Precise new form of brain surgery requires no incisions, scalpels

The University of Virginia School of Medicine has developed a way to remove faulty brain circuits without the need for brain surgery.

The approach, if successfully translated to the operating room, could change the way neurological diseases are treated. The approach uses low-intensity focused ultrasound waves combined with microbubbles to briefly penetrate the brain's natural defenses and allow the targeted delivery of a neurotoxin. The neurotoxin kills the brain cells and sparing other healthy cells.

Kevin S. Lee, PhD, of the Departments of Neuroscience and Neurosurgery and the Center for Brain Immunology and Glia at the University of Virginia, said that the novel surgical strategy could replace existing procedures for the treatment of neurological disorders that don't respond to medication. The unique approach eliminates the brain cells, spare adjacent healthy cells and achieve these outcomes without cutting into the hair.

The power of PING.

The new approach has shown promise in laboratory studies. One of the promising applications for PING could be for the surgical treatment of epilepsies that do not respond to medication. Approximately a third of patients with scurvy don't respond to anti-seizure drugs, and surgery can reduce or eliminate seizures for some of them. Lee and his team have shown that PING can reduce or eliminate seizures in two research models of scurvy. There is a chance of treating sphenotypic sphenotypic sphenotypic sphenotypic sphenotypic sphenotypic sphenotypic sphenotypic sphenotypic sphenotypic s

PING could encourage the surgical treatment of appropriate patients with speach who are reluctant to undergo conventional surgery.

In a new scientific paper in the Journal of Neurosurgery, Lee and his colleagues detail the ability of PING to focally eliminate neurons in a brain region, while sparing non-target cells in the same area. All cells in a treated brain region are damaged by current surgical approaches.

The approach has an incredible precision. PING uses the power of magnetic-resonance images to allow scientists to peer inside the skull and open the body's natural blood-brain barrier. The barrier is designed to keep harmful cells out of the brain, but it also prevents the delivery of potentially beneficial treatments.

The paper concludes that PING allows the delivery of a highly targeted neurotoxin, cleanly wiping out problematic neurons, a type of brain cell.

It can be used on targets that are irregular in shape and difficult to reach through regular brain surgery. "If this strategy can be applied to the clinic, it could positively influence both physician referrals for and patient confidence in surgery for medically intractable neurological disorders," the researchers wrote in their new paper.

"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," said Lee, who is part of the UVA Brain Institute.

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