Therapeutic Potentials of Localized Blood-Brain Barrier Disruption by Noninvasive Transcranial Focused Ultrasound: A Technical Review.

Authors: Cammalleri A, Croce P, Lee W, Yoon K, Yoo SS

The demands for region-specific, noninvasive therapies for neurologic/psychiatric conditions are growing. The rise of transcranial focused ultrasound technology has witnessed temporary and reversible disruptions of the blood-brain barrier in the brain with exceptional control over the spatial precisions and depth, all in a noninvasive manner. Starting with small animal studies about a decade ago, the technique is now being explored in nonhuman primates and humans for the assessment of its efficacy and safety. The ability to transfer exogenous/endogenous therapeutic agents, cells, and biomolecules across the blood-brain barrier opens up new therapeutic avenues for various neurologic conditions, with a possibility to modulate the excitability of regional brain function. This review addresses the technical fundamentals, sonication parameters, experimental protocols, and monitoring techniques to examine the efficacy/safety in focused ultrasound-mediated blood-brain barrier disruption and discuss its potential translations to clinical use.

Introduction

Purpose Drug delivery with BBB opening

Study Objective To review the technical fundamentals, sonication parameters, experimental protocols, and monitoring techniques for focused ultrasound–mediated blood–brain barrier disruption to assess its efficacy, safety, and potential for clinical translation.

Cargo name and characteristics Exogenous and endogenous therapeutic agents, cells, and biomolecules — unspecified types (e.g., small molecules and biologicals/proteins/cells); no specific cargo detailed in the paper

Outcomes and Safety

Summary of Outcomes Transcranial focused ultrasound (tFUS) can temporarily and reversibly disrupt the blood–brain barrier with high spatial precision, enabling delivery of therapeutic agents and potentially modulating regional brain excitability; evidence reviewed spans small animals through non-human primates to humans assessing efficacy and safety.

Safety-related matter The review discusses assessment of efficacy and safety and monitoring techniques for focused ultrasound–mediated BBB disruption, but the provided text does not report any specific adverse effects or safety outcomes.

Brain Region

Visualization unavailable

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None

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