Umansky Daniel, Bing Chenchen, Chu Tak Ho, Alzahrani Saud, Dunn Jeff F, Pichardo Samuel, Midha Rajiv
Division of Neurosurgery, Department of Clinical Neurosciences, Calgary Zone, Alberta Health Services, Canada.
Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada.
Phys Med Biol. 2022 Oct 7;67(20). doi: 10.1088/1361-6560/ac8f0f.
. Focused ultrasound (FUS) use with and without microbubbles (MB) for investigation of the blood-nerve barrier (BNB) within the peripheral nervous system (PNS) has been performed in this study. We evaluate the feasibility of BNB opening in a rodent sciatic nerve model by direct vision FUS treatment and provide preliminary results of magnetic resonance guided FUS (MRgFUS).. Twenty rodent bilateral sciatic nerves were investigated. Rodents were treated using a benchtop FUS system to directly visualize nerve FUS studies. Definity MB, Evans blue dye (EB) and latex micro beads were injected during studies. Selected animals underwent further compound muscle action potential (CMAP) studies. Sonication peak pressure (MPa), width, duty-cycle and duration as well as MB concentration were varied to investigate effective pressure threshold. Further preliminary MRgFUS studies were performed on selected animals. Immunohistochemistry and histological analysis under florescent microscopy were performed at termination of experiments to verify treatment outcomes.. Three ultrasound pressures and three microbubble concentrations at a single sonication frequency (476.5 kHz) were performed under direct open targeting. Histological analysis demonstrated nerve internal architecture disruption at 1.2 MPa with 166.7l kgwhile 0.3 MPa, with 40l kgMB concentration was the lower threshold for consistently observed disruption of the BNB without anatomical microarchitecture disruption. EB leakage was confirmed at the target region in histological evaluation of nerve following MB injection and FUS sonication. Supra-harmonic emissions were detected during FUS exposures following MB injection but not at baseline reference, indicating effective MB response and stable cavitation. CMAP amplitudes showed delayed onset latency and lower amplitudes in sonicated nerves compared to control nerves without evidence of complete conduction block, suggesting a transient BNB disruption, while at lower limit pressure subtle conduction changes were observed. In MRgFUS, targeted nerves demonstrated further contrast agent leak as well as supra-harmonic frequency detection.. Opening of the BNB in the PNS was achieved using FUS and MB in a rodent model. Ongoing work aims to refine FUS parameters for drug delivery into the nerve after experimental transient BNB disruption.
本研究使用聚焦超声(FUS)并联合或不联合微泡(MB)对周围神经系统(PNS)内的血神经屏障(BNB)进行了研究。我们通过直视FUS治疗评估了啮齿动物坐骨神经模型中BNB开放的可行性,并提供了磁共振引导FUS(MRgFUS)的初步结果。研究了20只啮齿动物的双侧坐骨神经。使用台式FUS系统对啮齿动物进行治疗,以直接观察神经FUS研究。在研究过程中注射了Definity MB、伊文思蓝染料(EB)和乳胶微珠。选择的动物进行了进一步的复合肌肉动作电位(CMAP)研究。改变超声峰值压力(MPa)、宽度、占空比和持续时间以及MB浓度,以研究有效压力阈值。对选择的动物进行了进一步的初步MRgFUS研究。在实验结束时进行免疫组织化学和荧光显微镜下的组织学分析,以验证治疗效果。在直接开放靶向条件下,在单个超声频率(476.5 kHz)下进行了三种超声压力和三种微泡浓度的实验。组织学分析表明,在1.2 MPa和166.7μl/kg时神经内部结构被破坏,而在0.3 MPa和40μl/kg MB浓度时是持续观察到BNB破坏而无解剖微结构破坏的较低阈值。在MB注射和FUS超声处理后的神经组织学评估中,证实了目标区域存在EB渗漏。在MB注射后的FUS暴露期间检测到了超谐波发射,但在基线参考时未检测到,表明有效的MB反应和稳定的空化。与对照神经相比,超声处理的神经中CMAP振幅显示出延迟的起始潜伏期和较低的振幅,没有完全传导阻滞的证据,表明BNB短暂破坏,而在压力下限观察到细微的传导变化。在MRgFUS中,靶向神经显示出进一步的造影剂渗漏以及超谐波频率检测。在啮齿动物模型中使用FUS和MB实现了PNS中BNB的开放。正在进行的工作旨在优化FUS参数,以便在实验性短暂BNB破坏后将药物输送到神经中。