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Bancel T, Béranger B, Daniel M, Didier M, Santin M, Rachmilevitch I, Shapira Y, Tanter M, Bardinet E, Fernandez Vidal S, Attali D, Galléa C, Dizeux A, Vidailhet M, Lehéricy S, Grabli D, Pyatigorskaya N, Karachi C, Hainque E, Aubry JF. Sustained reduction of essential tremor with low-power non-thermal transcranial focused ultrasound stimulations in humans. Brain Stimul 2024; 17:636-647. [PMID: 38734066 DOI: 10.1016/j.brs.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Transcranial ultrasound stimulation (TUS) is a non-invasive brain stimulation technique; when skull aberrations are compensated for, this technique allows, with millimetric accuracy, circumvention of the invasive surgical procedure associated with deep brain stimulation (DBS) and the limited spatial specificity of transcranial magnetic stimulation. OBJECTIVE /hypothesis: We hypothesize that MR-guided low-power TUS can induce a sustained decrease of tremor power in patients suffering from medically refractive essential tremor. METHODS The dominant hand only was targeted, and two anatomical sites were sonicated in this exploratory study: the ventral intermediate nucleus of the thalamus (VIM) and the dentato-rubro-thalamic tract (DRT). Patients (N = 9) were equipped with MR-compatible accelerometers attached to their hands to monitor their tremor in real-time during TUS. RESULTS VIM neurostimulations followed by a low-duty cycle (5 %) DRT stimulation induced a substantial decrease in the tremor power in four patients, with a minimum of 89.9 % reduction when compared with the baseline power a few minutes after the DRT stimulation. The only patient stimulated in the VIM only and with a low duty cycle (5 %) also experienced a sustained reduction of the tremor (up to 93.4 %). Four patients (N = 4) did not respond. The temperature at target was 37.2 ± 1.4 °C compared to 36.8 ± 1.4 °C for a 3 cm away control point. CONCLUSIONS MR-guided low power TUS can induce a substantial and sustained decrease of tremor power. Follow-up studies need to be conducted to reproduce the effect and better to understand the variability of the response amongst patients. MR thermometry during neurostimulations showed no significant thermal rise, supporting a mechanical effect.
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Affiliation(s)
- Thomas Bancel
- Physics for Medicine Paris, Inserm U1273, ESPCI Paris, CNRS UMR 8063, PSL University, Paris, France
| | - Benoît Béranger
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Maxime Daniel
- Physics for Medicine Paris, Inserm U1273, ESPCI Paris, CNRS UMR 8063, PSL University, Paris, France
| | - Mélanie Didier
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Mathieu Santin
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | | | | | - Mickael Tanter
- Physics for Medicine Paris, Inserm U1273, ESPCI Paris, CNRS UMR 8063, PSL University, Paris, France
| | - Eric Bardinet
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Sara Fernandez Vidal
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - David Attali
- Physics for Medicine Paris, Inserm U1273, ESPCI Paris, CNRS UMR 8063, PSL University, Paris, France; Université Paris Cité, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France
| | - Cécile Galléa
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Alexandre Dizeux
- Physics for Medicine Paris, Inserm U1273, ESPCI Paris, CNRS UMR 8063, PSL University, Paris, France
| | - Marie Vidailhet
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France; Department of Neurology, Hôpital de la Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - Stéphane Lehéricy
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France; Department of Neuroradiology, Hôpital de la Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - David Grabli
- Department of Neurology, Hôpital de la Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - Nadya Pyatigorskaya
- ICM-Paris Brain Institute, Centre de NeuroImagerie de Recherche-CENIR, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France; Department of Neuroradiology, Hôpital de la Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - Carine Karachi
- Department of Neurosurgery, Hôpital de la Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - Elodie Hainque
- Department of Neurology, Hôpital de la Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
| | - Jean-François Aubry
- Physics for Medicine Paris, Inserm U1273, ESPCI Paris, CNRS UMR 8063, PSL University, Paris, France.
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Meng W, Lin Z, Lu Y, Long X, Meng L, Su C, Wang Z, Niu L. Spatiotemporal Distributions of Acoustic Propagation in Skull During Ultrasound Neuromodulation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:584-595. [PMID: 38557630 DOI: 10.1109/tuffc.2024.3383027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
There is widespread interest and concern about the evidence and hypothesis that the auditory system is involved in ultrasound neuromodulation. We have addressed this problem by performing acoustic shear wave simulations in mouse skull and behavioral experiments in deaf mice. The simulation results showed that shear waves propagating along the skull did not reach sufficient acoustic pressure in the auditory cortex to modulate neurons. Behavioral experiments were subsequently performed to awaken anesthetized mice with ultrasound targeting the motor cortex or ventral tegmental area (VTA). The experimental results showed that ultrasound stimulation (US) of the target areas significantly increased arousal scores even in deaf mice, whereas the loss of ultrasound gel abolished the effect. Immunofluorescence staining also showed that ultrasound can modulate neurons in the target area, whereas neurons in the auditory cortex required the involvement of the normal auditory system for activation. In summary, the shear waves propagating along the skull cannot reach the auditory cortex and induce neuronal activation. Ultrasound neuromodulation-induced arousal behavior needs direct action on functionally relevant stimulation targets in the absence of auditory system participation.
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Karthika V, Badrinathan Sridharan, Nam JW, Kim D, Gyun Lim H. Neuromodulation by nanozymes and ultrasound during Alzheimer's disease management. J Nanobiotechnology 2024; 22:139. [PMID: 38555420 PMCID: PMC10981335 DOI: 10.1186/s12951-024-02406-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder with complex pathogenesis and effective clinical treatment strategies for this disease remain elusive. Interestingly, nanomedicines are under extensive investigation for AD management. Currently, existing redox molecules show highly bioactive property but suffer from instability and high production costs, limiting clinical application for neurological diseases. Compared with natural enzymes, artificial enzymes show high stability, long-lasting catalytic activity, and versatile enzyme-like properties. Further, the selectivity and performance of artificial enzymes can be modulated for neuroinflammation treatments through external stimuli. In this review, we focus on the latest developments of metal, metal oxide, carbon-based and polymer based nanozymes and their catalytic mechanisms. Recent developments in nanozymes for diagnosing and treating AD are emphasized, especially focusing on their potential to regulate pathogenic factors and target sites. Various applications of nanozymes with different stimuli-responsive features were discussed, particularly focusing on nanozymes for treating oxidative stress-related neurological diseases. Noninvasiveness and focused application to deep body regions makes ultrasound (US) an attractive trigger mechanism for nanomedicine. Since a complete cure for AD remains distant, this review outlines the potential of US responsive nanozymes to develop future therapeutic approaches for this chronic neurodegenerative disease and its emergence in AD management.
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Affiliation(s)
- Viswanathan Karthika
- Department of Biomedical Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Badrinathan Sridharan
- Department of Biomedical Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Ji Won Nam
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Daehun Kim
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Hae Gyun Lim
- Department of Biomedical Engineering, Pukyong National University, Busan, 48513, Republic of Korea.
- Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, 48513, Republic of Korea.
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Hahmann J, Ishaqat A, Lammers T, Herrmann A. Sonogenetics for Monitoring and Modulating Biomolecular Function by Ultrasound. Angew Chem Int Ed Engl 2024; 63:e202317112. [PMID: 38197549 DOI: 10.1002/anie.202317112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/01/2024] [Accepted: 01/08/2024] [Indexed: 01/11/2024]
Abstract
Ultrasound technology, synergistically harnessed with genetic engineering and chemistry concepts, has started to open the gateway to the remarkable realm of sonogenetics-a pioneering paradigm for remotely orchestrating cellular functions at the molecular level. This fusion not only enables precisely targeted imaging and therapeutic interventions, but also advances our comprehension of mechanobiology to unparalleled depths. Sonogenetic tools harness mechanical force within small tissue volumes while preserving the integrity of the surrounding physiological environment, reaching depths of up to tens of centimeters with high spatiotemporal precision. These capabilities circumvent the inherent physical limitations of alternative in vivo control methods such as optogenetics and magnetogenetics. In this review, we first discuss mechanosensitive ion channels, the most commonly utilized sonogenetic mediators, in both mammalian and non-mammalian systems. Subsequently, we provide a comprehensive overview of state-of-the-art sonogenetic approaches that leverage thermal or mechanical features of ultrasonic waves. Additionally, we explore strategies centered around the design of mechanochemically reactive macromolecular systems. Furthermore, we delve into the realm of ultrasound imaging of biomolecular function, encompassing the utilization of gas vesicles and acoustic reporter genes. Finally, we shed light on limitations and challenges of sonogenetics and present a perspective on the future of this promising technology.
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Affiliation(s)
- Johannes Hahmann
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 1, 52074, Aachen, Germany
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074, Aachen, Germany
- Max Planck School Matter to Life, Jahnstr. 29, 69120, Heidelberg, Germany
| | - Aman Ishaqat
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 1, 52074, Aachen, Germany
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074, Aachen, Germany
| | - Twan Lammers
- Institute for Experimental Molecular Imaging (ExMI), Center for Biohybrid Medical Systems (CBMS), RWTH Aachen University Clinic, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Andreas Herrmann
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Worringerweg 1, 52074, Aachen, Germany
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074, Aachen, Germany
- Max Planck School Matter to Life, Jahnstr. 29, 69120, Heidelberg, Germany
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Stoddart PR, Begeng JM, Tong W, Ibbotson MR, Kameneva T. Nanoparticle-based optical interfaces for retinal neuromodulation: a review. Front Cell Neurosci 2024; 18:1360870. [PMID: 38572073 PMCID: PMC10987880 DOI: 10.3389/fncel.2024.1360870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
Degeneration of photoreceptors in the retina is a leading cause of blindness, but commonly leaves the retinal ganglion cells (RGCs) and/or bipolar cells extant. Consequently, these cells are an attractive target for the invasive electrical implants colloquially known as "bionic eyes." However, after more than two decades of concerted effort, interfaces based on conventional electrical stimulation approaches have delivered limited efficacy, primarily due to the current spread in retinal tissue, which precludes high-acuity vision. The ideal prosthetic solution would be less invasive, provide single-cell resolution and an ability to differentiate between different cell types. Nanoparticle-mediated approaches can address some of these requirements, with particular attention being directed at light-sensitive nanoparticles that can be accessed via the intrinsic optics of the eye. Here we survey the available known nanoparticle-based optical transduction mechanisms that can be exploited for neuromodulation. We review the rapid progress in the field, together with outstanding challenges that must be addressed to translate these techniques to clinical practice. In particular, successful translation will likely require efficient delivery of nanoparticles to stable and precisely defined locations in the retinal tissues. Therefore, we also emphasize the current literature relating to the pharmacokinetics of nanoparticles in the eye. While considerable challenges remain to be overcome, progress to date shows great potential for nanoparticle-based interfaces to revolutionize the field of visual prostheses.
