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治疗性超声:一种针对影响基底神经节的神经系统疾病的创新方法。

Therapeutic ultrasound: an innovative approach for targeting neurological disorders affecting the basal ganglia.

作者信息

Singh Anurag, Reynolds John N J

机构信息

Translational Brain Plasticity Laboratory, Department of Anatomy, School of Biomedical Sciences, and the Brain Health Research Center, University of Otago, Dunedin, New Zealand.

出版信息

Front Neuroanat. 2024 Oct 2;18:1469250. doi: 10.3389/fnana.2024.1469250. eCollection 2024.

Abstract

The basal ganglia are involved in motor control and action selection, and their impairment manifests in movement disorders such as Parkinson's disease (PD) and dystonia, among others. The complex neuronal circuitry of the basal ganglia is located deep inside the brain and presents significant treatment challenges. Conventional treatment strategies, such as invasive surgeries and medications, may have limited effectiveness and may result in considerable side effects. Non-invasive ultrasound (US) treatment approaches are becoming increasingly recognized for their therapeutic potential for reversibly permeabilizing the blood-brain barrier (BBB), targeting therapeutic delivery deep into the brain, and neuromodulation. Studies conducted on animals and early clinical trials using ultrasound as a therapeutic modality have demonstrated promising outcomes for controlling symptom severity while preserving neural tissue. These results could improve the quality of life for patients living with basal ganglia impairments. This review article explores the therapeutic frontiers of ultrasound technology, describing the brain mechanisms that are triggered and engaged by ultrasound. We demonstrate that this cutting-edge method could transform the way neurological disorders associated with the basal ganglia are managed, opening the door to less invasive and more effective treatments.

摘要

基底神经节参与运动控制和动作选择,其功能受损会表现为帕金森病(PD)和肌张力障碍等运动障碍。基底神经节复杂的神经元回路位于大脑深处,这给治疗带来了重大挑战。传统的治疗策略,如侵入性手术和药物治疗,效果可能有限,且可能会产生相当多的副作用。非侵入性超声(US)治疗方法因其具有可逆性通透血脑屏障(BBB)、将治疗药物靶向递送至脑深部以及神经调节的治疗潜力而越来越受到认可。在动物身上进行的研究以及使用超声作为治疗方式的早期临床试验已显示出在控制症状严重程度的同时保留神经组织方面的有前景的结果。这些结果可以改善患有基底神经节功能障碍患者的生活质量。这篇综述文章探讨了超声技术的治疗前沿,描述了由超声触发和参与的脑机制。我们证明,这种前沿方法可以改变与基底神经节相关的神经系统疾病的管理方式,为侵入性更小、更有效的治疗打开大门。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/796d/11480080/89bffce9f2bc/fnana-18-1469250-g001.jpg

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