Domestic medical professionals have presented a new treatment method that can be applied to Alzheimer's disease, which accounts for about 70% of all dementia.
A major obstacle in treating Alzheimer's disease is the thick and rigid blood-brain barrier (BBB) surrounding the brain. Due to the BBB blocking access, there is a limitation in delivering drugs effectively to the target areas in the brain, but the possibility of using high-intensity focused ultrasound to open the BBB and remove amyloid beta plaques, the harmful proteins that cause the disease, has been confirmed.
Korea University Anam Hospital announced on the 20th that a research team led by Professor Jang Jin-woo of neurosurgery, Professor Ye Byeong-seok of neurology at Severance Hospital, and Professor Jang Kyung-won of neurosurgery at Samsung Medical Center confirmed the safety of the treatment method that opens the BBB using repeated high-intensity focused ultrasound and the improvement effects on some neurological symptoms.
Amyloid beta plaques are clumps of proteins that induce Alzheimer's disease. Although attempts have been made to remove them with drugs, drug delivery has been difficult due to the BBB and various other hindrances, and the treatment effects have been limited due to side effects caused by the drugs.
Professor Jang's research team conducted BBB opening surgeries using high-intensity focused ultrasound on six Alzheimer's disease patients three times at two-month intervals from June 2022 to July 2023. Various assessments, including changes in amyloid beta plaques before and after surgery, as well as evaluations of non-cognitive symptoms such as behavior and psychology using the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI), were performed.
The study results confirmed that the frontal lobe BBB of the six patients was temporarily opened by an average of 43.1㎤ after surgery. Additionally, amyloid beta plaques decreased by an average of 14.9 centiloids in four of the six patients. Among the six patients, 5 (83%) showed improvements in cognitive symptoms such as delusions, anxiety, irritability, and restlessness, with scores on the CGA-NPI falling from 6.3 to 2.8.
Professor Jang noted, "Through this study, we have partially confirmed the applicability of blood-brain barrier opening surgery using high-intensity focused ultrasound for intractable neurological diseases such as Alzheimer's disease," and added, "We aim to develop blood-brain barrier opening surgery into a treatment strategy that can be used clinically in the future through various additional clinical studies."
This study was conducted with the support of the Focused Ultrasound Foundation (FUS Foundation, USA), and the research results were published in the January 2025 issue of the Journal of Neurosurgery, a leading journal in the field of neurosurgery.
Reference materials
Journal of Neurosurgery (2025), DOI: https://doi.org/10.3171/2024.8.JNS24989