Ultrasound Brain Therapy for Addiction
Clip: Episode 8 | 5mVideo has Closed Captions
Patients struggling with addiction are benefitting from ultrasound brain therapy.
In West Virginia, one of the states hardest hit by the opioid crisis, neurosurgeon Ali Rezai is pioneering a new, non-invasive approach to treating addiction. Using highly focused beams of ultrasound, his team at the Rockefeller Neuroscience Institute targets the specific regions of the brain hijacked by compulsive behavior. This modulates neural circuits without surgery, without drugs or surgery.
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Made possible in part by support provided by Sue Hart-Wadley and Searle Wadley with additional support from Jerry Cox.
Ultrasound Brain Therapy for Addiction
Clip: Episode 8 | 5mVideo has Closed Captions
In West Virginia, one of the states hardest hit by the opioid crisis, neurosurgeon Ali Rezai is pioneering a new, non-invasive approach to treating addiction. Using highly focused beams of ultrasound, his team at the Rockefeller Neuroscience Institute targets the specific regions of the brain hijacked by compulsive behavior. This modulates neural circuits without surgery, without drugs or surgery.
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Learn Moreabout PBS online sponsorshipO'BRIEN: Ali Rezai is most comfortable pushing the boundaries of medical research, and when it comes to the human brain, he sees nothing but opportunity.
There's so much that needs to be discovered, and there's so little known.
They call it the final frontier for discovery in medicine.
O'BRIEN: Rezai is a pioneer in the field of deep brain stimulation, DBS: surgically implanted pacemakers for the brain.
REZAI: We put a pacemaker wire deep in the brain, and it modulates the electrical activity of the neurons to improve tremor or improve pain or, or stop epilepsy.
O'BRIEN: But Rezai is a neurosurgeon who would prefer not to cut.
REZAI: Surgery, in my opinion, should be a last resort.
And, uh, the less invasive, the better.
If we develop technology that people can be treated without brain surgery, why not?
O'BRIEN: So, how does a brain surgeon operate without surgery?
♪ ♪ He replaces the scalpel with sound: high-frequency sound waves, better known as focused ultrasound.
Doctors have used focused ultrasound since the 1950s to destroy tumors and kidney stones.
As the technology became more precise, they started aiming it at the brain.
It is now FDA-approved to treat essential tremor and Parkinson's disease.
Ali Rezai helped pioneer that work.
He wondered if focused ultrasound could also reset the circuits hijacked by addiction.
♪ ♪ Erin McNulty would also like to know.
She's anxiously awaiting her turn as a participant in Rezai's study.
They had to shave her hair, but she made the best of it with a wide variety of wigs.
♪ ♪ Erin has struggled with addiction for four decades.
Mostly, it's been heroin.
More recently, methamphetamines.
She remembers at least 14 overdoses.
I remember one time, they said my heart rate was six beats per minute.
Oh, wow.
-Um... That's pretty close to dead.
Yeah.
It's so sad, you know, um, to keep using, but then you feel bad about it, and it keeps the cycle going, and... It's a death spiral, is what it is, right?
-It's a death spiral, it is.
It really is.
It's very hard to get out from under it.
Extremely.
-Yeah.
O'BRIEN: Alive against all odds, she saw this procedure as her last hope for any kind of future.
At this point, were you ready?
To... -Yeah.
I, yeah, I was more than ready.
Honestly, I really was not nervous.
I know I'm in really good hands, and everything I've been through with addiction... (inhales sharply) I was, like, you know... (laughs) Bring it on.
Like... (laughing) MAN: How are ya?
-Good.
Just ready to get this done.
MAN: All right.
Let's make it happen.
Yeah.
WOMAN: Good morning, honey.
How are you?
ERIN MCNULTY: Good.
-Love you.
O'BRIEN: We were there on game day.
As she arrived, she was quickly surrounded by a team of about two dozen health professionals, there to perform a symphony conducted by Ali Rezai.
REZAI: There's her hat, right there.
O'BRIEN: It began with the only painful, invasive part of the procedure: the halo.
It's designed to keep her head perfectly still.
Okay, very good.
O'BRIEN: She'll remain inside the MRI throughout the procedure, giving the team a real-time view of the precise area of the brain they're targeting.
She has significant asymmetry between her right and left side of the brain.
We're just trying to fine-tune it to capture more of the nucleus accumbens.
O'BRIEN: The nucleus accumbens sits deep inside the brain.
Working with the chemical messenger dopamine, it's part of the reward system that motivates us to seek life's pleasures-- from food and sex to the satisfaction of a job well done.
But addiction hijacks that same circuitry, trapping the brain in compulsive loops that are hard to escape.
Could it be possible to break that cycle, not with drugs or surgery, but with something as simple as sound?
We are not destroying brain tissue, but we are modulating it, like a deep brain stimulation does with a pacemaker.
We're doing it without surgery.
O'BRIEN: The stakes are high.
There is no room for error.
REZAI: A lot of very precious brain territory that have a lot of different functions are close by, so you don't want to impact those areas.
O'BRIEN: To refine their aim, they merge real-time MRI data with earlier brain scans.
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Made possible in part by support provided by Sue Hart-Wadley and Searle Wadley with additional support from Jerry Cox.