Focused ultrasound as a potential means of facilitated exosome delivery to brodmann area 25 in the treatment of refractory depression

Emerging data has demonstrated that depression involves inflammatory processes in the brain. Exosome treatments are thought to have potential anti-inflammatory benefits. This study intended to provide clinical relief for patients with depression by increasing localized perfusion to Brodmann area 25 (BA25) in combination with intravenous exosome delivery. Here, we detail two case studies in which neuro-navigated ultrasound was used to aid exosomal delivery to the subgenual cingulate (SGC, BA25). The patients were both diagnosed with severe treatment-resistant Major Depressive Disorder (MDD) and had previously undergone transcranial magnetic stimulation (TMS) and intensive regimens of antidepressant medication with no symptom relief. Functional and structural imaging were used to navigate ultrasound application targets for the SGC. Safety and efficacy of focused ultrasound and exosomes were evaluated for both patients.