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News: Summer 2015

New imaging technologies create new neuroscience diagnostic and therapeutic tools.

Ultra-high resolution imaging tools like 7-Tesla MRI now allow researchers to glimpse the brain in extraordinary detail, opening the door to new diagnosis and treatment of neurological disorders.

Two imaging advances in particular – focused ultrasound and neuroimaging diagnostics in neurodegenerative and psychiatric illnesses – were featured in the 2015 Disruptive Dozen, the list of 12 technologies predicted to have the greatest impact on neurological care in the coming decade by Partners faculty.

“We have arrived at a historic inflexion point where these new imaging technologies coupled with new understandings of the CNS create powerful new tools to diagnose and treat neurological disease” says Bruce Rosen, MD, PhD, Director of the Massachusetts General Hospital (MGH) Athinoula A. Martinos Center for Biomedical Imaging and a professor of radiology at Harvard Medical School (HMS).

A particularly promising therapeutic strategy is focused ultrasound (FUS), a noninvasive technique that uses targeted and high-powered sound waves to remove brain tumors or other pathogenic tissues without damaging the surrounding healthy tissue. Studies are underway to explore whether lower powered FUS, perhaps in combination with injected agents like micro-bubbles, might help facilitate drug delivery to the brain or stimulate neural activity in certain brain regions – all without the need for incisions or radiation.

Focused ultrasound is a unique and flexible technology that we believe can have a profound impact on neuroscience, neuro-oncology and the management of neurodegenerative disease,” says Nathan McDannold, PhD, Director of the BWH Therapeutic Ultrasound Lab and an associate professor of radiology at HMS. “In particular, the use of ultrasound to temporarily disrupt the blood-brain barrier and target drugs to desired locations is a potentially disruptive technology that can change the way we think about treating diseases in the central nervous system.”

In addition to focused MRI, neuroimaging tools such as positron emission tomography (PET) are being applied in various ways to detect early signs of neurodegenerative disorders. A tool known as FDG-PET, for example, monitors how effectively glucose fuels the brain – and may help detect alterations in this process decades before a patient is diagnosed with Alzheimer’s disease (AD). Another type of PET uses radioactive material to measure the buildup of amyloid in the brain during AD pathogenesis.

Advances in brain-scanning technology are illuminating the biological pathways that underlie thought and emotional states, and may hold promise for diagnosing certain psychiatric illnesses such as major depressive disorder. Recent advances suggest that patterns of activity in certain areas of the brain may help predict how an individual patient will respond to certain medications or psychotherapy. These findings open the door to a new era of personalized medicine.

For example, neuroimaging projects at the BWH Functional Neuroimaging Laboratory in the Department of Psychiatry are helping to define profiles of brain activity associated with subtypes of mood, anxiety and psychotic disorders, as well as specific patient treatments.

“Such work is transforming the approach to mental illness, from description to biological mechanism like the rest of medicine,” says David Silbersweig, MD, Chairman of the Department of Psychiatry at BWH, Co-Director of the BWH Institute for the Neurosciences and Stanley Cobb Professor of Psychiatry at HMS.

“The Disruptive Dozen highlighted two extremely transformative applications in radiology for diagnosing and treating neurological disorders,” notes Jonathan Behr, PhD, Radiology Market Sector Leader at Partners Innovation. “This impact has been recognized by industry and we’re currently working on multiple collaborations and licenses around each of these themes for both the BWH and the MGH.

Advances in imaging will remain in the spotlight at the oncology-focused 2016 World Medical Innovation Forum. A number of pertinent projects are underway at Partners Healthcare, including a collaboration between Hiroto Hatabu, MD, PhD, at the BWH and Bruce Johnson, MD, at the Dana-Farber Cancer Institute to hone strategies for measuring tumor growth over time, potentially allowing clinicians to more closely monitor a patients’ response to treatment.

“It’s exciting that these various technologies, which have been developed for a long time in academia, are now at the cusp of being translated to patient care. Partners has world-leading expertise and is actively accelerating impacts in each of these important fields,” says Behr.