Name: a benchtop approach to the location specific blood brain barrier opening using focused ultrasound in a rat model
Uploaded: 2020-06-13T12:30:00
Description: Watch this Scientific Journal Video about A Benchtop Approach to the Location Specific Blood Brain Barrier Opening using Focused Ultrasound in a Rat Model at JoVE.com

This research was supported in part by an NSF EPSCoR Research Infrastructure grant to Clemson University (1632881). In addition, this research was supported in part by the Civitan International Research Center, Birmingham, AL. The authors gratefully acknowledge the use of the services and facilities of the University of Alabama at Birmingham Small Animal Imaging Shared Facility Grant [NIH P30 CA013148]. The authors acknowledge Rajiv Chopra for his support and guidance.

All experimental procedures were done in accordance with UAB Institutional Animal Care and Use Committee (IACUC) guidelines.
1. Focused ultrasound driving equipment setup
<ol>
	<li>Use 50 Ohm coaxial BNC cables to connect (1) the input of the ultrasound transducer to the output of the RF amplifier and (2) the input of the RF amplifier to the output of the function generator.</li>
	<li>Set the function generator mode to a sinusoid burst once per second with a 1% duty cycle.
	<ol>
		<li>For th...

Here we described a benchtop approach to microbubble assisted FUS BBB opening with alternative approaches including, two different transducers and methods for intracranial targeting with and without MRI guidance. Currently, in order to establish MRI-guided FUS BBB opening in the lab, there is the option to purchase excellent ready-to use devices that provide highly standardized and reproducible results with user-friendly interfaces. However, many labs are not prepared for the cost of such instruments. Therefore, the main...

Despite the many discoveries in basic neuroscience, the number of emerging treatments for neurodevelopmental and neurodegenerative disorders remains relatively limited1,2. A deeper understanding of the genes, molecules and cellular circuitry involved in neurological disorders has suggested promising treatments unrealizable in humans with current techniques3. Effective treatments are often limited by the need to be brain penetrable and site-specific4,5,6,7,8. However, existing methods of localized drug delivery to specific brain regions (e.g., delivery via injection or cannula) are invasive and require an opening to be made in the skull9. The invasiveness of this surgery prevents the routine use of localized delivery into the human brain. Additionally, tissue damage and the resulting inflammatory responses are ubiquitous confounds for basic and preclinical studies that rely on intracerebral injection10. The ability to noninvasively deliver agents across the blood brain barrier (BBB) and target them to specific brain regions could have a tremendous impact on treatments for neurological disorders, while simultaneously providing a powerful investigational tool for preclinical research.
One method of targeted transport across the BBB with minimal tissue damage is transcranial focused ultrasound (FUS) together with microbubbles to focally and transiently open the BBB11,12,13,14,15,16. FUS BBB opening has gained recent attention for the treatment of neurodegenerative disorders, stroke and glioma by localizing therapeutics to target brain regions such as neurotrophic factors17,18,19, gene therapies20,21,22, antibodies23, neurotransmitters24, and nanoparticles25,26,27,28,29. With its wide range of applications and its noninvasive nature30,31, FUS BBB opening is an ideal alternative to routine stereotaxic intracranial injections. Furthermore, due to its current use in humans30,32, preclinical investigations using this technique can be considered highly translational. However, FUS BBB opening has yet to be a widely established technique in basic science and preclinical research due to lack of accessibility. Therefore, we provide a detailed protocol for a benchtop approach to FUS BBB opening as a starting point for labs interested in establishing this technique.
These studies were conducted with either a high-power air backed FUS specific ultrasound transducer or a low power damped focused ultrasonic immersion transducer. The transducers were driven by an RF power amplifier designed for reactive loads and a standard benchtop function generator. Details for these items can be found in the Table of Materials.

