Glymphatics Visualization after Focused Ultrasound-Induced Blood-Brain Barrier Opening in Humans.
Authors: Meng Y, Abrahao A, Heyn CC, Bethune AJ, Huang Y, Pople CB, Aubert I, Hamani C, Zinman L, Hynynen K, Black SE, Lipsman N
It is currently unclear whether the glymphatic system, a brain-wide interstitial fluid-cerebrospinal fluid exchange described in rodents, exists in humans. Focal blood-brain barrier disruption using magnetic resonance-guided focused ultrasound allows parenchymal penetration of gadobutrol contrast, creating an opportunity to study glymphatics in vivo noninvasively. We describe patterns of contrast distribution in the perivascular space, subarachnoid space, and space surrounding large veins draining toward the dural sinuses on fluid-attenuated inversion recovery in subjects with Alzheimer disease and amyotrophic lateral sclerosis. This is the first evidence suggesting glymphatic efflux persists in humans. It's relevance to proteinopathies and drug delivery is discussed. ANN NEUROL 2019;86:975-980.
Introduction
Purpose
Other
Study Objective
To visualize and assess glymphatic pathways in humans following focused ultrasound-induced blood–brain barrier opening.
Animal model / Human subject
Human (Homo sapiens); strain: N/A; age: not specified; sex: not specified
Disease model
Alzheimer's disease
MRI or image guidance method
Not specified in provided text
Targeted brain region(s)
Not Specified In The Provided Text
Target coordinates
Not provided
Cargo name and characteristics
Focused ultrasound (FUS): a noninvasive physical modality used to transiently and focally open the blood–brain barrier in humans to enable glymphatic visualization; not a molecular cargo but an energy-based experimental intervention.
Route of administration
transcranial focused ultrasound
Outcomes and Safety
Summary of Outcomes
Focused ultrasound-induced blood–brain barrier opening in humans enables visualization of glymphatic pathways.
Duration of biological effect
Not reported
Safety-related matter
No safety issues or adverse effects are mentioned in the provided text.
Brain Region
Ultrasound Parameters
Ultrasound instrument
Not specified in provided text.
FUS Frequency
Not specified in provided text
FUS Intensity
Not reported in provided text.
FUS Mode
pulsed
Pulse duration
not reported
Duration of a single FUS session
Not reported in the provided text.
Focal Characteristics
Not reported
Treatment frequency
Not specified in provided text
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