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Affiliation(s)
- Paul R. Stoddart
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - James M. Begeng
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
- Department of Biomedical Engineering, Faculty of Engineering & Information Technology, The University of Melbourne, Melbourne, VIC, Australia
| | - Wei Tong
- Department of Biomedical Engineering, Faculty of Engineering & Information Technology, The University of Melbourne, Melbourne, VIC, Australia
- School of Physics, The University of Melbourne, Melbourne, VIC, Australia
| | - Michael R. Ibbotson
- Department of Biomedical Engineering, Faculty of Engineering & Information Technology, The University of Melbourne, Melbourne, VIC, Australia
| | - Tatiana Kameneva
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
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Feng R, Sheng H, Lian Y. Advances in using ultrasound to regulate the nervous system. Neurol Sci 2024:10.1007/s10072-024-07426-7. [PMID: 38436788 DOI: 10.1007/s10072-024-07426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
Ultrasound is a mechanical vibration with a frequency greater than 20 kHz. Due to its high spatial resolution, good directionality, and convenient operation in neural regulation, it has recently received increasing attention from scientists. However, the mechanism by which ultrasound regulates the nervous system is still unclear. This article mainly explores the possible mechanisms of ultrasound's mechanical effects, cavitation effects, thermal effects, and the rise of sonogenetics. In addition, the essence of action potential and its relationship with ultrasound were also discussed. Traditional theory treats nerve impulses as pure electrical signals, similar to cable theory. However, this theory cannot explain the phenomenon of inductance and cell membrane bulging out during the propagation of action potential. Therefore, the flexoelectric effect of cell membrane and soliton model reveal that action potential may also be a mechanical wave. Finally, we also elaborated the therapeutic effect of ultrasound on nervous system disease such as epilepsy, Parkinson's disease, and Alzheimer's disease.
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Affiliation(s)
- Rui Feng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hanqing Sheng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Zadeh AK, Raghuram H, Shrestha S, Kibreab M, Kathol I, Martino D, Pike GB, Pichardo S, Monchi O. The effect of transcranial ultrasound pulse repetition frequency on sustained inhibition in the human primary motor cortex: A double-blind, sham-controlled study. Brain Stimul 2024; 17:476-484. [PMID: 38621645 DOI: 10.1016/j.brs.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Non-invasive brain stimulation techniques such as transcranial magnetic stimulation and transcranial direct current stimulation hold promise for inducing brain plasticity. However, their limited precision may hamper certain applications. In contrast, Transcranial Ultrasound Stimulation (TUS), known for its precision and deep brain targeting capabilities, requires further investigation to establish its efficacy in producing enduring effects for treating neurological and psychiatric disorders. OBJECTIVE To investigate the enduring effects of different pulse repetition frequencies (PRF) of TUS on motor corticospinal excitability. METHODS T1-, T2-weighted, and zero echo time magnetic resonance imaging scans were acquired from 21 neurologically healthy participants for neuronavigation, skull reconstruction, and the performance of transcranial ultrasound and thermal modelling. The effects of three different TUS PRFs (10, 100, and 1000 Hz) with a constant duty cycle of 10 % on corticospinal excitability in the primary motor cortex were assessed using TMS-induced motor evoked potentials (MEPs). Each PRF and sham condition was evaluated on separate days, with measurements taken 5-, 30-, and 60-min post-TUS. RESULTS A significant decrease in MEP amplitude was observed with a PRF of 10 Hz (p = 0.007), which persisted for at least 30 min, and with a PRF of 100 Hz (p = 0.001), lasting over 60 min. However, no significant changes were found for the PRF of 1000 Hz and the sham conditions. CONCLUSION This study highlights the significance of PRF selection in TUS and underscores its potential as a non-invasive approach to reduce corticospinal excitability, offering valuable insights for future clinical applications.
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Affiliation(s)
- Ali K Zadeh
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | | | - Shirshak Shrestha
- Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
| | - Mekale Kibreab
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Iris Kathol
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - G Bruce Pike
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Samuel Pichardo
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Oury Monchi
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Department of Radiology, Radio-oncology and Nuclear Medicine, Université de Montreal, QC, Canada; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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Bendau EV, McCune EP, Blackman SG, Kamimura HAS, Aurup C, Konofagou EE. Modulation of cardio-respiratory activity in mice via transcranial focused ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:332-340. [PMID: 38105118 PMCID: PMC10903588 DOI: 10.1016/j.ultrasmedbio.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/16/2023] [Accepted: 11/04/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the effect of FUS on autonomic nervous system activity, including heart and respiratory rates, and to separate the thermal modulation from combined thermal and mechanical FUS effects. METHODS The thalamus and hypothalamus of wild-type mice were sonicated with a continuous-wave, 2 MHz FUS transducer at pressures of 425 and 850 kPa for 60 seconds. Cardiac and respiratory rates were monitored as signs of autonomic nervous activity. FUS-induced changes in autonomic activity were compared to FUS targeted to a spatially-distant motor region and to laser-induced heating. RESULTS FUS delivered to the primary target over the thalamus and hypothalamus at 850 kPa reversibly increased the respiratory rate by 6.5±3.2 breaths per minute and decreased the heart rate by 3.2±1.8 beats per minute. No significant changes occurred in this region at 425 kPa or when targeting the motor regions at 850 kPa. Laser heating with the same temperature rise profile produced by 850 kPa sonication resulted in cardiorespiratory modulation similar to that of FUS. CONCLUSIONS FUS is capable of reversibly and non-invasively modulating cardiorespiratory activity in mice. Localized changes in temperature may constitute the main cause for this activity, though further investigation is warranted into the distinct and complementary mechanisms of mechanically- and thermally-induced FUS neuromodulation. Close monitoring of vital signs during FUS neuromodulation may be warranted to monitor systemic responses to stimulation.
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Affiliation(s)
- Ethan V Bendau
- Department of Biomedical Engineering, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States
| | - Erica P McCune
- Department of Biomedical Engineering, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States
| | - Samuel G Blackman
- Department of Biomedical Engineering, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States
| | - Hermes A S Kamimura
- Department of Biomedical Engineering, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States
| | - Christian Aurup
- Department of Biomedical Engineering, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States; Department of Radiology, Columbia University, 630 West 168th Street, P&S 19-419, New York, NY, 10032, United States.
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Chen X, You J, Ma H, Zhou M, Huang C. Transcranial pulse stimulation in Alzheimer's disease. CNS Neurosci Ther 2024; 30:e14372. [PMID: 37469252 PMCID: PMC10848065 DOI: 10.1111/cns.14372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Transcranial pulse stimulation (TPS) is a novel noninvasive ultrasonic brain stimulation that can increase cortical and corticospinal excitability, induce neuroplasticity, and increase functional connectivity within the brain. Several trials have confirmed its potential in treating Alzheimer's disease (AD). OBJECTIVE To investigate the effect and safety of TPS on AD. DESIGN A systematic review. METHODS PubMed, Embase via Ovid, Web of Science, Cochrane Library, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), and WanFang were searched from inception to April 1, 2023. Study selection, data extraction, and quality evaluation of the studies were conducted by two reviewers independently, with any controversy resolved by consensus. The Methodological Index for Nonrandomized Studies was used to assess the risk of bias. RESULTS Five studies were included in this review, with a total of 99 patients with AD. For cognitive performance, TPS significantly improved the scores of the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) test battery, Alzheimer's Disease Assessment Scale (cognitive), Montreal Cognitive Assessment, and Mini-Mental Status Examination. For depressive symptoms, TPS significantly reduced the scores of the Alzheimer's Disease Assessment Scale (affective), Geriatric Depression Score, and Beck Depression Inventory. By functional magnetic resonance imaging, studies have shown that TPS improved cognitive performance in AD patients by increasing functional connectivity in the hippocampus, parahippocampal cortex, precuneus, and parietal cortex, and activating cortical activity in the bilateral hippocampus. TPS alleviated depressive symptoms in AD patients by decreasing functional connectivity between the ventromedial network (left frontal orbital cortex) and the salience network (right anterior insula). Adverse events in this review, including headache, worsening mood, jaw pain, nausea, and drowsiness, were reversible and lasted no longer than 1 day. No serious adverse events or complications were observed. CONCLUSIONS TPS is promising in improving cognitive performance and reducing depressive symptoms in patients with AD. TPS may be a safe adjunct therapy in the treatment of AD. However, these findings lacked a sham control and were limited by the small sample size of the included studies. Further research may be needed to better explore the potential of TPS. PATIENT AND PUBLIC INVOLVEMENT Patients and the public were not involved in this study.
