[Un article de The Conversation écrit par Jean-Michel Escoffre – Chargé de Recherche – Inserm, Inserm – & Thomas Desmidt – Professeur des universités, praticien hospitalier en psychiatrie, Université de Tours]
Indeed, ultrasound is a non -invasive technology widely exploited in medicine for the diagnosis and treatment of many pathologies. Their potential application in psychiatry is a subject of emerging research which opens up new perspectives for the management of psychiatric diseases and neurodevelopmental disorders.
Although ultrasound are mainly associated with biomedical imaging, their use in psychiatry, as a functional exploration modality of the brain or as a brain neuromodulation technique, is increasingly explored.
This technological revolution promises to radically transform the diagnosis and treatment of psychiatric disorders by offering more targeted and less invasive solutions.
Portability, non -invasiveness and limited costs of ultrasound
The development of objective markers, for the diagnosis and prognosis of psychiatric diseases, such as bipolar disorders, schizophrenia, depression and neurodevelopmental disorders such as autism, etc. is one of the major challenges in psychiatry.
To date, most of the diagnosis of these disorders is based on clinical and behavioral criteria. Conventional cerebral imaging, such as magnetic resonance imaging (MRI) and positron emission tomography, makes it possible to visualize the brain structures involved in these disorders and their metabolism. However, these medical imaging methods remain expensive and frequently limited in terms of availability and accessibility.
On the other hand, the ultrasound has unique advantages for the diagnosis of psychiatric diseases and neurodevelopmental disorders, in particular because of their portability (diagnosis in bed of the patient or at home), their non -invasiveness and their cost. Thus, thanks to brain imaging techniques that use ultrasound, it is now possible to visualize dysfunctions, in the brain, which are associated with certain psychiatric and neurodevelopmental disorders.
To the “ultrasonor” diagnosis
Today, one of the promising applications of ultrasound in psychiatry concerns functional brain imaging. Ultrasonorous imaging provides information on the mechanical properties of the brain fabric which can be precious to characterize pathological situations in mental health.
A set of studies has shown, for example, that depression was associated with excessive cerebral beating amplitudes, in this population known for its gorgeous brain damage and stroke.
In addition, our recent long -term work shows that natural brain movements observed by ultrasonic imaging tend to return to normal when people suffering from depression are starting to get better.
In other words, there is a kind of “reactivation” of the brain at the same time as an improvement in the mental state.
These movements could therefore serve as a useful indicator for knowing whether a treatment for depression works, especially in the case of medical nitrogen oxide, a gas sometimes used for its antidepressant effects.
When ultrasound treats psychiatric diseases
In addition to their diagnostic potential, ultrasound are also explored to ultimately treat various psychiatric diseases resisting pharmacological treatments or psychotherapy.
Among the most promising technologies, we will cite three.
- Low -intensity focused ultrasoundwhich make it possible to specifically modulate the electrical activity of brain regions, or to deliver therapeutic molecules in the brain (ultrasound combined with gas microbubbles) under the control of MRI or by neuronavigation.
- High intensity focused ultrasoundwhich concentrates this time the ultrasonic waves in a precise area of the brain in order to induce its selective and irreversible destruction by a thermal process (ultrasound focused with high intensity) or mechanical (ultrasonic history), thus reducing the abnormal activity of this region.
This modality is under clinical evaluation for the treatment of depression and obsessive compulsive disorders resistant to traditional drugs.
A study has shown the effectiveness and safety of this approach to treat obsessive compulsive disorders by targeting a specific area of the brain called the internal capsule. It has improved obsessive compulsive, depressed and anxious symptoms in patients with obsessive compulsive disorders, without inducing serious undesirable effects.
- Ultrasonor neuromodulationwhich consists in focusing ultrasound on brain regions involved in psychiatric disorders, without destroying them.
Unlike other neurostimulation techniques, this mechanical stimulation makes it possible to modulate the electrical activity of the superficial and deep regions of the brain, in a non -invasive manner. A recent study revealed that ultrasonic neuromodulation of a specific area of the brain of patients with depression has improved their depressive symptoms.
Today, many preclinical and clinical studies assess the therapeutic potential of this ultrasonic modality for the treatment of psychiatric diseases such as schizophrenia and depression, or even neurodevelopmental disorders such as autism.
Tomorrow, facilitate the delivery of drugs in the brain?
Ultrasound could also be used to facilitate targeted delivery of brain medication. This method, called “Sonoporation”, combines ultrasonic waves with gas microbubbles to increase the permeability of blood vessels, in order to better penetrate medications into brain tissue irrigated by these vessels.
This approach could improve the effectiveness of drug treatments for psychiatric and neurodevelopmental disorders, allowing drugs to reach the brain areas more effectively.
To date, this ultrasonic modality is only the subject of preclinical studies in animal models of psychiatric diseases such as addiction to drugs and depression and neurodevelopmental disorders such as autism.
Ultimately improve the quality of life of patients
The perspectives offered by ultrasound open a field of diagnostic and therapeutic innovations that could considerably improve the quality of life of people with psychiatric diseases and neurodevelopmental disorders.
Although this technology is still in the development phase, its potential applications are vast and could transform the way in which these disorders are diagnosed and treated.
From functional brain imaging to neuromodulation, including targeted administration of drugs, ultrasound offer innovative means to better understand and treat psychiatric diseases and neurodevelopmental disorders.
However, although these technologies are promising, their common practice in psychiatry requires clinical studies and additional validations, which include the determination of their long -term effectiveness, the safety of procedures as well as their accessibility for patients.
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