Researchers Develop New Form of Brain Surgery Without Incisions or Scalpels

Researchers at the University of Virginia School of Medicine have developed a non-invasive way to remove faulty brain circuitry that could allow doctors to treat debilitating neurological conditions without resorting to traditional brain surgery. The study was published in the ‘Journal of Neurosurgery’.

The UVA team, working with colleagues at Stanford University, indicated that the approach, if successfully applied to the operating room, could revolutionize the treatment of some of the most difficult neurological diseases and the most complex, including epilepsy, movement disorders, etc. The approach uses low-intensity focused ultrasound waves combined with microbubbles to briefly penetrate the brain’s natural defenses and allow targeted delivery of a neurotoxin. This neurotoxin killed offending brain cells while sparing other healthy cells and preserving the surrounding brain architecture. “This new surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders that do not respond to drugs,” said researcher Kevin S. Lee, PhD, of the departments of neuroscience and neurosurgery at the UVA and the Center for Brain. Immunology and Glia (BIG).

“This unique approach eliminates diseased brain cells, spares adjacent healthy cells, and achieves these results without even having to cut the scalp,” added Lee. The new approach is called PING, and it has already shown exciting potential in laboratory studies. For example, one of the promising applications of PING could be the surgical treatment of epilepsies that do not respond to drugs. About a third of patients with epilepsy do not respond to anti-epileptic drugs, and surgery may reduce or eliminate seizures for some of them. Lee and his team, as well as their collaborators at Stanford, have shown that PING can reduce or eliminate seizures in two models of epilepsy research. The results raised the possibility of treating epilepsy in a carefully targeted and non-invasive manner without resorting to traditional brain surgery.

Another important potential benefit of PING is that it could encourage the surgical treatment of appropriate epilepsy patients who are reluctant to undergo conventional invasive or ablative surgery. Lee and coworkers detail PING’s ability to focal kill neurons in one region of the brain while sparing non-target cells in the same area. In contrast, currently available surgical approaches damage all cells in a treated brain region.

A key advantage of the approach is its incredible precision. PING harnessed the power of Magnetic Resonance Imaging (MRI) to allow scientists to look inside the skull so they can precisely guide sound waves to open the body’s natural blood-brain barrier right there where it is needed. This barrier is designed to prevent harmful cells and molecules from entering the brain, but it also prevents the administration of potentially beneficial treatments. The UVA Panel’s new paper concluded that PING enables the delivery of a highly targeted neurotoxin, cleanly eliminating problematic neurons, a type of brain cell, without causing collateral damage.

Another key advantage of the accuracy of this approach is that it can be used on irregularly shaped targets in areas that would be extremely difficult or impossible to reach with regular brain surgery. “If this strategy translates into clinical practice,” the researchers write in their new paper, “the non-invasive nature and specificity of the procedure could positively influence both physician credentials and patient confidence in surgery for the disorders. medically insoluble neurological ‘.

“Our hope is that the PING strategy will become a key component of the next generation of very precise, non-invasive neurosurgical approaches to treat major neurological disorders,” said Lee, who is part of the UVA Brain Institute. (ANI)

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