帕金森病
血脑屏障
神经科学
医学
疾病
心理学
病理
中枢神经系统
作者
Carmen Gasca‐Salas,José A. Pineda‐Pardo,Marta del Álamo,Tamara Jiménez,Clara Trompeta,Gabriella Toltsis,L. García-Cañamaque,Beatriz Fernández‐Rodríguez,Michele Matarazzo,Isabel Plaza de las Heras,Elena Natera‐Villalba,Raúl Martínez‐Fernández,Alicia Duque,Santiago Ruiz de Aguiar,Javier Blesa,Itay Rachmilevich,José Á. Obeso
标识
DOI:10.1136/jnnp-2023-332967
摘要
Background The nigrostriatal system is especially vulnerable to neurodegeneration in Parkinson’s disease (PD) and the blood-brain barrier (BBB) is a limiting factor for delivery of therapeutic agents to the brain. This pilot study aimed to demonstrate safety, feasibility and tissue penetration (by 18F-Choline-positron emission tomography (PET)) of MR-guided focused ultrasound (MRgFUS) simultaneous BBB opening (BBB-O) in the substantia nigra (SN) and putamen in PD. Methods Three patients underwent MRgFUS for midbrain and putamen BBB-O. Patients were evaluated clinically and underwent brain MRI with gadolinium (baseline, 24 hours, 14 days and 3 months postprocedure). In two patients, BBB-O was repeated after 2–3 weeks, and 18F-Choline-PET was performed immediately after. Results The right SN and putamen were simultaneously opened unilaterally in 3 patients once and the left SN in 1 patient in a different session. No severe clinical or neuroimaging adverse events developed in any patient. 18F-Choline-PET uptake was enhanced in the targeted SN and putamen regions. Conclusion BBB-O of the nigrostriatal system is a feasible and well-tolerated approach in patients with PD. 18F-Choline-PET uptake indicates penetration into the parenchyma after BBB-O, which suggests that the opening is functionally effective. This minimally invasive technique could facilitate delivery of putative neurorestorative molecules to brain regions vulnerable to neurodegeneration.
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