Human Studies of Transcranial Ultrasound neuromodulation: A systematic review of effectiveness and safety

Sarica, Can; Nankoo, Jean-François; Fomenko, Anton; Grippe, Talyta Cortez; Yamamoto, Kazuaki; Samuel, Nardin; Milano, Vanessa; Vetkas, Artur; Darmani, Ghazaleh; Cizmeci, Mehmet Nevzat; Lozano, Andrés M.; Chen, Robert

doi:10.1016/j.brs.2022.05.002

Cited by 41 publications

(29 citation statements)

References 70 publications

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“…For addressing this issue, future work will in-depth investigate the geometric features of the treatment targets and plug them in the optimization of coil placement and parameter estimations in transcranial brain stimulation studies. Last but not least, the MRI-informed head model should be validated and used in other advanced modality of brain stimulation, such as transcranial ultrasound stimulation (TUS) [ 53 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

Pinpointing the precise stimulation targets for brain rehabilitation in early-stage Parkinson’s disease

Zhang

et al. 2023

BMC Neurosci

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Background Transcranial magnetic stimulation (TMS) is increasingly used as a promising non-pharmacological treatment for Parkinson’s disease (PD). Scalp-to-cortex distance (SCD), as a key technical parameter of TMS, plays a critical role in determining the locations of treatment targets and corresponding dosage. Due to the discrepancies in TMS protocols, the optimal targets and head models have yet to be established in PD patients. Objective To investigate the SCDs of the most popular used targets in left dorsolateral prefrontal cortex (DLPFC) and quantify its impact on the TMS-induced electric fields (E-fields) in early-stage PD patients. Methods Structural magnetic resonance imaging scans from PD patients (n = 47) and normal controls (n = 36) were drawn from the NEUROCON and Tao Wu datasets. SCD of left DLPFC was measured by Euclidean Distance in TMS Navigation system. The intensity and focality of SCD-dependent E-fields were examined and quantified using Finite Element Method. Results Early-stage PD patients showed an increased SCDs, higher variances in the SCDs and SCD-dependent E-fields across the seven targets of left DLPFC than normal controls. The stimulation targets located on gyral crown had more focal and homogeneous E-fields. The SCD of left DLPFC had a better performance in differentiating early-stage PD patients than global cognition and other brain measures. Conclusion SCD and SCD-dependent E-fields could determine the optimal TMS treatment targets and may also be used as a novel marker to differentiate early-stage PD patients. Our findings have important implications for developing optimal TMS protocols and personalized dosimetry in real-world clinical practice.

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Section: Discussionmentioning

confidence: 99%

Pinpointing the precise stimulation targets for brain rehabilitation in early-stage Parkinson’s disease

Zhang

et al. 2023

BMC Neurosci

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“…Ultrasonic brain stimulation shows much potential in a neuroscientific, translational and purely clinical context [ 3 , 60 ]. It is now possible to precisely target cortical as well as deep brain structures without targeting problems related to changed conductivity of pathological tissue [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Over the past decade, there have been considerable advances in developing new sonication methods for non-invasive brain stimulation [ 1 , 2 , 3 ]. Although deep brain stimulation (DBS) is known as an optimistic treatment method for various clinical indications including epilepsy, essential tremor, dystonia, and Parkinson’s disease [ 4 ], it is a surgical procedure, and the risk of side-effects cannot be completely ruled out [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Safety of Clinical Ultrasound Neuromodulation

et al. 2022

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Transcranial ultrasound holds much potential as a safe, non-invasive modality for navigated neuromodulation, with low-intensity focused ultrasound (FUS) and transcranial pulse stimulation (TPS) representing the two main modalities. While neuroscientific and preclinical applications have received much interest, clinical applications are still relatively scarce. For safety considerations, the current literature is largely based on guidelines for ultrasound imaging that uses various physical parameters to describe the ultrasound pulse form and expected bioeffects. However, the safety situation for neuromodulation is inherently different. This article provides an overview of relevant ultrasound parameters with a focus on bioeffects relevant for safe clinical applications. Further, a retrospective analysis of safety data for clinical TPS applications in patients is presented.

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“…Although significant advances in the development of remyelinating drugs have been made recently, further work remains necessary to minimize side effects and alleviate safety concerns. In contrast, TUS is a safe and noninvasive form of neuromodulation, which is broadly applied in novel therapeutic methods for initial human studies [ 43 , 44 , 45 , 46 , 47 , 48 ]. Although increasingly being investigated, TUS is still in its early phases.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Neuromodulation Reduces Demyelination in a Rat Model of Multiple Sclerosis

Yang

Huang

et al. 2022

IJMS

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Microglia, astrocytes, and oligodendrocyte progenitor cells (OPCs) may serve as targets for remyelination-enhancing therapy. Low-intensity pulsed ultrasound (LIPUS) has been demonstrated to ameliorate myelin loss and inhibit neuroinflammation in animal models of brain disorders; however, the underlying mechanisms through which LIPUS stimulates remyelination and glial activation are not well-understood. This study explored the impacts of LIPUS on remyelination and resident cells following lysolecithin (LPC)-induced local demyelination in the hippocampus. Demyelination was induced by the micro-injection of 1.5 μL of 1% LPC into the rat hippocampus, and the treatment groups received daily LIPUS stimulation for 5 days. The therapeutic effects of LIPUS on LPC-induced demyelination were assessed through immunohistochemistry staining. The staining was performed to evaluate remyelination and Iba-1 staining as a microglia marker. Our data revealed that LIPUS significantly increased myelin basic protein (MBP) expression. Moreover, the IHC results showed that LIPUS significantly inhibited glial cell activation, enhanced mature oligodendrocyte density, and promoted brain-derived neurotrophic factor (BDNF) expression at the lesion site. In addition, a heterologous population of microglia with various morphologies can be found in the demyelination lesion after LIPUS treatment. These data show that LIPUS stimulation may serve as a potential treatment for accelerating remyelination through the attenuation of glial activation and the enhancement of mature oligodendrocyte density and BDNF production.

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Human Studies of Transcranial Ultrasound neuromodulation: A systematic review of effectiveness and safety

Cited by 41 publications

References 70 publications

Pinpointing the precise stimulation targets for brain rehabilitation in early-stage Parkinson’s disease

Pinpointing the precise stimulation targets for brain rehabilitation in early-stage Parkinson’s disease

Safety of Clinical Ultrasound Neuromodulation

Ultrasound Neuromodulation Reduces Demyelination in a Rat Model of Multiple Sclerosis

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