Precise new form of brain surgery requires no incisions, scalpels

Date:
December 3, 2021
Source:
University of Virginia Health System
Summary:
Researchers have developed a noninvasive way to remove faulty brain
circuits that could allow doctors to treat debilitating neurological
diseases without the need for conventional brain surgery.



FULL STORY ========================================================================== University of Virginia School of Medicine researchers have developed
a noninvasive way to remove faulty brain circuits that could allow
doctors to treat debilitating neurological diseases without the need
for conventional brain surgery.


==========================================================================
The UVA team, together with colleagues at Stanford University, indicate
that the approach, if successfully translated to the operating room,
could revolutionize the treatment of some of the most challenging and
complex neurological diseases, including epilepsy, movement disorders and
more. The approach uses low-intensity focused ultrasound waves combined
with microbubbles to briefly penetrate the brain's natural defenses and
allow the targeted delivery of a neurotoxin. This neurotoxin kills the
culprit brain cells while sparing other healthy cells and preserving
the surrounding brain architecture.

"This novel surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders
that don't respond to medication," said researcher Kevin S. Lee, PhD,
of UVA's Departments of Neuroscience and Neurosurgery and the Center for
Brain Immunology and Glia (BIG). "This unique approach eliminates the
diseased brain cells, spares adjacent healthy cells and achieves these
outcomes without even having to cut into the scalp." The Power of PING
The new approach is called PING, and it has already demonstrated exciting potential in laboratory studies. For instance, one of the promising applications for PING could be for the surgical treatment of epilepsies
that do not respond to medication. Approximately a third of patients
with epilepsy do not respond to anti-seizure drugs, and surgery can
reduce or eliminate seizures for some of them. Lee and his team, along
with their collaborators at Stanford, have shown that PING can reduce
or eliminate seizures in two research models of epilepsy. The findings
raise the possibility of treating epilepsy in a carefully-targeted and noninvasive manner without the need for traditional brain surgery.

Another important potential advantage of PING is that it could encourage
the surgical treatment of appropriate patients with epilepsy who are
reluctant to undergo conventional invasive or ablative surgery.

In a new scientific paper in the Journal of Neurosurgery, Lee and his collaborators detail the ability of PING to focally eliminate neurons
in a brain region, while sparing non-target cells in the same area. In contrast, currently available surgical approaches damage all cells in
a treated brain region.

A key advantage of the approach is its incredible precision. PING
harnesses the power of magnetic-resonance imaging (MRI) to let scientists
peer inside the skull so that they can precisely guide sound waves to
open the body's natural blood-brain barrier exactly where needed. This
barrier is designed to keep harmful cells and molecules out of the brain,
but it also prevents the delivery of potentially beneficial treatments.

The UVA group's new paper concludes that PING allows the delivery of
a highly targeted neurotoxin, cleanly wiping out problematic neurons,
a type of brain cell, without causing collateral damage.

Another key advantage of the precision of this approach is that it can
be used on irregularly shaped targets in areas that would be extremely difficult or impossible to reach through regular brain surgery. "If this strategy translates to the clinic," the researchers write in their new
paper, "the noninvasive nature and specificity of the procedure could positively influence both physician referrals for and patient confidence
in surgery for medically intractable neurological disorders." "Our hope
is that the PING strategy will become a key element in the next generation
of very precise, noninvasive, neurosurgical approaches to treat major neurological disorders," said Lee, who is part of the UVA Brain Institute.

========================================================================== Story Source: Materials provided by
University_of_Virginia_Health_System. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Yi Wang et al. Noninvasive disconnection of targeted neuronal
circuitry
sparing axons of passage and nonneuronal cells. Journal of
Neurosurgery, 2021 DOI: 10.3171/2021.7.JNS21123 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/12/211203095804.htm

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