DESIGNING AN INTERACTIVE SONIC MEDIA ENVIRONMENT FOR STROKE REHABILITATION

I really have no idea on this one but your music therapist should know all about it. You do have a music therapist? Don't you? If not your stroke rehab department is completely out-of-date. 

DESIGNING AN INTERACTIVE SONIC MEDIA ENVIRONMENT FOR STROKE REHABILITATION

4. CONCLUSION
The purpose of this paper is to document three years' worth of research on the sonic media environment for the home-based mixed reality rehabilitation system and to exhibit validated proof that meaning connects action to music. Although the home-based system has not yet been used or tested in real scenarios, there is a significant ground-truth basis that conveys the need for such systems. Proposed within this paper was to change the dialogue surrounding sonic media environments for rehabilitation purposes by researching viable solutions and designing a system to provide an immersive, multi-layered sonic media environment. Discussed, herein, is the motivation behind the project. Herein, the previous sound paradigms are defined alongside the proposed sound design, as well as the system design and the quantitative and qualitative solutions that target a new discussion for audio biofeedback.

Propping Open the Door to the Blood Brain Barrier

Our researchers should be jumping for joy about getting drugs past the blood brain barrier for those possibilities that can stop the neuronal cascade of death.  But is it the sonication or the gas in the microbubbles that is the cause of entry?  Can't  we even figure out cause and effect? Earlier research used xenon gas which has a proven neuroprotective effect.
I await results in 20 years unless we take over.
Propping Open the Door to the Blood Brain Barrier

The treatment of central nervous system (CNS) diseases can be particularly challenging because many of the therapeutic agents such as recombinant proteins and gene medicines are not easily transported across the blood-brain barrier (BBB). Focused ultrasound can be used to "open the door" of the blood brain barrier.

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However, finding a way to "prop the door open" to allow therapeutics to reach diseased tissue without damaging normal brain tissue is the focus of a new study by a team of researchers at the Institute of Biomedical Engineering at National Taiwan University presenting at the 57th Annual Meeting of the Biophysical Society (BPS), held Feb. 2-6, 2013, in Philadelphia, Pa.
The group is investigating the feasibility of using heparin, a common anticoagulant, to enhance the delivery of therapeutic macromolecules using ultrasound into the brain. Heparin could be employed to increase treatment efficacy in patients with different types of CNS diseases under the guidance of medical imaging system providing new hope in these challenging cases. Initial results show that heparin does have the potential to optimize therapeutic delivery with ultrasound, acting as a "doorstop," allowing drugs to better permeate the BBB and enhancing treatment success.
"A higher acoustic pressure and longer sonication, and/or a higher dose of microbubbles may increase the delivery of drugs or tracers into the sonicated brain tissue," explains Kuo-Wei Lu, a member of the research team, "but side-effects, such as microhemorrhage, can also increase dramatically. The results of this study indicate that heparin may offer a safer way can to enhance the delivery of therapeutics to patients with CNS diseases."
With these encouraging results, the next step for the team is to develop a focused ultrasound system with Magnetic Resonance Imaging (MRI) guidance to establish suitable parameters needed for patient clinical trials. "Focused ultrasound sonication is a noninvasive technology capable of localized and transient BBB opening for the delivery of CNS therapeutics," Lu states. "We hope by developing suitable parameters and using chemical enhancers like heparin, this can be a valuable tool in the treatment of patients with CNS diseases, opening the door to better patient outcomes."

Efficiency of drug delivery enhanced by acoustic pressure during blood–brain barrier disruption induced by focused ultrasound

When we need to get drugs thru the blood-brain barrier we might be able to use this method. 

Efficiency of drug delivery enhanced by acoustic pressure during blood–brain barrier disruption induced by focused ultrasound

Purpose: We evaluated the delivery efficiency of intravenously injected large molecular agents, before and after disruption of the blood–brain barrier (BBB-D), induced by focused ultrasound (FUS) using various acoustic parameters.
Materials and methods: Male Sprague-Dawley rats were injected intravenously with Evans blue (EB) before or after BBB-D induction by pulsed FUS. We used a 1.0 MHz pulsed FUS with four acoustic power settings and an ultrasound contrast agent (UCA) at four different doses to induce BBB-D resulting from cavitation. The permeability of the BBB was assessed quantitatively based on the extravasation of EB. Contrast enhanced magnetic resonance imaging (MRI) was used to monitor the gadolinium deposition associated with FUS. Histological analysis was performed to examine tissue damage.
Results: The accumulation of EB in rat brain was found to be dependent on acoustic power and UCA dosage, regardless of whether EB administration occurred before or after FUS-induced BBB-D. Administration of EB followed by sonication resulted in greater EB extravasation than that for rats subjected to sonication prior to EB injection. To reduce tissue damage, EB extravasation was enhanced by first administering EB by intravenous injection, followed by sonication at reduced acoustic power or UCA dosage. The normalized signal intensity change in rat brains that received the same dose of UCA and sonicated after gadolinium injection was significantly greater than in rats undergoing sonication followed by gadolinium administration. Moreover, contrast enhanced MRI showed a more precise distribution of gadolinium in the brain when gadolinium was administered before sonication.
Conclusion: We demonstrated that a compound administered prior to sonication treatment promotes extravasation of the sonicated region. Thus, it is possible to optimize ultrasound parameters for lower sonication and reduced UCA doses, to induce BBB-D while minimizing damage to normal brain tissue.