![]() ![]() The field is also advancing to enhance drug delivery, improve patient comfort, and make the technology more accessible. “There are early glimmers of hope,” Lipsman says, referring to multiple clinical trials he’s overseeing to tackle everything from tumours to neurodegeneration. Numerous teams around the world have now shown that opening the blood-brain barrier with ultrasound is safe and feasible, so the next hurdle is proving the medical benefits. That’s why focused ultrasound, which is noninvasive, is so appealing. “Treating the heart, limbs, or lungs, won’t change someone’s personality, memory, or affect. “When treating the brain, we have to remember the person, too,” says Lipsman, who is also the director of Sunnybrook's Harquail Center for Neuromodulation. Methods such as surgical injection have been tried in the past but involve skin incisions, holes in the skull, and passing instruments through the brain, which all risk infection, bleeding, and swelling and could cause permanent brain damage. The challenge is that the brain is extraordinarily fragile and damage is irreversible, which is why surgeons want new strategies to bypass the blood-brain barrier. As a result, virtually all medications for conditions such as brain cancer and neurodegenerative diseases are effectively unable to reach the site where they are needed most. It keeps out the bad stuff, such as pathogens, but it also prevents potentially useful things from getting in. The novel procedure gets drugs into the brain by overcoming a major hurdle: the blood-brain barrier, a thin protective layer of specialised cells lining the very small blood vessels guarding the human body’s most privileged organ. After lying down on the bed of the MRI machine, his head is attached to a helmet-like transducer capable of transmitting more than a thousand intersecting beams of ultrasound energy deep within the brain with extraordinary precision.įocused ultrasound is “science-fiction medicine that is rapidly becoming non-fiction,” says Brad Wood, director of the National Institutes of Health Centre for Interventional Oncology. Butler is given a mild sedative and his skull is fastened with four pins into a lightweight frame to prevent any movement. Waiting for him are Nir Lipsman, his neurosurgeon and a scientist at the Hurvitz Brain Sciences Research Program, along with an MRI technician, a medical physicist, and an anaesthesiologist. Focused ultrasound is his only chance to prolong life with glioblastoma, a catastrophic form of cancer that is incredibly difficult to treat. Complete removal by surgery wasn’t possible without severely damaging the rest of his brain. In Butler’s case, the procedure is designed to deliver drugs that will try to destroy any cancer cells left behind after his surgery. Many experts believe this therapeutic technology will one day revolutionise brain medicine for a range of impossible or hard-to-cure conditions, from brain cancer to Alzheimer’s, Parkinson’s, and ALS. Today he is part of a clinical trial testing a new method of delivering drugs directly into the brain, with a technique called focused ultrasound. Aside from a trim white goatee, his head is freshly shorn-a style he’s sported since getting craniotomy surgery to remove as much as possible of an aggressive, plum-size brain tumour three months earlier. The retired sales executive and motorcyclist is hooked up to an IV and dressed in a hospital gown. on a spring morning in 2021, a jovial and spry 63-year-old named Michael Butler is wheeled into a special MRI suite at Sunnybrook Health Sciences Centre in Toronto. ![]()
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