Breaching the Blood-Brain Barrier to Target Glioblastoma

Image adapted with permission from the Focused Ultrasound Foundation

A preliminary trial of focused ultrasound (FUS) to open the blood-brain barrier (BBB) in patients with glioblastoma (GBM) is underway at Brigham and Women’s Hospital and two other sites. One of the study’s first patients, treated by  neurosurgeon Alexandra J. Golby, MD, has shown that the barrier was breached safely and successfully.

The study is a first step toward using non-invasive FUS technology to deliver chemotherapy more effectively to the site of a brain tumor at concentrations higher than occurs with current treatments.
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How We Improved Door-to-Needle Time for Thrombectomy

Using principles of industrial engineering and system dynamics, the stroke care team from Brigham and Women’s Hospital Department of Neurosurgery improved door-to-needle time for thrombectomy. Starting with a thorough assessment of workflow, the team replaced sequential processes with parallel ones, improved communication and transparency across the many disciplines involved, and increased awareness of how each role contributed to patient care. The result: Improved efficiency shortened the door-to-needle time that is a hallmark of quality in stroke care.
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Moving Toward a Tau Plasma Biomarker for Alzheimer’s Disease

Image: Neurofibrillary tangles (dark neurons) in an AD brain, from which tau fragments may derive

Progress in creating and evaluating a tau biomarker test at Brigham and Women’s Hospital is spurring rapid movement toward a blood-based screen to diagnose or predict risk for Alzheimer’s disease (AD) perhaps without the need for spinal fluid or imaging.
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Neuropsychiatry Focuses on Bringing Two Fields Together

It’s not uncommon for people who have neurological disorders to experience behavioral and emotional symptoms. The field of neuropsychiatry is dedicated to addressing this issue and bringing a neurobiological understanding to the field of psychiatry.

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Predicting Health Outcomes in Older Patients with Hematologic Cancers

Gait speed and grip strength are objective measures of physical health that have been shown to predict important health outcomes in older adults such as functional decline, acute care use and death. According to a recent study, these measures are particularly important to assess in older patients with hematologic malignancies including leukemia, lymphoma and multiple myeloma.
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Preventing Delirium During Hospital Stays With Nonpharmacologic Interventions

Delirium, a sudden onset of confusion frequently seen in older patients, was once thought to be a temporary condition that patients “snapped out of” after being discharged from the hospital. However, it is now recognized that delirium may lead to longer-term cognitive impairment and poor health outcomes, including an increased risk of death, nursing home placement and memory problems.
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Nasal Vaccine for Alzheimer’s Disease Nears Human Trials

Reduction in Aβ-levels (green) in mice after weekly intranasal Protollin for 6 weeks in treated (right) versus control (left)*

An intranasal vaccine for Alzheimer’s disease (AD) is expected to begin its first human trial in 2020, culminating nearly 25 years of research led by Howard L. Weiner, MD, co-director of the Ann Romney Center for Neurologic Diseases at Brigham and Women’s Hospital.

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Keyhole Surgery Through the Eyelid Expands Minimally Invasive Options

keyhole surgeryIn a rare through-the-eyelid surgery, neurosurgeon Omar Arnaout, MD of Brigham and Women’s Hospital’s Department of Neurosurgery and collaborators from the Division of Plastic and Reconstructive Surgery recently removed a recurring meningioma from the roof of the orbit. The patient, age 76, bypassed the ICU and was discharged to home the next day, with only non-prescription pain medication.
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Stroke Care Paradox: Tighter Personal Networks May Delay Hospital Arrivals

Could understanding a patient’s personal network of friends and family provide important clues to health and illness, and even guide care? Neurologist Amar Dhand, MD, DPhil, of the Department of Neurology at Brigham and Women’s Hospital, is investigating the relationship of  personal networks and stroke, with some surprising findings.
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Drug-Inducible Gene Therapy Yields Encouraging Preliminary Results in High-Grade Glioma Trial

From E. A. Chiocca, et al, Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: Results of a phase 1 trial. Sci. Transl. Med. 11, eaaw5680 (2019). Reprinted with permission from AAAS.
Image from E. A. Chiocca, et al, Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: Results of a phase 1 trial. Sci. Transl. Med. 11, eaaw5680 (2019). Reprinted with permission from AAAS.

In a recent clinical trial in patients with recurrent high-grade gliomas, investigators from the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center set out to test the safety and effectiveness of controlling the powerful immunotherapy human interleukin-12 (hIL-12) by using an oral activator to control when the gene gets turned on. While hIL-12 can stimulate many branches of the immune system, previous clinical trials that leveraged it were halted because of toxicity.
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