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低强度聚焦超声的无创神经调节和丘脑绘图。

Noninvasive neuromodulation and thalamic mapping with low-intensity focused ultrasound.

机构信息

Departments of1Neurosurgery.

2Biomedical Engineering.

出版信息

J Neurosurg. 2018 Mar;128(3):875-884. doi: 10.3171/2016.11.JNS16976. Epub 2017 Apr 21.


DOI:10.3171/2016.11.JNS16976
PMID:28430035
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7032074/
Abstract

OBJECTIVE Ultrasound can be precisely focused through the intact human skull to target deep regions of the brain for stereotactic ablations. Acoustic energy at much lower intensities is capable of both exciting and inhibiting neural tissues without causing tissue heating or damage. The objective of this study was to demonstrate the effects of low-intensity focused ultrasound (LIFU) for neuromodulation and selective mapping in the thalamus of a large-brain animal. METHODS Ten Yorkshire swine ( Sus scrofa domesticus) were used in this study. In the first neuromodulation experiment, the lemniscal sensory thalamus was stereotactically targeted with LIFU, and somatosensory evoked potentials (SSEPs) were monitored. In a second mapping experiment, the ventromedial and ventroposterolateral sensory thalamic nuclei were alternately targeted with LIFU, while both trigeminal and tibial evoked SSEPs were recorded. Temperature at the acoustic focus was assessed using MR thermography. At the end of the experiments, all tissues were assessed histologically for damage. RESULTS LIFU targeted to the ventroposterolateral thalamic nucleus suppressed SSEP amplitude to 71.6% ± 11.4% (mean ± SD) compared with baseline recordings. Second, we found a similar degree of inhibition with a high spatial resolution (∼ 2 mm) since adjacent thalamic nuclei could be selectively inhibited. The ventromedial thalamic nucleus could be inhibited without affecting the ventrolateral nucleus. During MR thermography imaging, there was no observed tissue heating during LIFU sonications and no histological evidence of tissue damage. CONCLUSIONS These results suggest that LIFU can be safely used to modulate neuronal circuits in the central nervous system and that noninvasive brain mapping with focused ultrasound may be feasible in humans.

摘要

目的 超声可以通过完整的人颅骨精确聚焦,以针对大脑深部区域进行立体定向消融。低强度的声能既能兴奋又能抑制神经组织,而不会引起组织加热或损伤。本研究的目的是证明低强度聚焦超声(LIFU)在大型动物丘脑的神经调节和选择性映射中的作用。

方法 本研究使用了 10 头约克夏猪(Sus scrofa domesticus)。在第一个神经调节实验中,LIFU 被立体定向靶向于感觉丘脑,同时监测体感诱发电位(SSEP)。在第二个映射实验中,交替靶向腹侧和腹后外侧感觉丘脑核,同时记录三叉神经和胫骨诱发的 SSEP。使用磁共振热成像评估声焦点处的温度。在实验结束时,所有组织均进行组织学评估以确定是否有损伤。

结果 LIFU 靶向腹后外侧丘脑核,与基线记录相比,SSEP 幅度抑制到 71.6%±11.4%(平均值±标准差)。其次,我们发现由于可以选择性地抑制相邻的丘脑核,因此具有类似程度的抑制作用,具有较高的空间分辨率(约 2 毫米)。可以抑制腹侧丘脑核而不影响腹侧核。在磁共振热成像成像期间,LIFU 超声期间没有观察到组织加热,也没有组织损伤的组织学证据。

结论 这些结果表明,LIFU 可安全地用于调节中枢神经系统中的神经元回路,并且使用聚焦超声进行非侵入性脑映射在人类中可能是可行的。

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本文引用的文献

[1]
Image-Guided Focused Ultrasound-Mediated Regional Brain Stimulation in Sheep.

Ultrasound Med Biol. 2016-2

[2]
Image-guided transcranial focused ultrasound stimulates human primary somatosensory cortex.

Sci Rep. 2015-3-4

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First experience with MR-guided focused ultrasound in the treatment of Parkinson's disease.

J Ther Ultrasound. 2014-5-31

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Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes.

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Curr Biol. 2013-12-2

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A magnetic resonance imaging, histological, and dose modeling comparison of focused ultrasound, radiofrequency, and Gamma Knife radiosurgery lesions in swine thalamus.

J Neurosurg. 2013-6-7

[10]
MR-guided focused ultrasound thalamotomy for essential tremor: a proof-of-concept study.

Lancet Neurol. 2013-3-21

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