Focused Ultrasound-Induced Blood–Spinal Cord Barrier Opening Using Short-Burst Phase-Keying Exposures in Rats: A Parameter Study

Fletcher, Stecia-Marie P.; Choi, Min Joo; Ramesh, Ranjith; O’Reilly, Meaghan A.

doi:10.1016/j.ultrasmedbio.2021.03.007

Cited by 10 publications

(2 citation statements)

References 36 publications

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“…Moreover, chemotherapy and targeted treatments can be limited by the blood-spinal cord barrier, which functions similarly to the blood-brain barrier to form a specialized micro-environment and restrict diffusion of large molecules into the central nervous system ( 150 ). Novel treatment strategies are being designed to improve permeability of the blood-spinal cord barrier, including the use of focused ultrasound to cause microbubble-induced transient opening of the barrier and improve drug delivery ( 151 , 152 ).…”

Section: Discussionmentioning

confidence: 99%

Surgical approaches to intramedullary spinal cord astrocytomas in the age of genomics

2022

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Intramedullary astrocytomas represent approximately 30%–40% of all intramedullary tumors and are the most common intramedullary tumor in children. Surgical resection is considered the mainstay of treatment in symptomatic patients with neurological deficits. Gross total resection (GTR) can be difficult to achieve as astrocytomas frequently present as diffuse lesions that infiltrate the cord. Therefore, GTR carries a substantial risk of new post-operative deficits. Consequently, subtotal resection and biopsy are often the only surgical options attempted. A midline or paramedian sulcal myelotomy is frequently used for surgical resection, although a dorsal root entry zone myelotomy can be used for lateral tumors. Intra-operative neuromonitoring using D-wave integrity, somatosensory, and motor evoked potentials is critical to facilitating a safe resection. Adjuvant radiation and chemotherapy, such as temozolomide, are often administered for high-grade recurrent or progressive lesions; however, consensus is lacking on their efficacy. Biopsied tumors can be analyzed for molecular markers that inform clinicians about the tumor’s prognosis and response to conventional as well as targeted therapeutic treatments. Stratification of intramedullary tumors is increasingly based on molecular features and mutational status. The landscape of genetic and epigenetic mutations in intramedullary astrocytomas is not equivalent to their intracranial counterparts, with important difference in frequency and type of mutations. Therefore, dedicated attention is needed to cohorts of patients with intramedullary tumors. Targeted therapeutic agents can be designed and administered to patients based on their mutational status, which may be used in coordination with traditional surgical resection to improve overall survival and functional status.

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Section: Discussionmentioning

confidence: 99%

Surgical approaches to intramedullary spinal cord astrocytomas in the age of genomics

2022

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“…Larger molecules, including proteins (e.g., transferrin and insulin) and low- Intrathecal administration (IT) delivers therapeutic agents directly into the cerebrospinal uid around the spinal cord and has been widely used in the both preclinic and clinical circumstance, partially bypassing the BSCB for more direct access of the spinal cord. 87 Focused ultrasound (FUS), combined with sound wave responsive microbubbles, shows promise in temporarily disrupting the BSCB in preclinical animal models, 88,89 and validation and optimization on human patients are ongoing. This technique creates localized transient openings, can be performed with transvertebral ultrasound, 90 enhancing the delivery of drugs or genes to focal lesion the spinal cord.…”

Section: Overcoming Biological Barriersmentioning

confidence: 99%

Strategies for enhanced gene delivery to the central nervous system

Gao

2024

Nanoscale Adv.

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Overview of Therapeutic Ultrasound Applications and Safety Considerations: 2024 Update

Bader,

Padilla,

Haworth

et al. 2024

J of Ultrasound Medicine

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A 2012 review of therapeutic ultrasound was published to educate researchers and physicians on potential applications and concerns for unintended bioeffects (doi: 10.7863/jum.2012.31.4.623). This review serves as an update to the parent article, highlighting advances in therapeutic ultrasound over the past 12 years. In addition to general mechanisms for bioeffects produced by therapeutic ultrasound, current applications, and the pre‐clinical and clinical stages are outlined. An overview is provided for image guidance methods to monitor and assess treatment progress. Finally, other topics relevant for the translation of therapeutic ultrasound are discussed, including computational modeling, tissue‐mimicking phantoms, and quality assurance protocols.

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Focused Ultrasound-Induced Blood–Spinal Cord Barrier Opening Using Short-Burst Phase-Keying Exposures in Rats: A Parameter Study

Cited by 10 publications

References 36 publications

Surgical approaches to intramedullary spinal cord astrocytomas in the age of genomics

Surgical approaches to intramedullary spinal cord astrocytomas in the age of genomics

Strategies for enhanced gene delivery to the central nervous system

Overview of Therapeutic Ultrasound Applications and Safety Considerations: 2024 Update

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