Researchers have discovered a method to facilitate the penetration of Alzheimer’s medication into the brain more quickly by temporarily breaching its protective barrier.

On Wednesday, researchers reported that the initial trial, conducted on only three patients, was a pioneering effort. The new technology targeted specific areas of the brain and effectively eliminated the plaque associated with Alzheimer’s disease.

According to Dr. Ali Rezai of West Virginia University’s Rockefeller Neuroscience Institute, our aim is to provide patients with a head start by enhancing the effectiveness of new Alzheimer’s treatments that have a lengthy timeline for results.

The subject being discussed is the blood-brain barrier, a safeguarding layer found in blood vessels that inhibits bacteria and harmful substances from seeping into the brain through the blood. However, this barrier can also impede medications for conditions like Alzheimer’s, tumors, and neurological diseases, necessitating higher and prolonged doses for sufficient amounts to reach their intended destination within the brain.

Scientists are currently utilizing focused ultrasound technology to create temporary gaps in the protective barrier surrounding the brain. This is achieved by injecting tiny bubbles into the bloodstream and using a specialized helmet device to direct sound waves to a specific area of the brain. The energy from the sound waves causes the microbubbles to vibrate, creating openings in the barrier that allow for medications to enter.

Previous smaller studies have demonstrated that the technology has the ability to create tiny holes that heal within 48 hours without harm. Dr. Rezai’s team has now taken it a step further by also administering an Alzheimer’s medication during the process.

Several recently released or in-development medications for Alzheimer’s disease claim to slightly delay the progression of the cognitive disorder. These drugs aim to eliminate beta-amyloid, a protein that accumulates in specific areas of the brain. However, they necessitate intravenous treatments every few weeks for a minimum of 18 months.

“Rezai suggested attempting to remove the plaques within a short period of a few months,” he explained as the reasoning behind the proof-of-concept research.

3 patients, 1 drug, 6 months

The researchers administered monthly doses of Aduhelm to three patients with mild Alzheimer’s over a period of six months. Following each intravenous treatment, they used focused ultrasound to target a specific area of the brain that was clogged with amyloid. This allowed for a greater amount of the medication to enter the targeted area.

PET scans revealed the levels of amyloid in patients before and after a six-month course of medication. According to a report in the New England Journal of Medicine, there was a 32% decrease in plaque in areas where the blood-brain barrier had been compromised, compared to the corresponding region on the other side of the brain.

Dr. Eliezer Masliah of the National Institute on Aging cautioned that while this pilot study is elegant, it is too small to draw any conclusions.

However, according to Masliah, who was not part of the study, the findings are “extremely exciting and compelling.” He also stated that it paves the way for larger and more comprehensive studies.

Additional experiments on the horizon.

Rezai is preparing to conduct another trial of a drug called Leqembi, which is similar to but more effective than previous versions. Further extensive research will be necessary to determine the impact of combining focused ultrasound with Alzheimer’s medications on patients.

According to Masliah, it is crucial to thoroughly examine if faster removal of plaque could potentially lead to a rare but concerning side effect of these novel medications – bleeding and inflammation in the brain.

Scientists are also exploring the potential of breaching the blood-brain barrier to increase the effectiveness of chemotherapy for brain tumors and to target other diseases. Alzheimer’s is not the sole focus of these research efforts.