford, CA, USA
| | - Edward H Bertram
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Kevin S Lee
- Department of Neuroscience, University of Virginia, Charlottesville, VA, USA; Department of Neurosurgery, and Center for Brain, Immunology, and Glia, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Max Wintermark
- Department of Radiology, Neuroradiology Division, Stanford University, CA, USA.
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Zhang Y, Liao C, Qu H, Huang S, Jiang H, Zhou H, Abrams E, Habte FG, Yuan L, Bertram EH, Lee KS, Pauly KB, Buckmaster PS, Wintermark M. Testing Different Combinations of Acoustic Pressure and Doses of Quinolinic Acid for Induction of Focal Neuron Loss in Mice Using Transcranial Low-Intensity Focused Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:129-136. [PMID: 30309748 PMCID: PMC6289648 DOI: 10.1016/j.ultrasmedbio.2018.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/21/2018] [Accepted: 08/28/2018] [Indexed: 05/31/2023]
Abstract
The goal of this study was to test different combinations of acoustic pressure and doses of quinolinic acid (QA) for producing a focal neuronal lesion in the murine hippocampus without causing unwanted damage to adjacent brain structures. Sixty male CD-1 mice were divided into 12 groups that underwent magnetic resonance-guided focused ultrasound at high (0.67 MPa), medium (0.5 MPa) and low (0.33 MPa) acoustic peak negative pressures and received QA at high (0.012 mmol), medium (0.006 mmol) and low (0.003 mmol) dosages. Neuronal loss occurred only when magnetic resonance-guided focused ultrasound with adequate acoustic power (0.67 or 0.5 MPa) was combined with QA. The animals subjected to the highest acoustic power had larger lesions than those treated with medium acoustic power, but two mice had evidence of bleeding. When the intermediate acoustic power was used, medium and high dosages of QA produced lesions larger than those produced by the low dosage.
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Affiliation(s)
- Yanrong Zhang
- Department of Ultrasound, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, China; Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA
| | - Chengde Liao
- Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA; Department of Radiology, Third Affiliated Hospital of Kunming Medical University, Tumor Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Haibo Qu
- Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA; Department of Medical Imaging, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Siqin Huang
- Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA; Traditional Chinese Medicine College, Chongqing Medical University, Chongqing, China
| | - Hong Jiang
- Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA; Department of Neurology, Peking University of People's Hospital, Beijing, China
| | - Haiyan Zhou
- Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA; The Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Emily Abrams
- Department of Comparative Medicine, Stanford University, Stanford, California, USA
| | - Frezghi G Habte
- Department of Radiology, Molecular Imaging Program, Stanford University, Stanford, California, USA
| | - Li Yuan
- Department of Ultrasound, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, China
| | - Edward H Bertram
- Department of Neurology, University of Virginia, Charlottesville, Virginia, USA
| | - Kevin S Lee
- Departments of Neuroscience and Neurosurgery and Center for Brain Immunology and Glia, University of Virginia, Charlottesville, Virginia, USA
| | - Kim Butts Pauly
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Paul S Buckmaster
- Department of Comparative Medicine, Stanford University, Stanford, California, USA
| | - Max Wintermark
- Neuroradiology Section, Department of Radiology, Stanford University, Stanford, California, USA.
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Zhang Y, Tan H, Bertram EH, Aubry JF, Lopes MB, Roy J, Dumont E, Xie M, Zuo Z, Klibanov AL, Lee KS, Wintermark M. Non-Invasive, Focal Disconnection of Brain Circuitry Using Magnetic Resonance-Guided Low-Intensity Focused Ultrasound to Deliver a Neurotoxin. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2261-2269. [PMID: 27260243 DOI: 10.1016/j.ultrasmedbio.2016.04.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/21/2016] [Accepted: 04/26/2016] [Indexed: 06/05/2023]
Abstract
Disturbances in the function of neuronal circuitry contribute to most neurologic disorders. As knowledge of the brain's connectome continues to improve, a more refined understanding of the role of specific circuits in pathologic states will also evolve. Tools capable of manipulating identified circuits in a targeted and restricted manner will be essential not only to expand our understanding of the functional roles of such circuits, but also to therapeutically disconnect critical pathways contributing to neurologic disease. This study took advantage of the ability of low-intensity focused ultrasound (FUS) to transiently disrupt the blood-brain barrier (BBB) to deliver a neurotoxin with poor BBB permeability (quinolinic acid [QA]) in a guided manner to a target region in the brain parenchyma. Ten male Sprague-Dawley rats were divided into two groups receiving the following treatments: (i) magnetic resonance-guided FUS + microbubbles + saline (n = 5), or (ii) magnetic resonance-guided FUS + microbubbles + QA (n = 5). Systemic administration of QA was well tolerated. However, when QA and microbubbles were systemically administered in conjunction with magnetic resonance-guided FUS, the BBB was disrupted and primary neurons were destroyed in the targeted subregion of the hippocampus in all QA-treated animals. Administration of vehicle (saline) together with microbubbles and FUS also disrupted the BBB but did not produce neuronal injury. These findings indicate the feasibility of non-invasively destroying a targeted region of the brain parenchyma using low-intensity FUS together with systemic administration of microbubbles and a neurotoxin. This approach could be of therapeutic value in various disorders in which disturbances of neural circuitry contribute to neurologic disease.
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Affiliation(s)
- Yanrong Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Radiology, Neuroradiology Division, University of Virginia, Charlottesville, Virginia, USA
| | - Hongying Tan
- Department of Anesthesiology, Sun Yat-Sen University Cancer Center, Guangzhou, China; Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
| | - Edward H Bertram
- Department of Neurology, University of Virginia, Charlottesville, Virginia, USA
| | - Jean-François Aubry
- Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA; ESPCI ParisTech, PSL Research University, Institut Langevin, Paris, France; CNRS, Institut Langevin, Paris, France; INSERM, Institut Langevin, Paris, France
| | - Maria-Beatriz Lopes
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
| | - Jack Roy
- Department of Radiology, University of Virginia, Charlottesville, Virginia, USA
| | | | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhiyi Zuo
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
| | - Alexander L Klibanov
- Cardiovascular Division, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Kevin S Lee
- Departments of Neuroscience and Neurosurgery, and Center for Brain Immunology and Glia, University of Virginia, Charlottesville, Virginia, USA.
| | - Max Wintermark
- Department of Radiology, Neuroradiology Division, University of Virginia, Charlottesville, Virginia, USA; Department of Radiology, Neuroradiology Section, Stanford University, Palo Alto, California, USA.
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