Summary: Researchers have developed a new, noninvasive technique to selectively remove dysfunctional brain circuits, enabling potential surgical treatment of neurological conditions without conventional open-brain surgery. The method, called PING, combines low-intensity focused ultrasound with microbubbles to transiently open the blood-brain barrier and deliver a targeted neurotoxin to problematic brain regions.
Source: University of Virginia
Researchers at the University of Virginia School of Medicine, in collaboration with colleagues at Stanford University, have reported a noninvasive approach that can selectively eliminate malfunctioning neurons. If translated successfully to clinical practice, this method could change how clinicians treat difficult neurological disorders while avoiding traditional surgical incisions.
The approach, named PING, uses focused, low-intensity ultrasound waves together with intravenously administered microbubbles to momentarily open the brain’s protective blood-brain barrier at a precise location. This temporary opening allows a cell-targeted neurotoxin to reach only the intended neuronal population, destroying disease-causing cells while preserving neighboring healthy cells and the surrounding brain structure.
According to lead researcher Kevin S. Lee of UVA’s Departments of Neuroscience and Neurosurgery and the Center for Brain Immunology and Glia (BIG), the treatment could replace some existing neurosurgical procedures for conditions that do not respond to medication. He emphasizes that PING is designed to remove diseased cells without cutting into the scalp or physically destroying the surrounding tissue, offering a minimally invasive alternative to current ablative techniques.
The potential and precision of PING
PING has demonstrated promising results in preclinical laboratory models. One of the most compelling potential applications is in the treatment of drug-resistant epilepsy. An estimated subset of people with epilepsy do not achieve seizure control with medication, and some of these patients undergo surgical removal of the seizure focus to reduce or eliminate seizures. The UVA-Stanford team reports that PING reduced or eliminated seizures in two experimental epilepsy models, suggesting the technique could provide a highly targeted, noninvasive surgical option when traditional open surgery is undesirable or risky.
A distinctive advantage of PING is its cell-type specificity. While conventional surgical ablation or thermal therapies typically destroy all cells within a treated volume, PING aims to deliver a neurotoxin that selectively kills only the pathogenic neurons. This selective approach could preserve non-target cells and the intricate architecture of nearby brain tissue, potentially reducing side effects and functional loss associated with broader tissue damage.
PING leverages magnetic resonance imaging (MRI) to guide the focused ultrasound precisely. MRI guidance permits clinicians and researchers to visualize the target structure within the skull and to steer acoustic energy so microbubbles open the blood-brain barrier only at the intended site. Because the blood-brain barrier normally prevents many therapeutic agents from entering the brain, this carefully controlled, transient opening is a critical enabling step for highly localized drug delivery.
Another practical benefit of such a noninvasive, image-guided procedure is its ability to reach irregularly shaped or deep-seated targets that are difficult or risky to access with standard surgical approaches. For some patients, the perceived invasiveness of traditional brain surgery discourages referrals or deters individuals from accepting a potentially beneficial procedure. The research team suggests that PING’s noninvasive profile and precision may increase both physician referrals and patient willingness to consider surgical treatment for medically refractory neurological disorders.
In their paper published in the Journal of Neurosurgery, the investigators describe how PING can focalize neuron elimination while sparing surrounding non-target cells. They highlight the potential to treat a range of neurological conditions where removing a discrete population of malfunctioning neurons could restore function or reduce symptoms, including certain forms of epilepsy and movement disorders. The researchers caution, however, that these results are from laboratory models and further translational work is required before clinical application.
Lee and colleagues envision PING as part of the next generation of neurosurgical tools that combine diagnostic imaging, focused energy delivery, and targeted molecular agents to treat brain disease with higher precision and less collateral damage. Ongoing research will need to address long-term safety, optimal dosing and targeting strategies, and regulatory pathways before this strategy can be tested in human patients.
About this neurosurgery and neurotech research news
Author: Josh Barney
Source: University of Virginia
Contact: Josh Barney – University of Virginia
Image: The image is in the public domain
Original Research: The findings will appear in Journal of Neurosurgery