Technological considerations for delivering focused ultrasound exposures to the spinal cord

Focused ultrasound opening of the blood-brain barrier (BBB) has reached clinical investigations and seems poised to revolutionize the treatment of brain disorders. Far less attention has been paid to the spinal cord and functionally equivalent blood-spinal cord barrier (BSCB). Small and large animal studies demonstrate that ultrasound and microbubbles can be used to modulate the BSCB in a similar manner to the BBB. However, the complex bony geometry of the vertebral column poses a challenge to the non-invasive delivery of therapeutic ultrasound exposures to the spinal canal. This talk will review work developing spine-specific ultrasound pulse trains and identifying optimal apertures for maximizing sound transmission through the vertebral arch.