Applications of MRI-Guided FUS in Alzheimer Disease: Ali Rezai, MD

WATCH TIME: 7 minutes

“The blood-brain barrier is a diffusion barrier, limiting the access of most substances from the blood vessels into the brain tissue, and essentially substances that are larger than 400 Dalton molecular weight do not cross the blood-brain barrier readily—this includes many pharmaceuticals, medications, antibodies, and other therapies. So, in the neurosciences, a big problem has been the noninvasive opening of the blood-brain barrier, and focused ultrasound allows that.”

The focal opening of the blood-brain barrier (BBB) in patients with mild Alzheimer disease (AD) using MRI-guided focused ultrasound (FUS) was found to be safe and effective, according to early findings from a multicenter clinical trial presented at the 14th Clinical Trials on Alzheimer’s Disease Conference (CTAD), November 9-12, 2021. Lead investigator Ali Rezai, MD, executive chair, Rockefeller Neuroscience Institute; vice president, neuroscience; and associate dean and John D. Rockefeller IV tenured professor in neuroscience, West Virginia University, spoke with NeurologyLive^® to provide an overview of the FUS technology, as well as processes for opening the BBB.

Emerging FUS technology is a noninvasive, outpatient procedure, allowing clinicians to use MRI to target different areas of the brain with precision. Rezai outlined 3 different applications of the treatment, including 1 that is FDA-approved and reimbursed by Medicare for the treatment of Parkinson disease (PD) and essential tremor. 

As noninvasive opening of the BBB has been a topic of conversation within the field of neurosciences, Rezai highlighted the importance of early, promising clinical findings presented at CTAD 2021. The trial was a continuation of an existing safety and efficacy trial, he said, intending to understand the long-term effects of opening the BBB in the hippocampus, frontal lobes, and parietal lobes in patients with mild AD. 

For more coverage of CTAD 2021, click here.

REFERENCE

Rezai A, Ranjan M, Haut M, et al. Longitudinal safety, clinical, and beta amyloid PET outcomes of a multi-center clinical trial of focused ultrasound blood brain barrier (BBB) opening of the hippocampus, front, and parietal lobes in early Alzheimer’s disease. Presented at CTAD; November 9-12, 2021; Virtual & Boston, MA. Abstract OC26.