Noninvasive brain surgery could treat neurological diseases without a scalpel

CHARLOTTESVILLE, Va. — A revolutionary procedure could soon change the way brain surgeons treat patients dealing with debilitating neurological conditions. Researchers from the University of Virginia and Stanford have developed a noninvasive brain surgery that can remove malfunctioning brain circuits without the need for scalpels or damaging healthy cells.

If scientists can successfully transfer this technique to the real-world operating room, it could allow doctors to repair hard-to-treat and complex neurological diseases, such as epilepsy. The new procedure uses a combination of focused, low-intensity ultrasound waves and microbubbles to penetrate the brain’s natural defenses (the blood-brain barrier). This allows doctors to target specific areas of the brain and deliver a neurotoxin which kills the faulty brain cells. This also spares the healthy brain cells in the surrounding area that traditional surgeries damage was well.

“This novel surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders that don’t respond to medication,” says Dr. Kevin Lee from UVA’s Departments of Neuroscience and Neurosurgery and the Center for Brain Immunology and Glia (BIG) in a university release. “This unique approach eliminates the diseased brain cells, spares adjacent healthy cells and achieves these outcomes without even having to cut into the scalp.”

PING could revolutionize epilepsy treatment

The noninvasive procedure, called PING, has displayed tremendous promise in lab tests. Researchers believe the technique may be especially useful for treating severe cases of epilepsy which don’t respond to medication. Around one in three epilepsy cases are resistant to anti-seizure drugs, leading some patients to opt for invasive brain surgery to reduce their symptoms.

In two research experiments, trials show PING could reduce or completely eliminate seizures in brains with epilepsy. Study authors note this procedure may also encourage patients who are reluctant to undergo conventional invasive or ablative operations to try a noninvasive and carefully targeted approach to brain surgery.

PING uses MRI technology to deliver amazing precision

The UVA team says the key to PING’s success is its incredible precision. The surgery uses the power of magnetic-resonance imaging to allow doctors to look inside a patient’s skull before the operation. This makes it possible to precisely guide the sound waves which open the blood-brain barrier to the exact spot where the trouble is.

Although the blood-brain barrier is vitally important for keeping harmful substances and molecules from reaching the brain, it also creates a major obstacle for scientists treating brain diseases. PING allows surgeons to bypass the barrier without damaging it or exposing healthy brain cells (neurons) to the neurotoxins which wipe out dysfunctional cells.

“If this strategy translates to the clinic, the noninvasive nature and specificity of the procedure could positively influence both physician referrals for and patient confidence in surgery for medically intractable neurological disorders,” the researchers add.

“Our hope is that the PING strategy will become a key element in the next generation of very precise, noninvasive, neurosurgical approaches to treat major neurological disorders,” Dr. Lee concludes.

The findings are published in the Journal of Neurosurgery.

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