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Affiliation(s)
- Xinxin Chen
- Department of Rehabilitation MedicineWest China HospitalSichuan UniversityChengduSichuanChina
- Key Laboratory of Rehabilitation Medicine in Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuanChina
- School of Rehabilitation SciencesWest China School of MedicineSichuan UniversityChengduSichuanChina
| | - Jiuhong You
- Department of Rehabilitation MedicineWest China HospitalSichuan UniversityChengduSichuanChina
- Key Laboratory of Rehabilitation Medicine in Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuanChina
- School of Rehabilitation SciencesWest China School of MedicineSichuan UniversityChengduSichuanChina
| | - Hui Ma
- Department of Rehabilitation MedicineWest China HospitalSichuan UniversityChengduSichuanChina
- Key Laboratory of Rehabilitation Medicine in Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuanChina
- School of Rehabilitation SciencesWest China School of MedicineSichuan UniversityChengduSichuanChina
| | - Mei Zhou
- Department of Rehabilitation MedicineWest China HospitalSichuan UniversityChengduSichuanChina
- Key Laboratory of Rehabilitation Medicine in Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuanChina
- School of Rehabilitation SciencesWest China School of MedicineSichuan UniversityChengduSichuanChina
| | - Cheng Huang
- Department of Rehabilitation MedicineWest China HospitalSichuan UniversityChengduSichuanChina
- Key Laboratory of Rehabilitation Medicine in Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuanChina
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Qin PP, Jin M, Xia AW, Li AS, Lin TT, Liu Y, Kan RL, Zhang BB, Kranz GS. The effectiveness and safety of low-intensity transcranial ultrasound stimulation: A systematic review of human and animal studies. Neurosci Biobehav Rev 2024; 156:105501. [PMID: 38061596 DOI: 10.1016/j.neubiorev.2023.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/07/2023] [Accepted: 12/02/2023] [Indexed: 12/26/2023]
Abstract
Low-intensity transcranial ultrasound stimulation (LITUS) is a novel non-invasive neuromodulation technique. We conducted a systematic review to evaluate current evidence on the efficacy and safety of LITUS neuromodulation. Five databases were searched from inception to May 31, 2023. Randomized controlled human trials and controlled animal studies were included. The neuromodulation effects of LITUS on clinical or pre-clinical, neurophysiological, neuroimaging, histological and biochemical outcomes, and adverse events were summarized. In total, 11 human studies and 44 animal studies were identified. LITUS demonstrated therapeutic efficacy in neurological disorders, psychiatric disorders, pain, sleep disorders and hypertension. LITUS-related changes in neuronal structure and cortical activity were found. From histological and biochemical perspectives, prominent findings included suppressing the inflammatory response and facilitating neurogenesis. No adverse effects were reported in controlled animal studies included in our review, while reversible headache, nausea, and vomiting were reported in a few human subjects. Overall, LITUS alleviates various symptoms and modulates associated brain circuits without major side effects. Future research needs to establish a solid therapeutic framework for LITUS.
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Affiliation(s)
- Penny Ping Qin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Minxia Jin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China; Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Adam Weili Xia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Ami Sinman Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Tim Tianze Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Yuchen Liu
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rebecca Laidi Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Bella Bingbing Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China; Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hong Kong, SAR, China; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
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11
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Li F, Gallego J, Tirko NN, Greaser J, Bashe D, Patel R, Shaker E, Van Valkenburg GE, Alsubhi AS, Wellman S, Singh V, Padill CG, Gheres KW, Bagwell R, Mulvihill M, Kozai TDY. Low-intensity pulsed ultrasound stimulation (LIPUS) modulates microglial activation following intracortical microelectrode implantation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.05.570162. [PMID: 38105969 PMCID: PMC10723293 DOI: 10.1101/2023.12.05.570162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Microglia are important players in surveillance and repair of the brain. Their activation mediates neuroinflammation caused by intracortical microelectrode implantation, which impedes the application of intracortical brain-computer interfaces (BCIs). While low-intensity pulsed ultrasound stimulation (LIPUS) can attenuate microglial activation, its potential to modulate the microglia-mediated neuroinflammation and enhance the bio-integration of microelectrodes remains insufficiently explored. We found that LIPUS increased microglia migration speed from 0.59±0.04 to 1.35±0.07 µm/hr on day 1 and enhanced microglia expansion area from 44.50±6.86 to 93.15±8.77 µm 2 /min on day 7, indicating improved tissue healing and surveillance. Furthermore, LIPUS reduced microglial activation by 17% on day 6, vessel-associated microglia ratio from 70.67±6.15 to 40.43±3.87% on day 7, and vessel diameter by 20% on day 28. Additionally, microglial coverage of the microelectrode was reduced by 50% in week 1, indicating better tissue-microelectrode integration. These data reveal that LIPUS helps resolve neuroinflammation around chronic intracortical microelectrodes.
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12
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He J, Zhu Y, Wu C, Wu J, Chen Y, Yuan M, Cheng Z, Zeng L, Ji X. Transcranial ultrasound neuromodulation facilitates isoflurane-induced general anesthesia recovery and improves cognition in mice. ULTRASONICS 2023; 135:107132. [PMID: 37604030 DOI: 10.1016/j.ultras.2023.107132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/13/2023] [Accepted: 08/05/2023] [Indexed: 08/23/2023]
Abstract
Delayed arousal and cognitive dysfunction are common, especially in older patients after general anesthesia (GA). Elevating central nervous system serotonin (5-HT) levels can promote recovery from GA and increase synaptic plasticity to improve cognition. Ultrasound neuromodulation has become a noninvasive physical intervention therapy with high spatial resolution and penetration depth, which can modulate neuronal excitability to treat psychiatric and neurodegenerative diseases. This study aims to use ultrasound to noninvasively modulate the brain 5-HT levels of mice to promote recovery from GA and improve cognition in mice. The dorsal raphe nucleus (DRN) of mice during GA was stimulated by the 1.1 MHz ultrasound with a negative pressure of 356 kPa, and the liquid chromatography coupled tandem mass spectrometry (LC-MS/MS) method was used to measure the DRN 5-HT concentrations. The mice's recovery time from GA was assessed, and the cognition was evaluated through spontaneous alternation Y-maze and novel object recognition (NOR) tests. After ultrasound stimulation, the mice's DRN 5-HT levels were significantly increased (control: 554.0 ± 103.2 ng/g, anesthesia + US: 664.2 ± 84.1 ng/g, *p = 0.0389); the GA recovery time (return of the righting reflex (RORR) emergence latency time) of mice was significantly reduced (anesthesia: 331.6 ± 70 s, anesthesia + US: 223.2 ± 67.7 s, *p = 0.0215); the spontaneous rotation behavior score of mice was significantly increased (anesthesia: 59.46 ± 5.26 %, anesthesia + US: 68.55 ± 5.24 %; *p = 0.0126); the recognition index was significantly increased (anesthesia: 55.02 ± 6.23 %, anesthesia + US: 78.52 ± 12.21 %; ***p = 0.0009). This study indicates that ultrasound stimulation of DRN increases serotonin levels, accelerates recovery from anesthesia, and improves cognition, which could be an important strategy for treating delayed arousal, postoperative delirium, or even lasting cognitive dysfunction after GA.
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Affiliation(s)
- Jiaru He
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Yiyue Zhu
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Canwen Wu
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Junwei Wu
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Yan Chen
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Maodan Yuan
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Zhongwen Cheng
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Lvming Zeng
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China
| | - Xuanrong Ji
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, China.
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13
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Choi MH, Li N, Popelka G, Butts Pauly K. Development and validation of a computational method to predict unintended auditory brainstem response during transcranial ultrasound neuromodulation in mice. Brain Stimul 2023; 16:1362-1370. [PMID: 37690602 DOI: 10.1016/j.brs.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/03/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Transcranial ultrasound stimulation (TUS) is a promising noninvasive neuromodulation modality. The inadvertent and unpredictable activation of the auditory system in response to TUS obfuscates the interpretation of non-auditory neuromodulatory responses. OBJECTIVE The objective was to develop and validate a computational metric to quantify the susceptibility to unintended auditory brainstem response (ABR) in mice premised on time frequency analyses of TUS signals and auditory sensitivity. METHODS Ultrasound pulses with varying amplitudes, pulse repetition frequencies (PRFs), envelope smoothing profiles, and sinusoidal modulation frequencies were selected. Each pulse's time-varying frequency spectrum was differentiated across time, weighted by the mouse hearing sensitivity, then summed across frequencies. The resulting time-varying function, computationally predicting the ABR, was validated against experimental ABR in mice during TUS with the corresponding pulse. RESULTS There was a significant correlation between experimental ABRs and the computational predictions for 19 TUS signals (R2 = 0.97). CONCLUSIONS To reduce ABR in mice during in vivo TUS studies, 1) reduce the amplitude of a rectangular continuous wave envelope, 2) increase the rise/fall times of a smoothed continuous wave envelope, and/or 3) change the PRF and/or duty cycle of a rectangular or sinusoidal pulsed wave to reduce the gap between pulses and increase the rise/fall time of the overall envelope. This metric can aid researchers performing in vivo mouse studies in selecting TUS signal parameters that minimize unintended ABR. The methods for developing this metric can be adapted to other animal models.
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Affiliation(s)
- Mi Hyun Choi
- Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA.
| | - Ningrui Li
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Gerald Popelka
- Department of Otolaryngology, Stanford School of Medicine, Stanford, CA, 94305, USA; Department of Radiology, Stanford School of Medicine, Stanford, CA, 94305, USA
| | - Kim Butts Pauly
- Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA; Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA; Department of Radiology, Stanford School of Medicine, Stanford, CA, 94305, USA.
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Karatum O, Han M, Erdogan ET, Karamursel S, Nizamoglu S. Physical mechanisms of emerging neuromodulation modalities. J Neural Eng 2023; 20:031001. [PMID: 37224804 DOI: 10.1088/1741-2552/acd870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/24/2023] [Indexed: 05/26/2023]
Abstract
One of the ultimate goals of neurostimulation field is to design materials, devices and systems that can simultaneously achieve safe, effective and tether-free operation. For that, understanding the working mechanisms and potential applicability of neurostimulation techniques is important to develop noninvasive, enhanced, and multi-modal control of neural activity. Here, we review direct and transduction-based neurostimulation techniques by discussing their interaction mechanisms with neurons via electrical, mechanical, and thermal means. We show how each technique targets modulation of specific ion channels (e.g. voltage-gated, mechanosensitive, heat-sensitive) by exploiting fundamental wave properties (e.g. interference) or engineering nanomaterial-based systems for efficient energy transduction. Overall, our review provides a detailed mechanistic understanding of neurostimulation techniques together with their applications toin vitro, in vivo, and translational studies to guide the researchers toward developing more advanced systems in terms of noninvasiveness, spatiotemporal resolution, and clinical applicability.
