Convection-Enhanced Delivery and Principles of Extracellular Transport in the Brain

Stereotactic neurosurgery involves a targeted intervention based on congruence of image guidance to a reference fiducial system. This discipline has widespread applications in radiosurgery, tumor therapy, drug delivery, functional lesioning, and neuromodulation. In this article, we focused on convec...

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Bibliographic Details
Published in:World neurosurgery 2021-07, Vol.151, p.163-171
Main Authors: Faraji, Amir H., Rajendran, Sibi, Jaquins-Gerstl, Andrea S., Hayes, Hunter J., Richardson, R. Mark
Format: Article
Language:English
Subjects:
Brain transport
Convection-enhanced delivery
Drug delivery
Electro-osmosis
Electrokinetic transport
Tortuosity
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Summary:Stereotactic neurosurgery involves a targeted intervention based on congruence of image guidance to a reference fiducial system. This discipline has widespread applications in radiosurgery, tumor therapy, drug delivery, functional lesioning, and neuromodulation. In this article, we focused on convection-enhanced delivery to deliver therapeutic agents to the brain addressing areas of research and clinical development. We performed a robust literature review of all relevant articles highlighting current efforts and challenges of making this delivery technique more widely understood. We further described key biophysical properties of molecular transport in the extracellular space that may impact the efficacy and control of drug delivery using stereotactic methods. Understanding these principles is critical for further refinement of predictive models that can inform advances in stereotactic techniques for convection-enhanced delivery of therapeutic agents to the brain.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2021.05.050