Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland, St Lucia Campus, Brisbane, Queenland 4072, Australia.
Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove Campus, Brisbane, Queenland 4059, Australia.
Nat Rev Neurol. 2016 Mar;12(3):161-74. doi: 10.1038/nrneurol.2016.13. Epub 2016 Feb 19.
Like cardiovascular disease and cancer, neurological disorders present an increasing challenge for an ageing population. Whereas nonpharmacological procedures are routine for eliminating cancer tissue or opening a blocked artery, the focus in neurological disease remains on pharmacological interventions. Setbacks in clinical trials and the obstacle of access to the brain for drug delivery and surgery have highlighted the potential for therapeutic use of ultrasound in neurological diseases, and the technology has proved useful for inducing focused lesions, clearing protein aggregates, facilitating drug uptake, and modulating neuronal function. In this Review, we discuss milestones in the development of therapeutic ultrasound, from the first steps in the 1950s to recent improvements in technology. We provide an overview of the principles of diagnostic and therapeutic ultrasound, for surgery and transient opening of the blood-brain barrier, and its application in clinical trials of stroke, Parkinson disease and chronic pain. We discuss the promising outcomes of safety and feasibility studies in preclinical models, including rodents, pigs and macaques, and efficacy studies in models of Alzheimer disease. We also consider the challenges faced on the road to clinical translation.
与心血管疾病和癌症一样，神经紊乱给老龄化人口带来了越来越大的挑战。虽然非药物程序是消除癌症组织或打开阻塞动脉的常规手段，但神经疾病的重点仍然是药物干预。临床试验的挫折和药物输送及手术进入大脑的障碍突显了超声在神经疾病中的治疗应用潜力，该技术已被证明可用于诱导聚焦损伤、清除蛋白聚集物、促进药物摄取和调节神经元功能。在这篇综述中，我们讨论了治疗性超声发展的里程碑，从 20 世纪 50 年代的最初步骤到最近的技术改进。我们概述了诊断和治疗超声的原理，包括手术和血脑屏障的短暂开放，以及在中风、帕金森病和慢性疼痛的临床试验中的应用。我们讨论了在临床转化道路上面临的挑战。
