One ultrasound treatment against cancer, Parkinson’s and depression

11 December 2024 Research news item

Radboud researchers are using focused ultrasound (FUS) to help improve treatment options for brain conditions, such as cancer or Parkinson's disease, as well as depression, addiction and chronic pain. 'With this technique, we can accurately and safely treat the brain, without pill or scalpel.' By raising funds, the researchers strive to allow more people to benefit from this treatment in the future.

Doctors use Focused ultrasound (FUS) sound waves to reach areas deep inside the body. They use sound waves to reach places deep inside the body. This new technique is like Swiss army knife, with many applications. For example, doctors can remove certain brain tumours or treat Parkinson's without surgery that opens up the skull. Soon they will also be able to use this to help with depression, anxiety, or addiction. With ultrasound, we can nudge the brain in the right direction – a treatment without a pill or surgery.

We are already familiar with the ultrasound technology from regular ultrasounds, used for example on pregnant women. The difference with FUS is that you can use the sound waves to stimulate a very specific small piece of tissue, whereas with ultrasound, you use sound waves to listen and thus create a larger picture of the whole area.

If you use ultrasound at a very high intensity you can use FUS to remove cancer, for example. “The major advantage is that doctors can cut out bad cells, so to speak, without using a scalpel”, explains neuroscientist Lennart Verhagen. “At the moment, cancer the brain is often not treatable because it can be too dangerous to cut it out. But using ultrasound, you can still treat the cancer without the risk of destroying the surrounding tissue.” The technique is also already being used for prostate, bone and breast cancer.

Neurological conditions

FUS can also help with neurological diseases, such as Parkinson's. Parkinson's patients are now often treated with deep brain stimulation (DBS), in which electrodes stimulate the brain, reducing the trembling typically associated with this disease. The procedure works by using a metal wire, which is always in the brain. To insert this, patients have to go to hospital for a few days and the brain is exposed, which carries risks. After that, the battery must be replaced once every few years; again, an invasive operation.

“DBS can slow down trembling, it really works, but such a surgery and the risks involved are not for everyone”, explains Verhagen. “With ultrasound, someone who comes in trembling in the morning can be outside four hours later without any tremors. This is high-intensity ultrasound, where you remove the brain cells that provide the vibration. But, be aware, you can’t reverse the operation.”

Verhagen is even more enthusiastic about the potential of FUS at low intensity, the same intensity as ultrasound in a pregnant woman. Thus, you can safely use FUS to treat depression, anxiety disorders, PTSD and even addiction or chronic pain. “These diseases are often dismissed as something you have to get over, while they are actually brain conditions. They are all diseases in which the brain has developed a certain reaction and the wrong connections are now stuck. So, you would want to help a specific brain area to unlearn this behaviour. We still have a lot of research to do on this application, but some cases already show that patients no longer have chronic pain or addiction problems for an extended period of time, after just one round of FUS treatment. Meanwhile, addiction care and chronic pain therapy have become incredibly expensive.”

Brain stimulation with FUS is an alternative to drugs. For many brain diseases, medication does not always work well and patients also often experience side effects. “For depression, drugs only work in half the cases”, explains Verhagen. “Another disadvantage is that pills often have side effects because they are active in the whole body, whereas you really only want to address the cause of the problem. That can be done with FUS”

Chemo without side effects

Besides the aforementioned applications, FUS is also a good tool for drugs against Alzheimer’s, for example, but also brain tumors. Often we already have working drugs, such as chemotherapy, but the brain stops it. This is called the blood-brain barrier, and it stops almost everything in the blood, including drugs. You need a very high dose of chemotherapy to still get to the tumor in the brain, with all its side effects. With FUS, one can get the medication to the right place.

“By introducing air bubbles into the blood and making them vibrate using ultrasound,” Verhagen explains, “you can deliver medication via the blood to exactly the right place in the brain. The brain is very well protected with a kind of membrane, which ensures that no foreign substances enter it. With ultrasound, you can temporarily—and exact to the millimetre—open up a little door that allows the medication to reach a specific brain area.” This way, you can ensure that chemotherapy only reaches the brain tumour itself and doesn't spread throughout the body, for instance. Patients can then make do with lower doses of medication and suffer fewer side effects.

Radboud FUS Centre

Plenty of benefits, then. But health insurance companies usually do not reimburse FUS technology at present. Research is needed to make the techniques as effective as possible, and new innovation to bring the technique safely to patients.

In the FUS initiative team at the Donders Institute at Radboud University, Verhagen and his colleagues are working daily to improve the technique. This collaboration was established in 2022 to support FUS research and innovation across campus. The team holds an internationally leading position in ultrasonic neuromodulation research. With help from the Radboud Fund, the researchers are now striving to transform the initiative team into the Radboud FUS Centre. Proceeds from the Radboud Fund are going towards technical support for research, the development of FUS applications in healthcare and teaching on FUS at the undergraduate and graduate levels. This will allow Radboud researchers to contribute to medical innovations and remain a high-quality source of knowledge for both the Netherlands and the international community.

“We would like to make sure that the knowledge about this technology really remains by and for everyone, and is not bought by a company, which happens with many medicines, for example”, says Verhagen. “With additional resources, we can standardise techniques, for instance. So that all FUS devices in the world have the same kind of plug, so to speak. That sounds boring, but it is very important that these kinds of standards are devised by researchers themselves—and not by companies making choices out of economic interest. We would like shared ownership: paid for by and available to the public.”

Guts needed

“I find it very exciting that my work allows me to engage with such a promising technique”, says Verhagen. “With this research, I am looking 10 or 20 years into the future. By then, everyone should be able to get this treatment. As early as the 1950s, there were indications that ultrasound technology might do a lot for healthcare. But thorough research takes a very long time: only in 2014 was neuromodulation first used in humans, and since that year Radboud researchers have also been working with the FUS technique. The developments are really promising, but we need guts and so we need to invest.

One in four people develops a brain disorder and for many, existing therapies do not work well enough. How great would it be if we could soon help these people?”

You can donate to Radboud FUS Centre via https://radbouduniversiteit.voorradboudfonds.nl/project/hersenen-gedrag-en-technologie

Contact information

Organizational unit: Donders Institute for Brain, Cognition and Behaviour
About person: Dr L. Verhagen (Lennart)
Theme: Brain, Innovation, Health & Healthcare