Focused transcranial ultrasound for treatment of neurodegenerative dementia

Natalie Eleanor Nicodemus; Sergio Becerra; Taylor P Kuhn; Hannah R Packham; John Duncan; Kennedy Mahdavi; Jessica Iovine; Santosh Kesari; Scott Pereles; Mike Whitney; Michael Mamoun; Daniel Franc; Alexander Bystritsky; Sheldon Jordan

doi:10.1016/j.trci.2019.06.007

Focused transcranial ultrasound for treatment of neurodegenerative dementia

Alzheimers Dement (N Y). 2019 Aug 8:5:374-381. doi: 10.1016/j.trci.2019.06.007. eCollection 2019.

Authors

Natalie Eleanor Nicodemus¹, Sergio Becerra¹, Taylor P Kuhn², Hannah R Packham¹, John Duncan¹, Kennedy Mahdavi¹, Jessica Iovine¹, Santosh Kesari^{3

4}, Scott Pereles⁵, Mike Whitney⁵, Michael Mamoun^{6

7}, Daniel Franc⁸, Alexander Bystritsky⁹, Sheldon Jordan^{1

10}

Affiliations

¹ Neurological Associates - The Interventional Group, USA, Los Angeles, CA.
² Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.
³ John Wayne Cancer Institute, Santa Monica, CA.
⁴ Pacific Neuroscience Institute, Santa Monica, CA.
⁵ RAD Alliance, Los Angeles, CA.
⁶ Departments of Research and Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, Los Angeles, CA.
⁷ CNS Health, Santa Monica, CA.
⁸ Los Angeles Brain Science Project, Santa Monica, CA.
⁹ Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.
¹⁰ Department of Neurology, University of California, Los Angeles, Los Angeles, CA.

Abstract

Introduction: Preclinical studies support investigation of focused ultrasound for breakdown of cerebral pathologies in neurodegenerative conditions including Alzheimer's disease (AD) and Parkinson's disease (PD).

Methods: A focused transcranial Doppler device with probes (2 MHz, 520 mW/cm²) affixed bilaterally was used to target the hippocampus (AD) or substantia nigra (PD) with functional magnetic resonance imaging navigation for enhanced plaque removal. A total of 22 patients (n = 11 AD, n = 11 PD) underwent 8 consecutive, weekly, 1-hour treatments wherein sleep was encouraged naturally or pharmacologically. Cognitive and motor functioning assessment was carried out using standardized evaluations at baseline and conclusion.

Results: Of all, 62.5% of patients had one or more improved cognitive scores without data incongruence, 87% had stable or improved fine motor scores, and 87.5% had stable or improved gross motor scores. No adverse events were reported.

Discussion: The safety of focused transcranial Doppler and possible enhancement in patient functioning were suggested by outcome data.

Keywords: ASL; Alzheimer's; Cognition; Dementia; Parkinson's; Sleep; Ultrasound.