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Affiliation(s)
- Onuralp Karatum
- Department of Electrical and Electronics Engineering, Koc University, Istanbul 34450, Turkey
| | - Mertcan Han
- Department of Electrical and Electronics Engineering, Koc University, Istanbul 34450, Turkey
| | - Ezgi Tuna Erdogan
- Department of Physiology, Koc University School of Medicine, Istanbul 34450, Turkey
| | - Sacit Karamursel
- Department of Physiology, Koc University School of Medicine, Istanbul 34450, Turkey
| | - Sedat Nizamoglu
- Department of Electrical and Electronics Engineering, Koc University, Istanbul 34450, Turkey
- Department of Biomedical Science and Engineering, Koc University, Istanbul 34450, Turkey
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15
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Yüksel MM, Sun S, Latchoumane C, Bloch J, Courtine G, Raffin EE, Hummel FC. Low-Intensity Focused Ultrasound Neuromodulation for Stroke Recovery: A Novel Deep Brain Stimulation Approach for Neurorehabilitation? IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 4:300-318. [PMID: 38196977 PMCID: PMC10776095 DOI: 10.1109/ojemb.2023.3263690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 01/11/2024] Open
Abstract
Stroke as the leading cause of adult long-term disability and has a significant impact on patients, society and socio-economics. Non-invasive brain stimulation (NIBS) approaches such as transcranial magnetic stimulation (TMS) or transcranial electrical stimulation (tES) are considered as potential therapeutic options to enhance functional reorganization and augment the effects of neurorehabilitation. However, non-invasive electrical and magnetic stimulation paradigms are limited by their depth focality trade-off function that does not allow to target deep key brain structures critically important for recovery processes. Transcranial ultrasound stimulation (TUS) is an emerging approach for non-invasive deep brain neuromodulation. Using non-ionizing, ultrasonic waves with millimeter-accuracy spatial resolution, excellent steering capacity and long penetration depth, TUS has the potential to serve as a novel non-invasive deep brain stimulation method to establish unprecedented neuromodulation and novel neurorehabilitation protocols. The purpose of the present review is to provide an overview on the current knowledge about the neuromodulatory effects of TUS while discussing the potential of TUS in the field of stroke recovery, with respect to existing NIBS methods. We will address and discuss critically crucial open questions and remaining challenges that need to be addressed before establishing TUS as a new clinical neurorehabilitation approach for motor stroke recovery.
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Affiliation(s)
- Mahmut Martin Yüksel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute and Brain Mind InstituteÉcole Polytechnique Fédérale de LausanneGeneva1201Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute and Brain Mind InstituteÉcole Polytechnique Fédérale de Lausanne Valais, Clinique Romande de Réadaptation Sion1951Switzerland
| | - Shiqi Sun
- Neuro-X Institute and Brain Mind Institute, School of Life SciencesSwiss Federal Institute of Technology (EPFL)Lausanne1015Switzerland
- Department of Clinical NeuroscienceLausanne University Hospital (CHUV) and the University of Lausanne (UNIL)Lausanne1011Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore)EPFL/CHUV/UNILLausanne1011Switzerland
| | - Charles Latchoumane
- Neuro-X Institute and Brain Mind Institute, School of Life SciencesSwiss Federal Institute of Technology (EPFL)Lausanne1015Switzerland
- Department of Clinical NeuroscienceLausanne University Hospital (CHUV) and the University of Lausanne (UNIL)Lausanne1011Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore)EPFL/CHUV/UNILLausanne1011Switzerland
| | - Jocelyne Bloch
- Neuro-X Institute and Brain Mind Institute, School of Life SciencesSwiss Federal Institute of Technology (EPFL)Lausanne1015Switzerland
- Department of Clinical NeuroscienceLausanne University Hospital (CHUV) and the University of Lausanne (UNIL)Lausanne1015Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore)EPFL/CHUV/UNILLausanne1015Switzerland
- Department of NeurosurgeryLausanne University HospitalLausanne1011Switzerland
| | - Gregoire Courtine
- Department of Clinical NeuroscienceLausanne University Hospital (CHUV) and the University of Lausanne (UNIL)Lausanne1015Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore)EPFL/CHUV/UNILLausanne1015Switzerland
- Department of NeurosurgeryLausanne University HospitalLausanne1011Switzerland
| | - Estelle Emeline Raffin
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute and Brain Mind InstituteÉcole Polytechnique Fédérale de LausanneGeneva1201Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute and Brain Mind InstituteÉcole Polytechnique Fédérale de Lausanne Valais, Clinique Romande de Réadaptation Sion1951Switzerland
| | - Friedhelm Christoph Hummel
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute and Brain Mind InstituteÉcole Polytechnique Fédérale de LausanneGeneva1202Switzerland
- Defitech Chair of Clinical Neuroengineering, Neuro-X Institute and Brain Mind InstituteÉcole Polytechnique Fédérale de Lausanne Valais, Clinique Romande de Réadaptation Sion1951Switzerland
- Clinical NeuroscienceUniversity of Geneva Medical SchoolGeneva1211Switzerland
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16
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Long T, Xie L, Pulati M, Wen Q, Guo X, Zhang D. C. elegans: Sensing the low-frequency profile of amplitude-modulated ultrasound. ULTRASONICS 2023; 128:106887. [PMID: 36395535 DOI: 10.1016/j.ultras.2022.106887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Several research groups have demonstrated that C. elegans can respond to pulsed ultrasound stimuli, and elucidating the underlying mechanisms is necessary to develop ultrasound neuromodulation. Here, amplitude-modulated (AM) ultrasound is applied to C. elegans, and its behavioral responses are investigated in detail. By loading surface acoustic waves (SAWs) onto free-moving worms on an agar surface, a carrier wave with a frequency of 8.80 MHz is selected. The signal is modulated by a rectangular or sinusoidal profile. It is demonstrated that sinusoidal modulation can produce similar responses in worms to rectangular modulation, with the strongest responses occurring at modulation frequencies of around 1.00 kHz. Meanwhile, the behavioral response is relatively weak when the ultrasonic signal is unmodulated, that is, when only the carrier wave is applied. At modulation frequencies other than 100.00 Hz to 10.00 kHz, the worms respond weakly, but when a second modulation frequency of 1.00 kHz is introduced, an improvement in response can be observed. These results suggest that C. elegans may sense the low-frequency envelope and respond to amplitude-modulated ultrasonic stimuli like an amplitude demodulator. MEC-4, an ion channel for touch sensing, is involved in the behavioral response of C. elegans to ultrasound in the present setup.
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Affiliation(s)
- Tianyang Long
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, China
| | - Linzhou Xie
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, China
| | - Mayibaier Pulati
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, University of Science and Technology of China, 230027 Hefei, China
| | - Quan Wen
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, University of Science and Technology of China, 230027 Hefei, China
| | - Xiasheng Guo
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, China.
| | - Dong Zhang
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, China.
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17
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Sahoo A, He H, Darrow D, Chen CC, Ebbini ES. Image-Guided Measurement of Radiation Force Induced by Focused Ultrasound Beams. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:138-146. [PMID: 36350863 PMCID: PMC10079628 DOI: 10.1109/tuffc.2022.3221049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The radiation force balance (RFB) is a widely used method for measuring acoustic power output of ultrasonic transducers. The reflecting cone target is attractive due to its simplicity and long-term stability, at a reasonable cost. However, accurate measurements using this method depend on the alignment between the ultrasound beam and cone axes, especially for highly focused beams utilized in therapeutic applications. With the advent of dual-mode ultrasound arrays (DMUAs) for imaging and therapy, image-guided measurements of acoustic output using the RFB method can be used to improve measurement accuracy. In this article, we describe an image-guided RFB measurement of focused DMUA beams using a widely used commercial instrument. DMUA imaging is used to optimize the alignment between the acoustic beam and reflecting cone axes. In addition to image-guided alignment, DMUA echo data is used to track the displacement of the cone, which provides an auxiliary measurement of acoustic power. Experimental results using a DMUA prototype with [Formula: see text] shows that 1-2 mm of misalignment can result in 5%-14% error in the measured acoustic power. In addition to the use of B-mode image guidance for improving measurement accuracy, we present preliminary results demonstrating the benefit of displacement tracking using real-time DMUA imaging during the application of (sub)therapeutic focused beams. Displacement tracking provides a direct measurement of the radiation force with high sensitivity and follows the expected dependence on changes in amplitude and duty cycle (DC) of the focused ultrasound (FUS) beam. This could lead to simpler, more reliable methods for measuring acoustic power based on the radiation force principle. Combined with appropriate computational modeling, the direct measurement of acoustic radiation force could lead to reliable dosimetry in situ in emerging applications such as transcranial FUS (tFUS) therapies.
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18
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He J, Zhu Y, Wu C, Wu J, Chen Y, Yuan M, Cheng Z, Zeng L, Ji X. Simultaneous multi-target ultrasound neuromodulation in freely-moving mice based on a single-element ultrasound transducer. J Neural Eng 2023; 20. [PMID: 36608340 DOI: 10.1088/1741-2552/acb104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/06/2023] [Indexed: 01/07/2023]
Abstract
Objective.Ultrasound neuromodulation has become an emerging method for the therapy of neurodegenerative and psychiatric diseases. The phased array ultrasonic transducer enables multi-target ultrasound neuromodulation in small animals, but the relatively large size and mass and the thick cables of the array limit the free movement of small animals. Furthermore, spatial interference may occur during multi-target ultrasound brain stimulation with multiple micro transducers.Approach.In this study, we developed a miniature power ultrasound transducer and used the virtual source time inversion method and 3D printing technology to design, optimize, and manufacture the acoustic holographic lens to construct a multi-target ultrasound neuromodulation system for free-moving mice. The feasibility of the system was verified byin vitrotranscranial ultrasound field measurements,in vivodual-target blood-brain barrier (BBB) opening experiments, andin vivodual-target ultrasound neuromodulation experiments.Main results.The developed miniature transducer had a diameter of 4.0 mm, a center frequency of 1.1 MHz, and a weight of 1.25 g. The developed miniature acoustic holographic lens had a weight of 0.019 g to generate dual-focus transcranial ultrasound. The ultrasonic field measurements' results showed that the bifocal's horizontal distance was 3.0 mm, the -6 dB focal spot width in thex-direction was 2.5 and 2.25 mm, and 2.12 and 2.24 mm in they-direction. Finally, thein vivoexperimental results showed that the system could achieve dual-target BBB opening and ultrasound neuromodulation in freely-moving mice.Significance.The ultrasonic neuromodulation system based on a miniature single-element transducer and the miniature acoustic holographic lens could achieve dual-target neuromodulation in awake small animals, which is expected to be applied to the research of non-invasive dual-target ultrasonic treatment of brain diseases in awake small animals.
