Current clinical investigations of focused ultrasound blood-brain barrier disruption: A review.

Authors: Durham PG, Butnariu A, Alghorazi R, Pinton G, Krishna V, Dayton PA

The blood-brain barrier (BBB) presents a formidable challenge in delivering therapeutic agents to the central nervous system. Ultrasound-mediated BBB disruption has emerged as a promising non-invasive technique to enhance drug delivery to the brain. This manuscript reviews fundamental principles of ultrasound-based techniques and their mechanisms of action in temporarily permeabilizing the BBB. Clinical trials employing ultrasound for BBB disruption are discussed, summarizing diverse applications ranging from the treatment of neurodegenerative diseases to targeted drug delivery for brain tumors. The review also addresses safety considerations, outlining the current understanding of potential risks and mitigation strategies associated with ultrasound exposure, including real-time monitoring and assessment of treatment efficacy. Among the large number of studies, significant successes are highlighted thus providing perspective on the future direction of the field.

Introduction

Purpose Drug delivery with BBB opening

Study Objective To review the principles, mechanisms, clinical applications, safety considerations, and future directions of ultrasound-mediated blood-brain barrier disruption for enhancing drug delivery to the brain.

Outcomes and Safety

Summary of Outcomes Ultrasound-mediated BBB disruption transiently increases blood–brain barrier permeability to enhance CNS drug delivery and has shown clinical promise using monitored, low-intensity focused ultrasound with microbubbles; the review did not report specific tested parameter sets.

Safety-related matter The review addresses safety considerations, noting potential risks associated with ultrasound-mediated BBB disruption and discussing mitigation strategies, including real-time monitoring and assessment of treatment efficacy.

Brain Region

Visualization unavailable

Ultrasound Parameters

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

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