Evidence of Amyloid Reduction With Blood-Brain Barrier Opening With Focused Ultrasound
April 27, 2021

By Erika Powers

VIRTUAL -- April 27, 2021 -- Hippocampal blood-brain barrier opening with focused ultrasound shows promise as a potential treatment for Alzheimer’s disease, according to a study presented at the Virtual 2021 Annual Meeting of the American Academy of Neurology (AAN).

“Progressive amyloid deposition and cognitive decline characterise Alzheimer’s disease,” said Vibhor Krishna, MD, The Ohio State University, Columbus, Ohio. “Blood-brain barrier opening with focused ultrasound is safe and feasible in patients with Alzheimer’s disease, and there is initial evidence of amyloid reduction.”

For the study, the researchers screened 10 individuals with probable Alzheimer’s disease with mild to moderate dementia symptoms. A total of 6 patients were enrolled, and 5 were treated.

At 3 timepoints, 2 weeks apart, blood-brain barrier was opened in 5 different locations with a high amyloid burden, defined by a standardised uptake value 25% greater than the cerebellum using amyloid positron emission tomography (PET). The targeted brain regions included the hippocampus, entorhinal cortex, thalamus, frontal cortex, and parietal cortex.

The primary outcome variable was the absence of cognitive decline, haemorrhage, new onset of seizures, or neurological deficits. The researchers also assessed blood-brain barrier opening (with dynamic contrast imaging) and postoperative PET amyloid levels.

“No haemorrhage and cerebral oedema were observed,” said Dr. Krishna. “Blood-brain barrier opening was focal, immediate, and no contrast enhancement was observed 1 day postoperative.”

The amyloid reduction varied between 1% to 15% from baseline without significant differences between different tissue types (gray vs white matter).

No serious adverse events were recorded, and the most common adverse event was confusion. One patient reported worsening in cognition at day, and another patient reported worsening cognition 5 weeks after treatment.

“This strategy needs further testing in a larger cohort as a potential therapeutic for Alzheimer’s disease,” said Dr. Krishna.

[Presentation title: Safety of Hippocampal Blood-Brain Barrier Opening With Focused Ultrasound in Alzheimer’s Disease]