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Affiliation(s)
- Jiaru He
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Yiyue Zhu
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Canwen Wu
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Junwei Wu
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Yan Chen
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Maodan Yuan
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Zhongwen Cheng
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Lvming Zeng
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
| | - Xuanrong Ji
- State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment, Guangdong University of Technology, Guangzhou 510006, People's Republic of China
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19
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Chen M, Peng C, Wu H, Huang CC, Kim T, Traylor Z, Muller M, Chhatbar PY, Nam CS, Feng W, Jiang X. Numerical and experimental evaluation of low-intensity transcranial focused ultrasound wave propagation using human skulls for brain neuromodulation. Med Phys 2023; 50:38-49. [PMID: 36342303 PMCID: PMC10099743 DOI: 10.1002/mp.16090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Low-intensity transcranial focused ultrasound (tFUS) has gained considerable attention as a promising noninvasive neuromodulatory technique for human brains. However, the complex morphology of the skull hinders scholars from precisely predicting the acoustic energy transmitted and the region of the brain impacted during the sonication. This is due to the fact that different ultrasound frequencies and skull morphology variations greatly affect wave propagation through the skull. PURPOSE Although the acoustic properties of human skull have been studied for tFUS applications, such as tumor ablation using a multielement phased array, there is no consensus about how to choose a single-element focused ultrasound (FUS) transducer with a suitable frequency for neuromodulation. There are interests in exploring the magnitude and dimension of tFUS beam through human parietal bone for modulating specific brain lobes. Herein, we aim to investigate the wave propagation of tFUS on human skulls to understand and address the concerns above. METHODS Both experimental measurements and numerical modeling were conducted to investigate the transmission efficiency and beam pattern of tFUS on five human skulls (C3 and C4 regions) using single-element FUS transducers with six different frequencies (150-1500 kHz). The degassed skull was placed in a water tank, and a calibrated hydrophone was utilized to measure acoustic pressure past it. The cranial computed tomography scan data of each skull were obtained to derive a high-resolution acoustic model (grid point spacing: 0.25 mm) in simulations. Meanwhile, we modified the power-law exponent of acoustic attenuation coefficient to validate numerical modeling and enabled it to be served as a prediction tool, based on the experimental measurements. RESULTS The transmission efficiency and -6 dB beamwidth were evaluated and compared for various frequencies. An exponential decrease in transmission efficiency and a logarithmic decrease of -6 dB beamwidth with an increase in ultrasound frequency were observed. It is found that a >750 kHz ultrasound leads to a relatively lower tFUS transmission efficiency (<5%), whereas a <350 kHz ultrasound contributes to a relatively broader beamwidth (>5 mm). Based on these observations, we further analyzed the dependence of tFUS wave propagation on FUS transducer aperture size. CONCLUSIONS We successfully studied tFUS wave propagation through human skulls at different frequencies experimentally and numerically. The findings have important implications to predict tFUS wave propagation for ultrasound neuromodulation in clinical applications, and guide researchers to develop advanced ultrasound transducers as neural interfaces.
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Affiliation(s)
- Mengyue Chen
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Chang Peng
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA.,School of Biomedical Engineering, ShanghaiTech University, Shanghai, China
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Chih-Chung Huang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA.,Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Taewon Kim
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Zachary Traylor
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Marie Muller
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Pratik Y Chhatbar
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Chang S Nam
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Wuwei Feng
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
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20
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Zhong YX, Liao JC, Liu X, Tian H, Deng LR, Long L. Low intensity focused ultrasound: a new prospect for the treatment of Parkinson's disease. Ann Med 2023; 55:2251145. [PMID: 37634059 PMCID: PMC10461511 DOI: 10.1080/07853890.2023.2251145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/17/2023] [Accepted: 08/20/2023] [Indexed: 08/28/2023] Open
Abstract
Background: As a chronic and progressive neurodegenerative disease, Parkinson's disease (PD) still lacks effective and safe targeted drug therapy. Low-intensity focused ultrasound (LIFU), a new method to stimulate the brain and open the blood-brain barrier (BBB), has been widely concerned by PD researchers due to its non-invasive characteristics.Methods: PubMed was searched for the past 10 years using the terms 'focused ultrasound', 'transcranial ultrasound', 'pulse ultrasound', and 'Parkinson's disease'. Relevant citations were selected from the authors' references. After excluding articles describing high-intensity focused ultrasound or non-Parkinson's disease applications, we found more than 100 full-text analyses for pooled analysis.Results: Current preclinical studies have shown that LIFU could improve PD motor symptoms by regulating microglia activation, increasing neurotrophic factors, reducing oxidative stress, and promoting nerve repair and regeneration, while LIFU combined with microbubbles (MBs) can promote drugs to cross the BBB, which may become a new direction of PD treatment. Therefore, finding an efficient drug carrier system is the top priority of applying LIFU with MBs to deliver drugs.Conclusions: This article aims to review neuro-modulatory effect of LIFU and the possible biophysical mechanism in the treatment of PD, summarize the latest progress in delivering vehicles with MBs, and discuss its advantages and limitations.
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Affiliation(s)
- Yun-Xiao Zhong
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jin-Chi Liao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xv Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hao Tian
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li-Ren Deng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ling Long
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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21
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Hu YY, Yang G, Liang XS, Ding XS, Xu DE, Li Z, Ma QH, Chen R, Sun YY. Transcranial low-intensity ultrasound stimulation for treating central nervous system disorders: A promising therapeutic application. Front Neurol 2023; 14:1117188. [PMID: 36970512 PMCID: PMC10030814 DOI: 10.3389/fneur.2023.1117188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/10/2023] [Indexed: 03/29/2023] Open
Abstract
Transcranial ultrasound stimulation is a neurostimulation technique that has gradually attracted the attention of researchers, especially as a potential therapy for neurological disorders, because of its high spatial resolution, its good penetration depth, and its non-invasiveness. Ultrasound can be categorized as high-intensity and low-intensity based on the intensity of its acoustic wave. High-intensity ultrasound can be used for thermal ablation by taking advantage of its high-energy characteristics. Low-intensity ultrasound, which produces low energy, can be used as a means to regulate the nervous system. The present review describes the current status of research on low-intensity transcranial ultrasound stimulation (LITUS) in the treatment of neurological disorders, such as epilepsy, essential tremor, depression, Parkinson's disease (PD), and Alzheimer's disease (AD). This review summarizes preclinical and clinical studies using LITUS to treat the aforementioned neurological disorders and discusses their underlying mechanisms.
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Affiliation(s)
- Yun-Yun Hu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
| | - Gang Yang
- Lab Center, Medical College of Soochow University, Suzhou, China
| | - Xue-Song Liang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
- Second Clinical College, Dalian Medical University, Dalian, Liaoning, China
| | - Xuan-Si Ding
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
| | - De-En Xu
- Wuxi No. 2 People's Hospital, Wuxi, Jiangsu, China
| | - Zhe Li
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Sleep Medicine Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Quan-Hong Ma
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
- Quan-Hong Ma
| | - Rui Chen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Rui Chen
| | - Yan-Yun Sun
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
- Yan-Yun Sun
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22
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Zhang Y, Yang D, Nie J, Dai J, Wu H, Zheng JC, Zhang F, Fang Y. Transcranial Nongenetic Neuromodulation via Bioinspired Vesicle-Enabled Precise NIR-II Optical Stimulation. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2208601. [PMID: 36305036 DOI: 10.1002/adma.202208601] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Regulating the activity of specific neurons is essentially important in neurocircuit dissection and neuropathy therapy. As a recently developed strategy, nanomaterial-enabled nongenetic neuromodulations that realize remote physical stimuli have made vast progress and shown great clinical potential. However, minimal invasiveness and high spatiotemporal resolution are still challenging for nongenetic neuromodulation. Herein, a second near-infrared (NIR-II)-light-induced transcranial nongenetic neurostimulation via bioinspired nanovesicles is reported. The rationally designed vesicles are obtained from vesicle-membrane-confined enzymatic reactions. This study demonstrates that the vesicle-enabled NIR-II photothermal stimuli can elicit neuronal signaling dynamics with precise spatiotemporal control and thus evoke defined neural circuits in nontransgenic mice. Moreover, the vesicle-mediated NIR-II optical stimulation can regulate mouse motor behaviors with minimal invasiveness by eliminating light-emitting implants. Furthermore, the biological modulation is integrated with photoacoustic brain imaging, realizing navigational, and efficient neuromodulation. Such transcranial and precise NIR-II optical neuromodulation mediated by bioinspired vesicles shows the potential for the optical-theranostics of neurological diseases in nontransgenic organisms.
