Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, 90095, USA.
Brain Stimul. 2011 Jul;4(3):125-36. doi: 10.1016/j.brs.2011.03.007. Epub 2011 Apr 1.
With the recent approval by the Food and Drug Administration (FDA) of Deep Brain Stimulation (DBS) for Parkinson's Disease, dystonia and obsessive compulsive disorder (OCD), vagus nerve stimulation (VNS) for epilepsy and depression, and repetitive transcranial magnetic stimulation (rTMS) for the treatment of depression, neuromodulation has become increasingly relevant to clinical research. However, these techniques have significant drawbacks (eg, lack of special specificity and depth for the rTMS, and invasiveness and cumbersome maintenance for DBS). This article reviews the background, rationale, and pilot studies to date, using a new brain stimulation method-low-intensity focused ultrasound pulsation (LIFUP). The ability of ultrasound to be focused noninvasively through the skull anywhere within the brain, together with concurrent imaging (ie, functional magnetic resonance imaging [fMRI]) techniques, may create a role for research and clinical use of LIFUP. This technique is still in preclinical testing and needs to be assessed thoroughly before being advanced to clinical trials. In this study, we review over 50 years of research data on the use of focused ultrasound (FUS) in neuronal tissue and live brain, and propose novel applications of this noninvasive neuromodulation method.
随着最近食品和药物管理局 (FDA) 批准深部脑刺激 (DBS) 用于治疗帕金森病、肌张力障碍和强迫症 (OCD)、迷走神经刺激 (VNS) 用于治疗癫痫和抑郁症,以及重复经颅磁刺激 (rTMS) 用于治疗抑郁症,神经调节在临床研究中变得越来越重要。然而,这些技术存在明显的缺点(例如,rTMS 缺乏特殊的特异性和深度,DBS 具有侵入性和繁琐的维护)。本文综述了使用新的脑刺激方法——低强度聚焦超声脉冲 (LIFUP) 的背景、原理和迄今为止的初步研究。超声能够通过颅骨在大脑内的任何位置进行非侵入性聚焦,同时结合同步成像(即功能磁共振成像 [fMRI])技术,可能为 LIFUP 的研究和临床应用创造条件。该技术仍处于临床前测试阶段,在推进临床试验之前需要进行全面评估。在这项研究中,我们回顾了 50 多年来关于聚焦超声 (FUS) 在神经元组织和活体大脑中的应用的研究数据,并提出了这种非侵入性神经调节方法的新应用。