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Neuronavigation-guided FUS-induced BBB Opening in Alzheimer's Disease Patients and Its Effects on Brain Amyloid and Tau

Phase 1
Not yet recruiting
Conditions
Alzheimer Disease, Early Onset
Interventions
Device: Neuronavigation-guided single-element focused ultrasound transducer
Other: Magnetic Resonance Imaging (MRI) with or without gadolinium contrast agents
Radiation: Positron Emission Tomography (PET)
Diagnostic Test: Blood draw
Device: UR5e
Diagnostic Test: Urine test
Registration Number
NCT06600880
Lead Sponsor
Columbia University
Brief Summary

The primary purpose of this phase 1b study is to further assess the safety and reversibility of focused ultrasound induced blood-brain barrier opening (FUS-BBBO) in participants with Alzheimer´s Disease (AD) using a single-element transducer with neuronavigation guidance. Preliminary results from our phase 1a study demonstrate that our neuronavigation-guided FUS system was capable of safely and transiently open the BBB in participants with AD. The information collected in this new study may be used to design future clinical trials to ultimately provide a viable alternative for treatment of AD in a safe and noninvasive manner.

Our secondary objective includes the assessment of the therapeutic efficacy of FUS-BBBO in reducing amyloid beta and neurofibrillary tangles, the main hallmark pathologies of AD, using PET tracers. Based on our preclinical studies in AD transgenic mouse models, FUS-BBBO alone was able to reduce both the amyloid beta and tau protein load, resulting in improvements in behavioral tasks assessing memory. Therefore, in this new study, the effect of FUS-BBBO on the amyloid beta and tau protein load in patients with AD will be assessed through the use of PET tracers.

Detailed Description

Regarding the primary purpose of this study, the human module for the neuronavigator was implemented in our phase 1a trial, and initial feasibility and safety in a small cohort of AD patients had been tested, with a fast procedural time that required no anesthesia.

Regarding the secondary objective, both amyloid beta and tau protein load in the brain will be assessed at baseline (before FUS-BBBO treatment), and 3-weeks and 3-months after FUS-BBBO treatment, to assess any short-term or long-term changes, respectively.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
6
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Focused ultrasound treatmentNeuronavigation-guided single-element focused ultrasound transducerNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentLumasonNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentMagnetic Resonance Imaging (MRI) with or without gadolinium contrast agentsNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentPositron Emission Tomography (PET)Neuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentAmyvidNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentMK-6240Neuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentDotaremNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentBlood drawNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentUR5eNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Focused ultrasound treatmentUrine testNeuronavigation-guided focused ultrasound treatment in Alzheimer's disease patients using a single-element transducer in conjunction with microbubbles.
Primary Outcome Measures
NameTimeMethod
Total Number of Individuals With Successful Opening of the BBB4 days, including the day of treatment

Opening the BBB successfully in all the patients, while obtaining a volume of BBB opened being similar and consistent for all patients

Secondary Outcome Measures
NameTimeMethod
Total Number of Safety Events Related to Opening of BBB4 days, including the day of treatment

Showing safe BBB opening for all patients without any Adverse Event nor Serious Adverse Event, and showing its safety as well in 3 days after treatment

Percent Change in Amyloid PET Signal Intensity3 months (±2 weeks)

A moderately shown in our previous clinical trial study, we expect to observe a slowed down increase of Amyloid protein load after the treatment on the two follow-ups performed at 3 weeks (±1 week) and 3 months (±2 week) after treatment.

Percent Change in MK-6240 PET Signal Intensity3 months (±2 weeks)

As shown in our previous studies in mice, we expect to observe a slowed down increase or reduction on Tau protein load after the treatment on the two follow-ups performed at 3 weeks (±1 week) and 3 months (±2 week) after treatment.

Trial Locations

Locations (1)

Columbia University Irving Medical Center

🇺🇸

New York, New York, United States

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