Enhancement of glymphatic activity in early Alzheimer’s disease using low-intensity ultrasound
Poster No:
94
Submission Type:
Abstract Submission
Authors:
Sang Won Jo1, Jaeho Kim1, Bo-yong Park2
Institutions:
1Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, 2Inha University, Incheon, Incheon
First Author:
Sang Won Jo
Dongtan Sacred Heart Hospital, Hallym University College of Medicine
Hwaseong, Gyeonggi-do
Dongtan Sacred Heart Hospital, Hallym University College of Medicine
Hwaseong, Gyeonggi-do
Co-Author(s):
Jaeho Kim
Dongtan Sacred Heart Hospital, Hallym University College of Medicine
Hwaseong, Gyeonggi-do
Dongtan Sacred Heart Hospital, Hallym University College of Medicine
Hwaseong, Gyeonggi-do
Introduction:
Alzheimer's disease (AD) is marked by the accumulation of metabolic waste in the brain, with glymphatic dysfunction implicated in its progression. Low-intensity ultrasound (LIUS) has emerged as a potential non-invasive modality to facilitate glymphatic clearance.
This study was aimed to evaluate the efficacy and safety of LIUS in improving glymphatic system activity and cognitive function in early AD patients.
This study was aimed to evaluate the efficacy and safety of LIUS in improving glymphatic system activity and cognitive function in early AD patients.
Methods:
In this prospective pilot study, conducted from September to November 2022, ten participants (mean age 69 years; 5 men) with positive amyloid positron emission tomography (PET) imaging underwent LIUS. The LIUS treatment involved thrice-weekly sessions over four weeks. Magnetic resonance imaging (MRI) and amyloid PET scans were used for quantitative analysis of glymphatic activity, blood-brain barrier (BBB) integrity, microbleeds occurrence and amyloid deposition changes, respectively. The study also employed neuropsychological tests to assess cognitive changes. To analyze the quantitative values of different MRI sequences and neuropsychological test results before and after LIUS treatment, the paired sample t-test (or Wilcoxon signed-rank test) was used.
·Figure 1. Flowchart shows selection of the study population.
Results:
All participants completed the treatment without significant adverse events. Post-treatment, the cerebral cortex showed increased glymphatic activity (slope mean ratio on T1 value-time graph [slope (post-treatment)/slope (pre-treatment)]: 1.14, p=0.048). Neuropsychological testing demonstrated improvements in cognitive function (the Trail Making Test Black & White Part A and B, p=0.017 and p=0.044, respectively; the Korean version of Quality of Life, p=0.046; Attention Questionnaire Scale, p=0.036). No significant changes were observed in blood-brain barrier integrity, microbleed, or brain volumetry.
·Figure 2. Schematic illustrations of coregistered brain regional masks on T1 maps and T1 value–time graphs of variable brain regions.
Conclusions:
LIUS appears to be a safe method for enhancing glymphatic clearance and cognitive function in early AD patients. These results highlight LIUS's potential as an effective therapeutic option for AD, warranting further investigation with a larger cohort and a control group for more definitive conclusions.
Brain Stimulation:
Sonic/Ultrasound 1
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s)
Learning and Memory:
Neural Plasticity and Recovery of Function 2
Modeling and Analysis Methods:
Other Methods
Physiology, Metabolism and Neurotransmission :
Physiology, Metabolism and Neurotransmission Other
Keywords:
MRI
Positron Emission Tomography (PET)
Treatment
ULTRASOUND
Other - Early Alzheimer's disease
1|2Indicates the priority used for review
Provide references using author date format
2. Lee S, Yoo RE (co-first authors), (2021), 'Contrast-enhanced MRI T1 Mapping for Quantitative Evaluation of Putative Dynamic Glymphatic Activity in the Human Brain in Sleep-Wake States', Radiology 2021;300(3):661-668.
3. Popescu T, (2021), 'Transcranial ultrasound pulse stimulation reduces cortical atrophy in Alzheimer's patients: A follow-up study' Alzheimers Dement (N Y) 2021;7(1):e12121.
4. Yoo SS, (2022) 'Enhancement of cerebrospinal fluid tracer movement by the application of pulsed transcranial focused ultrasound', Sci Rep 2022;12(1):12940.
5. Yoo SS, (2023), 'Non-invasive enhancement of intracortical solute clearance using transcranial focused ultrasound' Sci Rep 2023;13(1):12339.