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Affiliation(s)
- Ya Zhang
- Research Center for Translational Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Deqi Yang
- Research Center for Translational Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Jianfang Nie
- Research Center for Translational Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Jing Dai
- Research Center for Translational Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Haofan Wu
- Research Center for Translational Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Jialin Charles Zheng
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
- Center for Translational Neurodegeneration and Regenerative Therapy, Tongji Hospital affiliated to Tongji University, Shanghai, 200065, China
| | - Fan Zhang
- Department of Chemistry, State Key Laboratory of Molecular Engineering of Polymers and iChem, Shanghai Key Laboratory of Molecular Catalysis and Innovative Material, Fudan University, Shanghai, 200433, China
| | - Yin Fang
- Research Center for Translational Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, 200120, China
- The Institute for Biomedical Engineering & Nano Science, School of Medicine, Tongji University, Shanghai, 200092, China
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23
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Collins MN, Mesce KA. A review of the bioeffects of low-intensity focused ultrasound and the benefits of a cellular approach. Front Physiol 2022; 13:1047324. [PMID: 36439246 PMCID: PMC9685663 DOI: 10.3389/fphys.2022.1047324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/25/2022] [Indexed: 10/28/2023] Open
Abstract
This review article highlights the historical developments and current state of knowledge of an important neuromodulation technology: low-intensity focused ultrasound. Because compelling studies have shown that focused ultrasound can modulate neuronal activity non-invasively, especially in deep brain structures with high spatial specificity, there has been a renewed interest in attempting to understand the specific bioeffects of focused ultrasound at the cellular level. Such information is needed to facilitate the safe and effective use of focused ultrasound to treat a number of brain and nervous system disorders in humans. Unfortunately, to date, there appears to be no singular biological mechanism to account for the actions of focused ultrasound, and it is becoming increasingly clear that different types of nerve cells will respond to focused ultrasound differentially based on the complement of their ion channels, other membrane biophysical properties, and arrangement of synaptic connections. Furthermore, neurons are apparently not equally susceptible to the mechanical, thermal and cavitation-related consequences of focused ultrasound application-to complicate matters further, many studies often use distinctly different focused ultrasound stimulus parameters to achieve a reliable response in neural activity. In this review, we consider the benefits of studying more experimentally tractable invertebrate preparations, with an emphasis on the medicinal leech, where neurons can be studied as unique individual cells and be synaptically isolated from the indirect effects of focused ultrasound stimulation on mechanosensitive afferents. In the leech, we have concluded that heat is the primary effector of focused ultrasound neuromodulation, especially on motoneurons in which we observed a focused ultrasound-mediated blockade of action potentials. We discuss that the mechanical bioeffects of focused ultrasound, which are frequently described in the literature, are less reliably achieved as compared to thermal ones, and that observations ascribed to mechanical responses may be confounded by activation of synaptically-coupled sensory structures or artifacts associated with electrode resonance. Ultimately, both the mechanical and thermal components of focused ultrasound have significant potential to contribute to the sculpting of specific neural outcomes. Because focused ultrasound can generate significant modulation at a temperature <5°C, which is believed to be safe for moderate durations, we support the idea that focused ultrasound should be considered as a thermal neuromodulation technology for clinical use, especially targeting neural pathways in the peripheral nervous system.
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Affiliation(s)
- Morgan N. Collins
- Graduate Program in Neuroscience, University of Minnesota, Saint Paul, MN, United States
| | - Karen A. Mesce
- Department of Entomology and Graduate Program in Neuroscience, University of Minnesota, Saint Paul, MN, United States
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24
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Li Y, Jiang Y, Lan L, Ge X, Cheng R, Zhan Y, Chen G, Shi L, Wang R, Zheng N, Yang C, Cheng JX. Optically-generated focused ultrasound for noninvasive brain stimulation with ultrahigh precision. LIGHT, SCIENCE & APPLICATIONS 2022; 11:321. [PMID: 36323662 PMCID: PMC9630534 DOI: 10.1038/s41377-022-01004-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 06/01/2023]
Abstract
High precision neuromodulation is a powerful tool to decipher neurocircuits and treat neurological diseases. Current non-invasive neuromodulation methods offer limited precision at the millimeter level. Here, we report optically-generated focused ultrasound (OFUS) for non-invasive brain stimulation with ultrahigh precision. OFUS is generated by a soft optoacoustic pad (SOAP) fabricated through embedding candle soot nanoparticles in a curved polydimethylsiloxane film. SOAP generates a transcranial ultrasound focus at 15 MHz with an ultrahigh lateral resolution of 83 µm, which is two orders of magnitude smaller than that of conventional transcranial-focused ultrasound (tFUS). Here, we show effective OFUS neurostimulation in vitro with a single ultrasound cycle. We demonstrate submillimeter transcranial stimulation of the mouse motor cortex in vivo. An acoustic energy of 0.6 mJ/cm2, four orders of magnitude less than that of tFUS, is sufficient for successful OFUS neurostimulation. OFUS offers new capabilities for neuroscience studies and disease treatments by delivering a focus with ultrahigh precision non-invasively.
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Affiliation(s)
- Yueming Li
- Department of Mechanical Engineering, Boston University, Boston, MA, 02215, USA
| | - Ying Jiang
- Graduate Program for Neuroscience, Boston University, Boston, MA, 02215, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA
| | - Lu Lan
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Xiaowei Ge
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Ran Cheng
- Department of Chemistry, Boston University, Boston, MA, 02215, USA
| | - Yuewei Zhan
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Guo Chen
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Linli Shi
- Department of Chemistry, Boston University, Boston, MA, 02215, USA
| | - Runyu Wang
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA
| | - Nan Zheng
- Division of Materials Science and Engineering, Boston University, Boston, MA, 02215, USA
| | - Chen Yang
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA.
- Department of Chemistry, Boston University, Boston, MA, 02215, USA.
| | - Ji-Xin Cheng
- Department of Electrical and Computer Engineering, Boston University, Boston, MA, 02215, USA.
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA.
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25
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Liu T, Choi MH, Zhu J, Zhu T, Yang J, Li N, Chen Z, Xian Q, Hou X, He D, Guo J, Fei C, Sun L, Qiu Z. Sonogenetics: Recent advances and future directions. Brain Stimul 2022; 15:1308-1317. [PMID: 36130679 DOI: 10.1016/j.brs.2022.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
Sonogenetics refers to the use of genetically encoded, ultrasound-responsive mediators for noninvasive and selective control of neural activity. It is a promising tool for studying neural circuits. However, due to its infancy, basic studies and developments are still underway, including gauging key in vivo performance metrics such as spatiotemporal resolution, selectivity, specificity, and safety. In this paper, we summarize recent findings on sonogenetics to highlight technical hurdles that have been cleared, challenges that remain, and future directions for optimization.
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Affiliation(s)
- Tianyi Liu
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China
| | - Mi Hyun Choi
- Department of Bioengineering, Stanford University, CA, USA
| | - Jiejun Zhu
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China
| | - Tingting Zhu
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China
| | - Jin Yang
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China
| | - Na Li
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China; School of Microelectronics, Xidian University, Xi'an, China
| | - Zihao Chen
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China; School of Microelectronics, Xidian University, Xi'an, China
| | - Quanxiang Xian
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Xuandi Hou
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Dongmin He
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China
| | - Jinghui Guo
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China; Department of Physiology, Faculty of Medicine, Jinan University, Guangzhou, China
| | - Chunlong Fei
- School of Microelectronics, Xidian University, Xi'an, China
| | - Lei Sun
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.
| | - Zhihai Qiu
- Guangdong Institute of Intelligence Science and Technology, Hengqin, Zhuhai, Guangdong, 519031, China.
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26
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Gibson BC, Claus ED, Sanguinetti J, Witkiewitz K, Clark VP. A review of functional brain differences predicting relapse in substance use disorder: Actionable targets for new methods of noninvasive brain stimulation. Neurosci Biobehav Rev 2022; 141:104821. [PMID: 35970417 DOI: 10.1016/j.neubiorev.2022.104821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022]
Abstract
Neuroimaging studies have identified a variety of brain regions whose activity predicts substance use (i.e., relapse) in patients with substance use disorder (SUD), suggesting that malfunctioning brain networks may exacerbate relapse. However, this knowledge has not yet led to a marked improvement in treatment outcomes. Noninvasive brain stimulation (NIBS) has shown some potential for treating SUDs, and a new generation of NIBS technologies offers the possibility of selectively altering activity in both superficial and deep brain structures implicated in SUDs. The goal of the current review was to identify deeper brain structures involved in relapse to SUD and give an account of innovative methods of NIBS that might be used to target them. Included studies measured fMRI in currently abstinent SUD patients and tracked treatment outcomes, and fMRI results were organized with the framework of the Addictions Neuroclinical Assessment (ANA). Four brain structures were consistently implicated: the anterior and posterior cingulate cortices, ventral striatum and insula. These four deeper brain structures may be appropriate future targets for the treatment of SUD using these innovative NIBS technologies.
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Affiliation(s)
- Benjamin C Gibson
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA
| | - Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jay Sanguinetti
- The Center for Consciousness Studies, University of Arizona, Tucson, AZ 85719, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA.
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27
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Jafari S, Baum IS, Udalov OG, Lee Y, Rodriguez O, Fricke ST, Jafari M, Amini M, Probst R, Tang X, Chen C, Ariando DJ, Hevaganinge A, Mair LO, Albanese C, Weinberg IN. Opening the Blood Brain Barrier with an Electropermanent Magnet System. Pharmaceutics 2022; 14:1503. [PMID: 35890398 PMCID: PMC9317373 DOI: 10.3390/pharmaceutics14071503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Opening the blood brain barrier (BBB) under imaging guidance may be useful for the treatment of many brain disorders. Rapidly applied magnetic fields have the potential to generate electric fields in brain tissue that, if properly timed, may enable safe and effective BBB opening. By tuning magnetic pulses generated by a novel electropermanent magnet (EPM) array, we demonstrate the opening of tight junctions in a BBB model culture in vitro, and show that induced monophasic electrical pulses are more effective than biphasic ones. We confirmed, with in vivo contrast-enhanced MRI, that the BBB can be opened with monophasic pulses. As electropermanent magnets have demonstrated efficacy at tuning B0 fields for magnetic resonance imaging studies, our results suggest the possibility of implementing an EPM-based hybrid theragnostic device that could both image the brain and enhance drug transport across the BBB in a single sitting.
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Affiliation(s)
- Sahar Jafari
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - Ittai S. Baum
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - Oleg G. Udalov
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - Yichien Lee
- Department of Oncology, Georgetown University Medical Center, Washington, DC 20057, USA; (Y.L.); (O.R.); (S.T.F.); (C.A.)
| | - Olga Rodriguez
- Department of Oncology, Georgetown University Medical Center, Washington, DC 20057, USA; (Y.L.); (O.R.); (S.T.F.); (C.A.)
- Center for Translational Imaging, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Stanley T. Fricke
- Department of Oncology, Georgetown University Medical Center, Washington, DC 20057, USA; (Y.L.); (O.R.); (S.T.F.); (C.A.)
- Center for Translational Imaging, Georgetown University Medical Center, Washington, DC 20057, USA
- Department of Radiology, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Maryam Jafari
- Independent Consultant, Oklahoma City, OK 73134, USA;
| | - Mostafa Amini
- Department of Management Science and Information Systems, Oklahoma State University, Stillwater, OK 74078, USA;
| | | | - Xinyao Tang
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - Cheng Chen
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - David J. Ariando
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA;
| | - Anjana Hevaganinge
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - Lamar O. Mair
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
| | - Christopher Albanese
- Department of Oncology, Georgetown University Medical Center, Washington, DC 20057, USA; (Y.L.); (O.R.); (S.T.F.); (C.A.)
