A man with Alzheimer’s disease knows there is no cure for the disease, so he donated a million dollar helmet that uses about a thousand ultrasound beams to target the brain the size of a lead point.
Dan Miller, 61, said he had nothing to lose when he signed up for an experimental procedure pioneered by neurosurgeon Dr. Ali Rezai. Doctors have used ultrasound for 70 years to get better views of the body and fetal development. Rezai is currently testing it as a treatment tool for people with it. Alzheimer’s And those who struggle with drug addiction.
“There is no miracle cure here,” said Rezai. “It’s about advancing medicine with calculated risks and pushing the boundaries.”
Can ultrasound help people with Alzheimer’s disease?
Miller was one of three patients in the Rezai trial at the Rockefeller Institute of Neuroscience in Morgantown, West Virginia. Rezai gave 60 Minutes a look at his revolutionary experiment using ultrasound to slow cognitive decline in people with Alzheimer’s disease.
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A scan of Miller’s brain showed red areas indicating a buildup of beta amyloid proteins, a type of “brain plaque” believed to play a role in Alzheimer’s disease by disrupting communication between brain cells. In the hours before the test procedure, trial patients will receive an IV treatment with aducanumab, which is used to reduce plaques.
Aducanumab It works slowly the way it’s typically administered, when people take the antibody for an hour or two once or twice a month for 18 months or more, Rezai said. Because the drugs have difficulty crossing the blood-brain barrier, it takes much longer.
In July, the Food and Drug Administration granted traditional approval for the Alzheimer’s drug lecanemabUnder the brand name Leqembi, from an Expedited approval Released in January 2023.
Rezai uses focused ultrasound to open the blood brain barrier. Patients in the experiment lie on an MRI table wearing a special helmet. Once inside, you will receive an IV solution containing tiny bubbles. When hit with ultrasound energy, the bubbles vibrate and open the blood-brain barrier, which temporarily allows medical drugs to enter the brain.
“That way, we get the payload, the therapeutic load, right from the point of maximum penetration to the area that needs it,” said the neurosurgeon. “But we have to be careful because we want to be safe in this case. You don’t want to deliver too much, you don’t want to open the blood-brain barrier too much.”
If the blockage is too open, it can cause bleeding and swelling in the brain, Rezai said.
Although Rezai’s test patients were awake during the procedure, they said they felt nothing. Each of them received the treatment once a month for a period of six months.
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Rezai’s team said that since the ultrasound treatment ended in July, there has been no change in the ability of the three patients to carry out their daily activities. The patient’s brain scans show a clear reduction in beta amyloid proteins; Beta-amyloid plaques targeted by ultrasound were reduced by 50% more than areas targeted by injection alone.
Now that Rezai has shown that focused ultrasound can quickly clear away beta-amyloid plaque, he has received Food and Drug Administration approval to use ultrasound to restore brain cell function lost in Alzheimer’s.
“We don’t know if it will reverse the damage to the brain because the underlying cause is Alzheimer’s still occurring,” Rezai said. “So we have another study that we’re looking at with ultrasound. First, clear the plaques, then deliver the ultrasound at a different dose to improve brain function in people with dementia or Alzheimer’s.”
But Rezai doesn’t just work to help people with Alzheimer’s disease. He and his team are targeting drug addiction, which affects 21 million Americans. Rezai is using ultrasound for his addiction treatment.
Planting addiction in the brain
Before the concept of using ultrasound to treat addiction came to light, Rezai began by adapting technology used to treat Parkinson’s disease to treat people with serious drug addictions. For Parkinson’s, brain implants are used to stop tremors. Rezai plans to use a similar implant in the brain targeted for behavioral control, anxiety and craving addiction.
““There’s a part of the brain that malfunctions electrically and chemically with addiction,” he said.
The National Institute on Drug Abuse agreed to fund the study, and in 2019, the Food and Drug Administration gave the research green light to Razi.
Gerrod Buchhalter agrees to become the first addict to undergo implant surgery in the US. After a shoulder injury, he became addicted to painkillers for over 15 years. Buckhalter couldn’t stay clean for more than four days at a time, he said. He doesn’t remember how many times he overdosed.
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“Some nights I didn’t know where I was going to sleep. You know, my family didn’t want me around anymore,” Buchhalter said. “I just, I did so much to hurt them, you know, it was too much for them to handle.”
He met Rezai four years ago. The fact that the neurosurgeon operated on Buchler during a seven-hour operation is so new that he has not yet been named. Rezai drilled a nickel-sized hole in Buckhalter’s skull and guided a thin wire with four electrodes through it. Buckhalter was awake during the operation.
Once in place, the wire is connected to the device placed under the collar bone. The electrical impulses it sends to the brain are meant to curb cravings. Buckhalter has no pain after surgery. The system is adjusted remotely with a tablet computer as needed.
After the operation, when they turned on the system, there was an immediate change.
“I feel better so far, you know, just like I did before I was on drugs, but a little bit better,” Buchhalter said. “And that’s when I knew I had a legitimate shot at doing well.”
In all, four patients with severe drug addiction had the transplant: one had a minor relapse, another withdrew completely from the trial, and two, including Buckhalter, became drug-free after the operation.
How Ultrasound Therapy Can Help People With Drug Addiction
Opening someone’s skull is always dangerous. Rezai thought that if he used ultrasound technology, which he had already used to treat other brain diseases, he could see more patients faster.
“No cutting the skin, no opening the skull,” he said. “So it’s brain surgery without cutting the skin, really.”
In the new experiment, he and his team treat addiction by targeting hundreds of ultrasound beams at precise points in the brain.
“So the area we treat is the reward center in the brain, which is the nucleus accumbens, which is at the bottom of this dark area,” Rezai said. “And then we deliver the ultrasound waves to that particular part of the brain, and on the table, we see how your appetite and anxiety change in response to the ultrasound.”
The whole process takes an hour, Rezai said.
Last February, Rezai used focused ultrasound to treat Dave Martin, surrounded by friends and family who have been drug addicts his whole life. Martin said he started using drugs at the age of 7 and continued for 37 years. A lot has changed after the ultrasound treatment.
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“The day of the procedure was the best day of my life,” Martin said.
According to Dr. Rezai’s team, Martin admitted to taking a pain pill at a party in December. Still, 10 of the 15 patients in the ultrasound clinical trials remained completely drug-free.
What’s Next for Rezai Ultrasound Therapy?
Rezai is testing the same treatment on 45 more addicts and is considering expanding the use of ultrasound to help people with other mental illnesses, including post-traumatic stress disorder and obesity.
He is determined to learn more and replicate his findings.
“There’s always risk, but you can’t make breakthroughs without risk,” Rezai said. “But we have to push forward and take risks, because people with addiction and Alzheimer’s are not going away. It’s here, so why wait 10, 20 years? Do it now.”