<table border="0" cellpadding="0" cellspacing="0" style="width:1437px;" width="1437">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Bubble shaker</td>
			<td style="width:240px;">Lantheus Medical Imaging</td>
			<td style="width:197px;">VMIX</td>
			<td style="width:729px;">VIALMIX, actiation device used to activate Definity microbubbles</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Catheter plug/ Injection cap</td>
			<td>SAI infusion technologies</td>
			<td>Part Number: IC</td>
			<td style="width:729px;">Catheter plug/ Injection cap</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Evans blue dye</td>
			<td style="width:240px;">Sigma</td>
			<td style="width:197px;">E2129-10G</td>
			<td style="width:729px;">Evans blue dye</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Function generator</td>
			<td style="width:240px;">Tektronix</td>
			<td style="width:197px;">AFG3022B</td>
			<td>Dual channel, 250MS/s, 25MHz</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">FUS transducer, 1.1MHz</td>
			<td style="width:240px;">FUS Instruments</td>
			<td>TX-110</td>
			<td>1 MHz MRI-compatible spherically focused ultrasound transducer with a hydrophone</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Heating pad for Mice and Rats</td>
			<td style="width:240px;">Kent Scientific</td>
			<td style="width:197px;">PS-03</td>
			<td>Heating pad- PhysioSuite for Mice and Rats</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Infusion pump</td>
			<td style="width:240px;">KD Scientific</td>
			<td style="width:197px;">780100</td>
			<td>KDS 100 Legacy Single Syringe Infusion Pump</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Kapton tape</td>
			<td style="width:240px;">Gizmo Dorks</td>
			<td>https://www.amazon.com/dp/B01N1GGKRC/ 
			ref=cm_sw_em_r_mt_dp_U_GbR7Db56HKD91</td>
			<td>Gizmo Dorks Kapton Tape (Polyimide) for 3D Printers and Printing, 8 x 8 inches, 10 Sheets per Pack</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Low power immersion transducer, 1MHz</td>
			<td style="width:240px;">Olympus</td>
			<td>V303-SU</td>
			<td>Immersion Transducer, 1 MHz, 0.50 in. Element Diameter, Standard Case Style, Straight UHF Connector, F=0.80IN PTF</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Magnet sets</td>
			<td style="width:240px;">WINOMO</td>
			<td>https://www.amazon.com/dp/B01DJZQJBG/ 
			ref=cm_sw_em_r_mt_dp_U_JYQ7DbM32E5QC</td>
			<td>WINOMO 15mm Sew In Magnetic Bag Clasps for Sewing Scrapbooking - 10 Sets</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">RF amplifier</td>
			<td style="width:240px;">E&#38;I</td>
			<td style="width:197px;">A075</td>
			<td>75W</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Tail vein catheter</td>
			<td style="width:240px;">BD</td>
			<td>382512/ Fisher Item: NC1228513</td>
			<td>24g BD Insyte Autoguard shielded IV catheters (non-winged)</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Ultrasound contrast microbubbles</td>
			<td>Lantheus Medical Imaging</td>
			<td style="width:197px;">DE4, DE16</td>
			<td>DEFINITY (Perflutren Lipid Microsphere)</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Ultrasound gel</td>
			<td style="width:240px;">Aquasonic</td>
			<td>https://www.amazon.com/dp/B07FPQDM4F/ 
			ref=cm_sw_em_r_mt_dp_U_D6Q7Db3J9QP7P</td>
			<td>Ultrasound Gel Aquasonic 100 Transmission 1 Liter Squeeze Bottle</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Winged infusion sets, 22ga.</td>
			<td style="width:240px;">Fisher Healthcare</td>
			<td>22-258087</td>
			<td>Terumo Surflo Winged Infusion Sets</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">motor controller software</td>
			<td style="width:240px;">N/A</td>
			<td>N/A</td>
			<td style="width:729px;">custom software written in LabView for controlling the Velmex motor controller</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">runtime environment for the motor controller software</td>
			<td style="width:240px;">National Instruments</td>
			<td>LabView runtime engine version 2017 or better</td>
			<td>https://www.ni.com/en-us/support/downloads/software-products/download.labview.html</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">3 axis Linear stage actuator (XYZ positioner)</td>
			<td style="width:240px;">Velmex</td>
			<td style="width:197px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">bolts</td>
