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阿尔茨海默病中的经颅超声脉冲刺激——一种新的导航聚焦脑疗法。

Transcranial Pulse Stimulation with Ultrasound in Alzheimer's Disease-A New Navigated Focal Brain Therapy.

作者信息

Beisteiner Roland, Matt Eva, Fan Christina, Baldysiak Heike, Schönfeld Marleen, Philippi Novak Tabea, Amini Ahmad, Aslan Tuna, Reinecke Raphael, Lehrner Johann, Weber Alexandra, Reime Ulrike, Goldenstedt Cédric, Marlinghaus Ernst, Hallett Mark, Lohse-Busch Henning

机构信息

Department of Neurology Laboratory for Functional Brain Diagnostics and Therapy High Field MR Center Medical University of Vienna Spitalgasse 23 Vienna 1090 Austria.

Applied Research Center Storz Medical AG Lohstampfestrasse 8 Tägerwilen 8274 Switzerland.

出版信息

Adv Sci (Weinh). 2019 Dec 23;7(3):1902583. doi: 10.1002/advs.201902583. eCollection 2020 Feb.


DOI:10.1002/advs.201902583
PMID:32042569
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7001626/
Abstract

Ultrasound-based brain stimulation techniques may become a powerful new technique to modulate the human brain in a focal and targeted manner. However, for clinical brain stimulation no certified systems exist and the current techniques have to be further developed. Here, a clinical sonication technique is introduced, based on single ultrashort ultrasound pulses (transcranial pulse stimulation, TPS) which markedly differs from existing focused ultrasound techniques. In addition, a first clinical study using ultrasound brain stimulation and first observations of long term effects are presented. Comprehensive feasibility, safety, and efficacy data are provided. They consist of simulation data, laboratory measurements with rat and human skulls and brains, in vivo modulations of somatosensory evoked potentials (SEP) in healthy subjects (sham controlled) and clinical pilot data in 35 patients with Alzheimer's disease acquired in a multicenter setting (including neuropsychological scores and functional magnetic resonance imaging (fMRI)). Preclinical results show large safety margins and dose dependent neuromodulation. Patient investigations reveal high treatment tolerability and no major side effects. Neuropsychological scores improve significantly after TPS treatment and improvement lasts up to three months and correlates with an upregulation of the memory network (fMRI data). The results encourage broad neuroscientific application and translation of the method to clinical therapy and randomized sham-controlled clinical studies.

摘要

基于超声的脑刺激技术可能会成为一种强大的新技术,能够以局部和靶向的方式调节人类大脑。然而,对于临床脑刺激而言,目前尚无经过认证的系统,当前技术仍需进一步发展。在此,我们介绍一种临床超声处理技术,该技术基于单个超短超声脉冲(经颅脉冲刺激,TPS),与现有的聚焦超声技术显著不同。此外,还展示了一项使用超声脑刺激的首次临床研究以及对长期效果的首次观察结果。提供了全面的可行性、安全性和有效性数据。这些数据包括模拟数据、对大鼠和人类头骨及大脑的实验室测量、健康受试者体感诱发电位(SEP)的体内调制(假对照)以及在多中心环境下对35例阿尔茨海默病患者的临床试点数据(包括神经心理学评分和功能磁共振成像(fMRI))。临床前结果显示出较大的安全边际和剂量依赖性神经调节作用。患者调查显示治疗耐受性高且无重大副作用。经TPS治疗后,神经心理学评分显著改善,改善持续长达三个月,且与记忆网络的上调相关(fMRI数据)。这些结果鼓励该方法在神经科学领域广泛应用,并转化为临床治疗以及随机假对照临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/1df011454770/ADVS-7-1902583-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/458775099d88/ADVS-7-1902583-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/42c27dc49819/ADVS-7-1902583-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/1df011454770/ADVS-7-1902583-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/458775099d88/ADVS-7-1902583-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/42c27dc49819/ADVS-7-1902583-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c0/7001626/1df011454770/ADVS-7-1902583-g003.jpg

相似文献

[1]
Transcranial Pulse Stimulation with Ultrasound in Alzheimer's Disease-A New Navigated Focal Brain Therapy.

Adv Sci (Weinh). 2019-12-23

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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Psychol Med. 2025-3-4

[8]
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[9]
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Alzheimers Dement (N Y). 2025-3-10

[10]
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引用本文的文献

[1]
Transcranial Pulse Stimulation in Alzheimer's: Long-Term Feasibility and a Multifocal Treatment Approach.

Brain Sci. 2025-8-1

[2]
Study Protocol: Investigating the Effects of Transcranial Pulse Stimulation in Parkinson's Disease.

Bioengineering (Basel). 2025-7-17

[3]
Real-time Monitoring Unveils Three Distinct Neuronal Response Patterns to SAW Ultrasound via L-type Calcium Channels.

Neurosci Bull. 2025-7-16

[4]
Commentary: Treating Diseases from Alzheimer's to Parkinson's Using Transcranial Pulse Stimulation: Mechanistic Insights, Recent Evidence, and Ethical Considerations.

NeuroSci. 2025-6-17

[5]
Effects of noninvasive brain stimulation on motor functions in animal models of ischemia and trauma in the central nervous system.

Neural Regen Res. 2026-4-1

[6]
Transcranial ultrasound stimulation parameters for neurological diseases: a systematic review.

Front Neurol. 2025-5-21

[7]
Bioadhesive hydrogel-coupled and miniaturized ultrasound transducer system for long-term, wearable neuromodulation.

Nat Commun. 2025-5-28

[8]
Transcranial ultrasound stimulation in neuromodulation: a bibliometric analysis from 2004 to 2024.

Front Neurosci. 2025-5-13

[9]
Non-invasive brain stimulation to modulate neural activity in Parkinson's disease.

NPJ Parkinsons Dis. 2025-4-5

[10]
Targeting Neural Oscillations for Cognitive Enhancement in Alzheimer's Disease.

Medicina (Kaunas). 2025-3-20

本文引用的文献

[1]
Reversible neuroinhibition by focused ultrasound is mediated by a thermal mechanism.

Brain Stimul. 2019-7-23

[2]
Offline impact of transcranial focused ultrasound on cortical activation in primates.

Elife. 2019-2-12

[3]
Magnetic Resonance-Guided Focused Ultrasound : Current Status and Future Perspectives in Thermal Ablation and Blood-Brain Barrier Opening.

J Korean Neurosurg Soc. 2019-1

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Focused Ultrasound for Neuromodulation.

Neurotherapeutics. 2019-1

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Effects of Low Intensity Focused Ultrasound on Liposomes Containing Channel proteins.

Sci Rep. 2018-11-22

[6]
Lack of Target Engagement Following Low-Frequency Deep Transcranial Magnetic Stimulation of the Anterior Insula.

Neuromodulation. 2018-10-29

[7]
Transcranial direct current stimulation combined with cognitive training for the treatment of Parkinson Disease: A randomized, placebo-controlled study.

Brain Stimul. 2018-7-18

[8]
Blood-brain barrier opening in Alzheimer's disease using MR-guided focused ultrasound.

Nat Commun. 2018-7-25

[9]
Whole-brain low-intensity pulsed ultrasound therapy markedly improves cognitive dysfunctions in mouse models of dementia - Crucial roles of endothelial nitric oxide synthase.

Brain Stimul. 2018-5-22

[10]
From Subjective Cognitive Decline to Alzheimer's Disease: The Predictive Role of Neuropsychological Assessment, Personality Traits, and Cognitive Reserve. A 7-Year Follow-Up Study.

J Alzheimers Dis. 2018

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