低强度经颅聚焦超声通过调节疼痛处理脑回路来抑制疼痛。

Low-intensity transcranial focused ultrasound suppresses pain by modulating pain-processing brain circuits.

机构信息

Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA.

Department of Medicine, University of California, Irvine, Irvine, CA.

出版信息

Blood. 2024 Sep 5;144(10):1101-1115. doi: 10.1182/blood.2023023718.

Abstract

There is an urgent and unmet clinical need to develop nonpharmacological interventions for chronic pain management because of the critical side effects of opioids. Low-intensity transcranial focused ultrasound (tFUS) is an emerging noninvasive neuromodulation technology with high spatial specificity and deep brain penetration. Here, we developed a tightly focused 128-element ultrasound transducer to specifically target small mouse brains using dynamic focus steering. We demonstrate that tFUS stimulation at pain-processing brain circuits can significantly alter pain-associated behaviors in mouse models in vivo. Our findings indicate that a single-session focused ultrasound stimulation to the primary somatosensory cortex (S1) significantly attenuates heat pain sensitivity in wild-type mice and modulates heat and mechanical hyperalgesia in a humanized mouse model of chronic pain in sickle cell disease. Results further revealed a sustained behavioral change associated with heat hypersensitivity by targeting deeper cortical structures (eg, insula) and multisession focused ultrasound stimulation to S1 and insula. Analyses of brain electrical rhythms through electroencephalography demonstrated a significant change in noxious heat hypersensitivity-related and chronic hyperalgesia-associated neural signals after focused ultrasound treatment. Validation of efficacy was carried out through control experiments, tuning ultrasound parameters, adjusting interexperiment intervals, and investigating effects on age, sex, and genotype in a head-fixed awake model. Importantly, tFUS was found to be safe, causing no adverse effects on motor function or the brain's neuropathology. In conclusion, the validated proof-of-principle experimental evidence demonstrates the translational potential of novel focused ultrasound neuromodulation for next-generation pain treatment without adverse effects.

摘要

由于阿片类药物存在严重的副作用,因此临床上迫切需要开发非药物干预措施来治疗慢性疼痛。低强度经颅聚焦超声(tFUS)是一种新兴的非侵入性神经调节技术,具有高度的空间特异性和大脑深部穿透性。在这里,我们开发了一种紧密聚焦的 128 元件超声换能器,通过动态焦点转向,专门针对小型小鼠大脑。我们证明,在疼痛处理脑回路中进行 tFUS 刺激,可以显著改变体内小鼠模型的与疼痛相关的行为。我们的研究结果表明,单次聚焦超声刺激初级体感皮层(S1)可显著减轻野生型小鼠的热痛敏感性,并调节镰状细胞病慢性疼痛人源化小鼠模型中的热和机械性痛觉过敏。结果进一步表明,通过靶向更深的皮质结构(例如脑岛)和 S1 和脑岛的多回合聚焦超声刺激,可以产生与热感觉过敏相关的持续行为变化。通过脑电图进行脑电节律分析表明,聚焦超声治疗后,与有害热感觉过敏相关的和与慢性痛觉过敏相关的神经信号发生了显著变化。通过对照实验、调整超声参数、调整实验间隔以及在头部固定清醒模型中研究年龄、性别和基因型对疗效的影响,对疗效进行了验证。重要的是,tFUS 被发现是安全的,不会对运动功能或大脑的神经病理学产生不良影响。总之,经过验证的初步实验证据证明了新型聚焦超声神经调节技术具有治疗下一代疼痛而无不良反应的转化潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc30/11406192/a047ba5f8a32/BLOOD_BLD-2023-023718-ga1.jpg

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