			<td style="width:240px;">Velmex</td>
			<td>MB-1</td>
			<td>BiSlide Bolt 1/4-20x3/4&#34; Socket cap screw (10 pack), Qty:3</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">motor controller</td>
			<td style="width:240px;">Velmex</td>
			<td>VXM-3</td>
			<td style="width:729px;">Control,3 axis programmable stepping motor control, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">mounting cleats</td>
			<td style="width:240px;">Velmex</td>
			<td>MC-2</td>
			<td>Cleat, 2 hole BiSlide, Qty:6</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">mounting cleats</td>
			<td style="width:240px;">Velmex</td>
			<td>MC-2</td>
			<td style="width:729px;">Cleat, 2 hole BiSlide, Qty:2</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">usb to serial converter</td>
			<td style="width:240px;">Velmex</td>
			<td>VXM-USB-RS232</td>
			<td style="width:729px;">USB to RS232 Serial Communication Cable 10ft, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">x-axis linear stage</td>
			<td style="width:240px;">Velmex</td>
			<td>MN10-0100-M02-21</td>
			<td style="width:729px;">BiSlide, travel=10 inch, 2 mm/rev, limits, NEMA 23, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">x-axis stepper motor</td>
			<td style="width:240px;">Velmex</td>
			<td>PK266-03A-P1</td>
			<td>Vexta Type 23T2, Single Shaft Stepper Motor, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">y-axis linear stage</td>
			<td style="width:240px;">Velmex</td>
			<td>MN10-0100-M02-21</td>
			<td>BiSlide, travel=10 inch, 2 mm/rev, limits, NEMA 23, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">y-axis stepper motor</td>
			<td style="width:240px;">Velmex</td>
			<td>PK266-03A-P1</td>
			<td style="width:729px;">Vexta Type 23T2, Single Shaft Stepper Motor, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">z-axis damper</td>
			<td style="width:240px;">Velmex</td>
			<td>D6CL-6.3F</td>
			<td style="width:729px;">D6CL Damper for Type 23 Double Shaft Stepper Motor, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">z-axis linear stage</td>
			<td style="width:240px;">Velmex</td>
			<td>MN10-0100-M02-21</td>
			<td style="width:729px;">BiSlide, travel=10 inch, 2 mm/rev, limits, NEMA 23, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">z-axis stepper motor</td>
			<td style="width:240px;">Velmex</td>
			<td>PK266-03B-P2</td>
			<td style="width:729px;">Vexta Type 23T2, Double Shaft Stepper Motor, Qty:1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">3D printable files</td>
			<td style="width:240px;"></td>
			<td style="width:197px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Immersion transducer mount and pointer</td>
			<td></td>
			<td style="width:197px;"></td>
			<td>https://www.tinkercad.com/things/cRgTthGXSRq</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Stereotaxic frame</td>
			<td></td>
			<td style="width:197px;"></td>
			<td>https://www.tinkercad.com/things/ilynoQcdqlH</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Stereotaxic frame holder</td>
			<td></td>
			<td style="width:197px;"></td>
			<td>https://www.tinkercad.com/things/aZNgqhBOHAX</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">9.4T small bore animal MRI</td>
			<td style="width:240px;">Bruker</td>
			<td style="width:197px;">Bruker BioSpec 94/20</td>
			<td>ParaVision version 5.1</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">AAV9-hsyn-GFP</td>
			<td style="width:240px;">Addgene</td>
			<td style="width:197px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Cream hair remover</td>
			<td style="width:240px;">Church &#38; Dwight</td>
			<td style="width:197px;"></td>
			<td>Nair cream</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">gadobutrol MRI contrast agent</td>
			<td style="width:240px;">Bayer</td>
			<td style="width:197px;"></td>
			<td>Gadavist (Gadobutrol, 1mM/mL)</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">Stereotactic frame</td>
			<td style="width:240px;">Stoelting</td>
			<td style="width:197px;">#51500</td>
			<td>not MRI compatible</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:271px;">turnkey FUS delivery device</td>
			<td style="width:240px;">FUS Instruments</td>
			<td style="width:197px;">RK-300</td>
			<td style="width:729px;">ready to use MRI compatible FUS for rodents</td>
		</tr>
	</tbody>
</table>

