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Ultrasound Blood–Brain Barrier Opening and Aducanumab in Alzheimer’s Disease

Ali R. Rezai, Pierre-François D’Haese, Victor Finomore, Jeffrey Carpenter, Manish Ranjan, Kirk C. Wilhelmsen, Rashi I. Mehta, Peng Wang, Umer Najib, Camila Vieira Ligo Teixeira, Tasneem Arsiwala, Abdul Tarabishy, Padmashree S. Tirumalai, Daniel O. Claassen, Sally Hodder, Marc W. Haut

2024New England Journal of Medicine266 citationsDOI

Abstract

Antiamyloid antibodies have been used to reduce cerebral amyloid-beta (Aβ) load in patients with Alzheimer's disease. We applied focused ultrasound with each of six monthly aducanumab infusions to temporarily open the blood-brain barrier with the goal of enhancing amyloid removal in selected brain regions in three participants over a period of 6 months. The reduction in the level of Aβ was numerically greater in regions treated with focused ultrasound than in the homologous regions in the contralateral hemisphere that were not treated with focused ultrasound, as measured by fluorine-18 florbetaben positron-emission tomography. Cognitive tests and safety evaluations were conducted over a period of 30 to 180 days after treatment. (Funded by the Harry T. Mangurian, Jr. Foundation and the West Virginia University Rockefeller Neuroscience Institute.).

Topics & Concepts

UltrasoundFocused ultrasoundMedicinePositron emission tomographyAlzheimer's diseaseBlood–brain barrierAmyloid (mycology)Lateralization of brain functionDiseaseNuclear medicinePsychologyInternal medicinePathologyCentral nervous systemRadiologyAudiologyUltrasound and Hyperthermia ApplicationsUltrasound Imaging and ElastographyPhotoacoustic and Ultrasonic Imaging
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