Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Ann Med. 2023;55(2):2251145. doi: 10.1080/07853890.2023.2251145.
As a chronic and progressive neurodegenerative disease, Parkinson's disease (PD) still lacks effective and safe targeted drug therapy. Low-intensity focused ultrasound (LIFU), a new method to stimulate the brain and open the blood-brain barrier (BBB), has been widely concerned by PD researchers due to its non-invasive characteristics. PubMed was searched for the past 10 years using the terms 'focused ultrasound', 'transcranial ultrasound', 'pulse ultrasound', and 'Parkinson's disease'. Relevant citations were selected from the authors' references. After excluding articles describing high-intensity focused ultrasound or non-Parkinson's disease applications, we found more than 100 full-text analyses for pooled analysis. Current preclinical studies have shown that LIFU could improve PD motor symptoms by regulating microglia activation, increasing neurotrophic factors, reducing oxidative stress, and promoting nerve repair and regeneration, while LIFU combined with microbubbles (MBs) can promote drugs to cross the BBB, which may become a new direction of PD treatment. Therefore, finding an efficient drug carrier system is the top priority of applying LIFU with MBs to deliver drugs. This article aims to review neuro-modulatory effect of LIFU and the possible biophysical mechanism in the treatment of PD, summarize the latest progress in delivering vehicles with MBs, and discuss its advantages and limitations.
作为一种慢性且进行性的神经退行性疾病，帕金森病（PD）仍然缺乏有效且安全的靶向药物治疗。低强度聚焦超声（LIFU）是一种新的刺激大脑和打开血脑屏障（BBB）的方法，由于其非侵入性的特点，引起了 PD 研究人员的广泛关注。使用“focused ultrasound”、“transcranial ultrasound”、“pulse ultrasound”和“Parkinson's disease”等术语在过去 10 年内在 PubMed 中进行了搜索。从作者的参考文献中选择了相关的引文。排除描述高强度聚焦超声或非帕金森病应用的文章后，我们发现有 100 多篇全文分析可供汇总分析。目前的临床前研究表明，LIFU 通过调节小胶质细胞激活、增加神经营养因子、减轻氧化应激以及促进神经修复和再生，可改善 PD 运动症状，而 LIFU 联合微泡（MBs）可以促进药物穿越 BBB，这可能成为 PD 治疗的新方向。因此，寻找有效的药物载体系统是将 LIFU 与 MBs 联合应用于药物输送的首要任务。本文旨在综述 LIFU 的神经调节作用及其在 PD 治疗中的可能生物物理机制，总结 MBs 载体输送的最新进展，并讨论其优缺点。