a benchtop approach to the location specific blood brain barrier opening using focused ultrasound in a rat model

Stereotaxic surgery is the gold standard for localized drug and gene delivery to the rodent brain. This technique has many advantages over systemic delivery including precise localization to a target brain region and reduction of off target side effects. However, stereotaxic surgery is highly invasive which limits its translational efficacy, requires long recovery times, and provides challenges when targeting multiple brain regions. Focused ultrasound (FUS) can be used in combination with circulating microbubbles to transiently open the blood brain barrier (BBB) in millimeter sized regions. This allows intracranial localization of systemically delivered agents that cannot normally cross the BBB. This technique provides a noninvasive alternative to stereotaxic surgery. However, to date this technique has yet to be widely adopted in neuroscience laboratories due to the limited access to equipment and standardized methods. The overall goal of this protocol is to provide a benchtop approach to FUS BBB opening (BBBO) that is affordable and reproducible and can therefore be easily adopted by any laboratory.

Here, we demonstrate that focused ultrasound with microbubbles can induce localized BBB opening using the parameters specified above with both the low-power immersion transducer (Figure 3) and the FUS transducer (Figure 4). First, in early experiments, the low-power immersion transducer was targeted to one brain hemisphere either anterior (Figure 3b) or medial (Figure 3a). Animals were then sacrificed 2...

Watch this Scientific Journal Video about A Benchtop Approach to the Location Specific Blood Brain Barrier Opening using Focused Ultrasound in a Rat Model at JoVE.com

A Benchtop Approach to the Location Specific Blood Brain Barrier Opening using Focused Ultrasound in a Rat Model

Focused ultrasound with microbubble agents can open the blood brain barrier focally and transiently. This technique has been used to deliver a wide range of agents across the blood brain barrier. This article provides a detailed protocol for the localized delivery to the rodent brain with or without MRI guidance.

Stereotaxic surgery is the gold standard for localized drug and gene delivery to the rodent brain. This technique has many advantages over systemic ...