- Center for Translational Imaging, Georgetown University Medical Center, Washington, DC 20057, USA
- Department of Radiology, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Irving N. Weinberg
- Weinberg Medical Physics, Inc., North Bethesda, MD 20852, USA; (S.J.); (I.S.B.); (O.G.U.); (X.T.); (C.C.); (A.H.); (L.O.M.)
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28
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Yuan Y, Long A, Wu Y, Li X. Closed-loop transcranial ultrasound stimulation with a fuzzy controller for modulation of motor response and neural activity of mice. J Neural Eng 2022; 19. [PMID: 35700694 DOI: 10.1088/1741-2552/ac7893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/14/2022] [Indexed: 11/12/2022]
Abstract
Objective. We propose a closed-loop transcranial ultrasound stimulation (TUS) with a fuzzy controller to realize real-time and precise control of the motor response and neural activity of mice.Approach. The mean absolute value (MAV) of the electromyogram (EMG) and peak value (PV) of the local field potential (LFP) were measured under different ultrasound intensities. A model comprising the characteristics of the MAV of the EMG, PV of the LFP, and ultrasound intensity was built using a neural network, and a fuzzy controller, proportional-integral-derivative (PID) controller, and immune feedback controller were proposed to adjust the ultrasound intensity using the feedback of the EMG MAV and the LFP PV.Main results. In simulation, the quantitative calculation indicated that the maximum relative errors between the simulated EMG MAV and the expected values were 17% (fuzzy controller), 110% (PID control), 66% (immune feedback control); furthermore, the corresponding values of the LFP PV were 12% (fuzzy controller), 53% (PID control), 55% (immune feedback control). The average relative errors of fuzzy controller, PID control, immune feedback control were 4.97%, 13.15%, 11.52%, in the EMG closed-loop experiment and 7.76%, 11.84%, 13.56%, in the LFP closed-loop experiment.Significance. The simulation and experimental results demonstrate that the closed-loop TUS with a fuzzy controller can realize the tracking control of the motor response and neural activity of mice.
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Affiliation(s)
- Yi Yuan
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China.,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Ai Long
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China.,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Yongkang Wu
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China.,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, People's Republic of China
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Nasr K, Haslacher D, Dayan E, Censor N, Cohen LG, Soekadar SR. Breaking the boundaries of interacting with the human brain using adaptive closed-loop stimulation. Prog Neurobiol 2022; 216:102311. [PMID: 35750290 DOI: 10.1016/j.pneurobio.2022.102311] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022]
Abstract
The human brain is arguably one of the most complex systems in nature. To understand how it operates, it is essential to understand the link between neural activity and behavior. Experimental investigation of that link requires tools to interact with neural activity during behavior. Human neuroscience, however, has been severely bottlenecked by the limitations of these tools. While invasive methods can support highly specific interaction with brain activity during behavior, their applicability in human neuroscience is limited. Despite extensive development in the last decades, noninvasive alternatives have lacked spatial specificity and yielded results that are commonly fraught with variability and replicability issues, along with relatively limited understanding of the neural mechanisms involved. Here we provide a comprehensive review of the state-of-the-art in interacting with human brain activity and highlight current limitations and recent efforts to overcome these limitations. Beyond crucial technical and scientific advancements in electromagnetic brain stimulation, new frontiers in interacting with human brain activity such as task-irrelevant sensory stimulation and focal ultrasound stimulation are introduced. Finally, we argue that, along with technological improvements and breakthroughs in noninvasive methods, a paradigm shift towards adaptive closed-loop stimulation will be a critical step for advancing human neuroscience.
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Affiliation(s)
- Khaled Nasr
- Clinical Neurotechnology Laboratory & Center for Translational Neuromodulation, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - David Haslacher
- Clinical Neurotechnology Laboratory & Center for Translational Neuromodulation, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eran Dayan
- Department of Radiology and Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nitzan Censor
- School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institutes of Neurological Disorders and Stroke (NINDS), Bethesda, MD, USA
| | - Surjo R Soekadar
- Clinical Neurotechnology Laboratory & Center for Translational Neuromodulation, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Mechanistic insights into ultrasonic neurostimulation of disconnected neurons using single short pulses. Brain Stimul 2022; 15:769-779. [PMID: 35561960 DOI: 10.1016/j.brs.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 02/06/2023] Open
Abstract
Ultrasonic neurostimulation is a potentially potent noninvasive therapy, whose mechanism has yet to be elucidated. We designed a system capable of applying ultrasound with minimal reflections to neuronal cultures. Synaptic transmission was pharmacologically controlled, eliminating network effects, enabling examination of single-cell processes. Short single pulses of low-intensity ultrasound were applied, and time-locked responses were examined using calcium imaging. Low-pressure (0.35MPa) ultrasound directly stimulated ∼20% of pharmacologically disconnected neurons, regardless of membrane poration. Stimulation was resistant to the blockade of several purinergic receptor and mechanosensitive ion channel types. Stimulation was blocked, however, by suppression of action potentials. Surprisingly, even extremely short (4μs) pulses were effective, stimulating ∼8% of the neurons. Lower-pressure pulses (0.35MPa) were less effective than higher-pressure ones (0.65MPa). Attrition effects dominated, with no indication of compromised viability. Our results detract from theories implicating cavitation, heating, non-transient membrane pores >1.5nm, pre-synaptic release, or gradual effects. They implicate a post-synaptic mechanism upstream of the action potential, and narrow down the list of possible targets involved.
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Guerra A, Bologna M. Low-Intensity Transcranial Ultrasound Stimulation: Mechanisms of Action and Rationale for Future Applications in Movement Disorders. Brain Sci 2022; 12:brainsci12050611. [PMID: 35624998 PMCID: PMC9139935 DOI: 10.3390/brainsci12050611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023] Open
Abstract
Low-intensity transcranial ultrasound stimulation (TUS) is a novel non-invasive brain stimulation technique that uses acoustic energy to induce changes in neuronal activity. However, although low-intensity TUS is a promising neuromodulation tool, it has been poorly studied as compared to other methods, i.e., transcranial magnetic and electrical stimulation. In this article, we first focus on experimental studies in animals and humans aimed at explaining its mechanisms of action. We then highlight possible applications of TUS in movement disorders, particularly in patients with parkinsonism, dystonia, and tremor. Finally, we highlight the knowledge gaps and possible limitations that currently limit potential TUS applications in movement disorders. Clarifying the potential role of TUS in movement disorders may further promote studies with therapeutic perspectives in this field.
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Affiliation(s)
| | - Matteo Bologna
- IRCCS Neuromed, 86077 Pozzilli, Italy;
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
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Magaram U, Weiss C, Vasan A, Reddy KC, Friend J, Chalasani SH. Two pathways are required for ultrasound-evoked behavioral changes in Caenorhabditis elegans. PLoS One 2022; 17:e0267698. [PMID: 35511952 PMCID: PMC9071135 DOI: 10.1371/journal.pone.0267698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
Ultrasound has been shown to affect the function of both neurons and non-neuronal cells, but, the underlying molecular machinery has been poorly understood. Here, we show that at least two mechanosensitive proteins act together to generate C. elegans behavioral responses to ultrasound stimuli. We first show that these animals generate reversals in response to a single 10 msec pulse from a 2.25 MHz ultrasound transducer. Next, we show that the pore-forming subunit of the mechanosensitive channel TRP-4, and a DEG/ENaC/ASIC ion channel MEC-4, are both required for this ultrasound-evoked reversal response. Further, the trp-4;mec-4 double mutant shows a stronger behavioral deficit compared to either single mutant. Finally, overexpressing TRP-4 in specific chemosensory neurons can rescue the ultrasound-triggered behavioral deficit in the mec-4 null mutant, suggesting that both TRP-4 and MEC-4 act together in affecting behavior. Together, we demonstrate that multiple mechanosensitive proteins likely cooperate to transform ultrasound stimuli into behavioral changes.
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Affiliation(s)
- Uri Magaram
- Neurosciences Graduate Program, University of California San Diego, La Jolla, CA, United States of America
- Molecular Neurobiology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, United States of America
| | - Connor Weiss
- Molecular Neurobiology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, United States of America
| | - Aditya Vasan
- Medically Advanced Devices Laboratory, Department of Mechanical and Aerospace Engineering, Jacobs School of Engineering and Department of Surgery, School of Medicine, University of California San Diego, La Jolla, CA, United States of America
| | - Kirthi C. Reddy
- Molecular Neurobiology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, United States of America
| | - James Friend
- Medically Advanced Devices Laboratory, Department of Mechanical and Aerospace Engineering, Jacobs School of Engineering and Department of Surgery, School of Medicine, University of California San Diego, La Jolla, CA, United States of America
| | - Sreekanth H. Chalasani
- Molecular Neurobiology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, United States of America
- * E-mail:
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Smith CS, O'Driscoll C, Ebbini ES. Spatio-Spectral Ultrasound Characterization of Reflection and Transmission Through Bone With Temperature Dependence. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:1727-1737. [PMID: 35349438 PMCID: PMC9050954 DOI: 10.1109/tuffc.2022.3163225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Transcranial focused ultrasound (tFUS) is a promising approach for the treatment of neurological disorders. It has proven useful in several clinical applications, with promising outcomes reported in the recent literature. Furthermore, it is currently being investigated in a range of neuromodulation (NM) and ablative applications, including epilepsy. In this application, tFUS access through the temporal window is the key to optimizing the treatment safety and efficacy. Traditional approaches have utilized transducers with low operating frequencies for tFUS applications. Modern array transducers and driving systems allow for more intelligent use of the temporal window by exploiting the spatio-spectral transmission bandwidth to a specified target or targets within the brain. To demonstrate the feasibility of this approach, we have investigated the ultrasound reflection and transmission characteristics for different access points within the temporal window of human skull samples ex vivo. Different transmit-receive (Rx) configurations are used for characterization of the spatio-spectral variability in reflection and transmission through the temporal window. In this article, we show results from a dual-piston transducer set up in the frequency range of 2-7 MHz. Broadband pulses as well as synthesized orthogonal frequency division multiplexed (OFDM) waveforms were used. The latter was used to improve the magnitude and phase measurements in 100-kHz subbands within the 2-7 MHz spectral window. A temperature-controlled water bath was used to characterize the change in reflection and transmission characteristics with temperature in the 25°C-43°C range. The measured values of the complex reflection and transmission coefficients exhibited significant variations with space, frequency, and temperature. On the other hand, the measured transmission phase varied more with location and frequency, with smaller sensitivity to temperature. A measurement-based hybrid angular spectrum (HAS) simulation through the human temporal bone was used to demonstrate the dependence of focusing gain on the skull profile and spatial distribution of change of speed of sound (SOS) at different skull temperatures.
