A recent study published in the New England Journal of Medicine has shown that the combination of focused ultrasound and the amyloid-clearing drug aducanumab can lead to increased removal of amyloid plaque from the brain compared to treatment with aducanumab alone. The study involved patients with mild Alzheimer's disease who received an infusion of aducanumab followed by MRI-guided focused ultrasound targeted at specific brain regions to open up the blood-brain barrier (BBB). The BBB is a protective barrier that prevents toxins from entering the brain but also hinders the delivery of medications to treat brain disorders.
Prior research has demonstrated that focused ultrasound can temporarily open the BBB, allowing medications to penetrate the brain more effectively. In this study, one side of the brain was targeted with focused ultrasound while the other side served as a control. Follow-up brain scans showed a lower amount of amyloid in the side of the brain treated with focused ultrasound.
The study included three subjects with mild Alzheimer's disease, and while there was no evidence of improved cognition, the reduction in amyloid plaque offers hope for Alzheimer's patients. However, larger studies are needed to better understand the benefits and potential side effects of this approach.
There are concerns regarding the potential risks of using focused ultrasound to open the BBB, such as the possibility of other toxins gaining access to the brain or the alteration of BBB integrity after recurrent treatments. Additionally, aducanumab infusions have been associated with an increased risk of brain bleeds, although potential subjects in this trial were tested to identify those at risk and exclude them from the study.
The ability to deliver medications to the brain more effectively through the use of focused ultrasound has implications not only for Alzheimer's disease but also for other neurological conditions that require treatment beyond the BBB. This includes brain tumors, Parkinson's disease, schizophrenia, multiple sclerosis, and epilepsy.
Overall, this study highlights the potential of combining focused ultrasound with aducanumab to improve the removal of amyloid plaque from the brain. While further research is needed, this approach offers hope for Alzheimer's patients and potentially for other neurological diseases as well.