Focused Ultrasound in combination with circulating micro-bubbles can be used to provide temporary millimeter size openings in the blood-brain barrier. This enables non-invasive delivery of systemically circulating agents to target brain regions. To begin, fill the catheter plug with saline and warm the rat's tail with a lamp, taking care not to overheat the animal.Insert a 24 gauge tail vein catheter that will be used to deliver micro-bubbles, Evans blue dye, gadobutrol MRI contrast if using MRI, and the experimental agent of interest. Blood will fill the sheath when the vein is hit. Slowly, remove the inner needle while pushing the sheath further into the vein.Screw the catheter plug into the end of the catheter port, as soon as the port has filled with blood. Carefully wrap lab tape around the catheter and the tail to keep it in place, starting with a small piece at the top and working in the caudal direction. Leave the very end of the catheter plug exposed.Plug the anesthesia line onto the anesthesia connector on the stereotactic frame. Then fix the animal's head into the frame by placing the mouth onto the bite bar, and by guiding the ear bars into both ear canals and tightening the set screws. Move the animal to the MRI bed.Using parameters described in the text manuscript collect coronal and axial T2 weighted images that capture the whole brain as well as the MRI fiducial for coordinate measurements. On the coronal images, find the image in which the fiducial is the largest, indicating the center of the fiducial. Record the distance from the top of the fiducial to the brain region of interest in millimeters, in both the medial-lateral direction and in the dorsal-ventral direction.On the axial images, find the image that shows the very top of the fiducial and record the X and Y coordinates for the center of the fiducial and the X and Y coordinates of the brain region of interest. Calculate the distance from the center of the fiducial to the target brain region in both the rostral-caudal and medial-lateral directions. After gathering the coordinates, collect the pre-scan images.Keeping the animal in this stereotaxic frame, quickly transport it from the MRI bed to the bench top FUS set up. Ensure that the animal remains asleep under the effect of anesthesia. Slide the frame into the frame holder and firmly snap it into place.Use clippers to shave the animal's head, then brush away excess hair and apply hair remover cream to the scalp. Let it sit for three minutes and wipe it away with water and gauze. If using MRI guidance, attach the pointer and move the pointer to the location of the MRI fiducial.Position the pointer at the very top and center of the MRI fiducial then, which is the point from which all distances in the MRI image were calculated. Remove the pointer and move the positioner to the medial-lateral coordinates and the rostral-caudal coordinates. Lick the null position button and raise the positioner up by pressing the up 50 button, to allow for the placement of the water bath and ultrasound gel.Apply ultrasound gel to the animal's scalp and place the water bath over the animal, with the polyimide tape window pressed onto the gel, making sure that there are no air bubbles in the gel. Fill the water bath with degassed water. If using the high power transducer, lower the positioner so that the magnet is just above the water.Attach the transducer to the positioner by carefully lowering the transducer into the water at an angle and connecting the magnets. Lower the positioner to the dorsal-ventral coordinate and turn on the RF power amp. Inject one milliliter per kilogram of 3%Evans blue dye by sticking a needle tip into the catheter plug and injecting.The whole animal should become blue within seconds, indicating the catheter is properly positioned in the tail vein. Allow the dye to circulate for five minutes, then activate the micro-bubbles by shaking them violently with the bubble shaker. Invert this syringe several times to get a uniform distribution of micro-bubbles, then attach and fill the winged infusion set.Position the syringe on the infusion pump and set the infusion pump to deliver 0.2 milliliters at a rate of six milliliters per hour, providing slow infusion of the micro-bubbles over the two minute FUS exposure. Insert the winged needle into the catheter plug. First run the infusion pump, wait three seconds, then start the FUS treatment by pressing the on button and on the function generator.Repeat this twice per region with five minutes in between to allow the micro-bubbles to clear. Press the on button on the function generator again to stop the FUS treatment when the infusion pump stops at two minutes. Wait for five minutes for the micro bubbles to clear, then start the infusion and the second FUS treatment.Immediately after the second FUS treatment, inject gadobutrol contrast and the agent of interest. Total delivered volume of all agents should not exceed five milliliters per kilogram. To confirm BBB opening, place the animal back onto the MRI bed at the exact same location and plug in the anesthesia line.Collect MRI post-scans with the same imaging parameters as the pre-scan images to confirm gadobutrol MRI enhancement in the region of BBB opening. This protocol was used to induce localized blood-brain barrier opening with both the low power immersion transducer and the high power focused ultrasound transducer. First, the low power immersion transducer was targeted to either the anterior or medial brain hemisphere.The animals were sacrificed with or without perfusion, and the BBB opening was visualized via Evans blue dye auto-fluorescence. In later experiments, the FUS transducer was targeted to either the hippocampus or the anterior cingulate cortex. In addition to Evans blue dye, the MRI contrast agent gadobutrol was used to verify the targeted opening of the BBB in VIVO.After the animals were sacrificed, Evans blue dye auto-fluorescence confirmed the opening location. To assess whether this technique could be used for targeted gene delivery, AAV nine expressing green fluorescent protein and gadobutrol contrast were injected immediately after blood brain barrier opening in the hippocampus. The animal was imaged to verify the opening with gadobutrol contrast.Then, gene delivery was confirmed by GFP expression. This protocol offers a bench-top approach to MRI guided Focus Ultrasound mediated blood-brain barrier opening, that can be easily adapted by other laboratories to provide a non-invasive translational alternative to stereotactic surgery.

Research

JoVE Journal

Neuroscience

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