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Dell'Italia J, Sanguinetti JL, Monti MM, Bystritsky A, Reggente N. Current State of Potential Mechanisms Supporting Low Intensity Focused Ultrasound for Neuromodulation. Front Hum Neurosci 2022; 16:872639. [PMID: 35547195 PMCID: PMC9081930 DOI: 10.3389/fnhum.2022.872639] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 01/07/2023] Open
Abstract
Low intensity focused ultrasound (LIFU) has been gaining traction as a non-invasive neuromodulation technology due to its superior spatial specificity relative to transcranial electrical/magnetic stimulation. Despite a growing literature of LIFU-induced behavioral modifications, the mechanisms of action supporting LIFU's parameter-dependent excitatory and suppressive effects are not fully understood. This review provides a comprehensive introduction to the underlying mechanics of both acoustic energy and neuronal membranes, defining the primary variables for a subsequent review of the field's proposed mechanisms supporting LIFU's neuromodulatory effects. An exhaustive review of the empirical literature was also conducted and studies were grouped based on the sonication parameters used and behavioral effects observed, with the goal of linking empirical findings to the proposed theoretical mechanisms and evaluating which model best fits the existing data. A neuronal intramembrane cavitation excitation model, which accounts for differential effects as a function of cell-type, emerged as a possible explanation for the range of excitatory effects found in the literature. The suppressive and other findings need additional theoretical mechanisms and these theoretical mechanisms need to have established relationships to sonication parameters.
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Affiliation(s)
- John Dell'Italia
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- *Correspondence: John Dell'Italia
| | - Joseph L. Sanguinetti
- Department of Psychology, University of Arizona, Tuscon, AZ, United States
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Martin M. Monti
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexander Bystritsky
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Tiny Blue Dot Foundation, Santa Monica, CA, United States
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Tiny Blue Dot Foundation, Santa Monica, CA, United States
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Darmani G, Bergmann T, Butts Pauly K, Caskey C, de Lecea L, Fomenko A, Fouragnan E, Legon W, Murphy K, Nandi T, Phipps M, Pinton G, Ramezanpour H, Sallet J, Yaakub S, Yoo S, Chen R. Non-invasive transcranial ultrasound stimulation for neuromodulation. Clin Neurophysiol 2022; 135:51-73. [DOI: 10.1016/j.clinph.2021.12.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/13/2022]
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Zhang Y, Pang N, Huang X, Meng W, Meng L, Zhang B, Jiang Z, Zhang J, Yi Z, Luo Z, Wang Z, Niu L. Ultrasound Deep Brain Stimulation Decelerates Telomere Shortening in Alzheimer's Disease and Aging Mice. FUNDAMENTAL RESEARCH 2022. [DOI: 10.1016/j.fmre.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Kim E, Kum J, Kim H. Trans-Spinal Focused Ultrasound Stimulation Selectively Modulates Descending Motor Pathway. IEEE Trans Neural Syst Rehabil Eng 2022; 30:314-320. [PMID: 35108206 DOI: 10.1109/tnsre.2022.3148877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Compared to current non-invasive methods utilizing magnetic and electrical means, focused ultrasound provides greater spatial resolution and penetration depth. Despite the broad application of ultrasound stimulation, there is a lack of studies dedicated to the investigation of acoustic neuromodulation on the spinal cord. This study aims to apply focused ultrasound on the spinal cord to modulate the descending pathways in a non-invasive fashion. The application of trans-spinal focused ultrasound (tsFUS) was examined on the motor deficit mouse model. tsFUS was achieved using a single-element focused ultrasound transducer operating at 3 MHz. The sonication was performed on anesthetized 6 week-old mice targeting T12 and L3 vertebrae. The effect was analyzed by comparing electromyography responses from the hindlimb induced by electrical stimulation of the motor cortex. Further, the mouse model with the Harmaline-induced essential tremor was selected to investigate the potential clinical application of tsFUS. The safety was verified by histological assessment. Sonication at the T12 area inhibited motor response, while sonication over the L3 region provided signal enhancement. Sonication of T12 of the ET mouse also showed the ability of ultrasound to suppress tremors. Meanwhile, the histological examination did not show any abnormalities with the highest applied acoustic pressure. In this work, a non-invasive motor signal modulation was achieved using tsFUS. Moreover, the results showed the ability of focused ultrasound to manage tremors in a safe manner. This study provides a stepping stone for the trans-spinal application of focused ultrasound to motor-related disorders.
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Zhou W, Wang X, Wang K, Farooq U, Kang L, Niu L, Meng L. Ultrasound Activation of Mechanosensory Ion Channels in Caenorhabditis Elegans. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:473-479. [PMID: 34652999 DOI: 10.1109/tuffc.2021.3120750] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ultrasound is capable of noninvasive transcranial focusing and activating the targeted neurons in brain regions, receiving increasing attention. Ion channel, acting as a nano-ionic switch, enables to modulate the ion flow across cellular membranes and it is of importance to control the firing frequency of a neuron. In this article, we demonstrate the behavioral response of Caenorhabditis elegans (C. elegans) in response to ultrasound stimulation mediated by the activation of mechanical sensitive MEC-4 and MEC-6 ion channels. By specific mutation of MEC-4 and MEC-6 ion channels, mutant worms show a significant decrease in the percentage of reversal behavior (30% ± 10.5% and 10% ± 6.9%, respectively), compared with wild type (85% ± 8.2%). Furthermore, ALM and PLM neurons expressing MEC-4 and MEC-6 ion channels could be evoked directly by ultrasound stimulation, indicating MEC-4 and MEC-6 may pave a new way for sonogenetics.
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Spivak NM, Sanguinetti JL, Monti MM. Focusing in on the Future of Focused Ultrasound as a Translational Tool. Brain Sci 2022; 12:brainsci12020158. [PMID: 35203922 PMCID: PMC8870102 DOI: 10.3390/brainsci12020158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/14/2022] [Accepted: 01/22/2022] [Indexed: 12/22/2022] Open
Abstract
This article summarizes the field of focused ultrasound for use in neuromodulation and discusses different ways of targeting, delivering, and validating focused ultrasound. A discussion is focused on parameter space and different ongoing theories of ultrasonic neuromodulation. Current and future applications of the technique are discussed.
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Affiliation(s)
- Norman M. Spivak
- UCLA—Caltech Medical Scientist Training Program, David Geffen School of Medicine, Los Angeles, CA 90095, USA
- Department of Neurosurgery, University of California, Los Angeles, CA 90095, USA;
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
- Correspondence:
| | - Joseph L. Sanguinetti
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA;
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Martin M. Monti
- Department of Neurosurgery, University of California, Los Angeles, CA 90095, USA;
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
- Department of Psychology, University of California, Los Angeles, CA 90095, USA
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Matt E, Kaindl L, Tenk S, Egger A, Kolarova T, Karahasanović N, Amini A, Arslan A, Sariçiçek K, Weber A, Beisteiner R. First evidence of long-term effects of transcranial pulse stimulation (TPS) on the human brain. J Transl Med 2022; 20:26. [PMID: 35033118 PMCID: PMC8760674 DOI: 10.1186/s12967-021-03222-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/28/2021] [Indexed: 12/22/2022] Open
Abstract
Background With the high spatial resolution and the potential to reach deep brain structures, ultrasound-based brain stimulation techniques offer new opportunities to non-invasively treat neurological and psychiatric disorders. However, little is known about long-term effects of ultrasound-based brain stimulation. Applying a longitudinal design, we comprehensively investigated neuromodulation induced by ultrasound brain stimulation to provide first sham-controlled evidence of long-term effects on the human brain and behavior. Methods Twelve healthy participants received three sham and three verum sessions with transcranial pulse stimulation (TPS) focused on the cortical somatosensory representation of the right hand. One week before and after the sham and verum TPS applications, comprehensive structural and functional resting state MRI investigations and behavioral tests targeting tactile spatial discrimination and sensorimotor dexterity were performed. Results Compared to sham, global efficiency significantly increased within the cortical sensorimotor network after verum TPS, indicating an upregulation of the stimulated functional brain network. Axial diffusivity in left sensorimotor areas decreased after verum TPS, demonstrating an improved axonal status in the stimulated area. Conclusions TPS increased the functional and structural coupling within the stimulated left primary somatosensory cortex and adjacent sensorimotor areas up to one week after the last stimulation. These findings suggest that TPS induces neuroplastic changes that go beyond the spatial and temporal stimulation settings encouraging further clinical applications.
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Affiliation(s)
- Eva Matt
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Lisa Kaindl
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Saskia Tenk
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Anicca Egger
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Teodora Kolarova
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Nejla Karahasanović
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Ahmad Amini
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Andreas Arslan
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Kardelen Sariçiçek
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Alexandra Weber
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Roland Beisteiner
- Imaging-Based Functional Brain Diagnostics and Therapy, Department of Neurology, High Field Magnetic Resonance Centre, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Nguyen DT, Berisha DE, Konofagou EE, Dmochowski JP. Neuronal responses to focused ultrasound are gated by pre-stimulation brain rhythms. Brain Stimul 2022; 15:233-243. [PMID: 34990877 DOI: 10.1016/j.brs.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/29/2021] [Accepted: 01/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Owing to its high spatial resolution and penetration depth, transcranial focused ultrasound stimulation (tFUS) is one of the most promising approaches to non-invasive neuromodulation. Identifying the impact of endogenous neural activity on neuromodulation outcome is critical to harnessing the potential of tFUS. OBJECTIVE Here we sought to identify the relationship between pre-stimulation neural activity and the neuronal response to tFUS. METHODS We applied 3 min of continuous-wave tFUS to the hippocampal region of the rat while recording local field potentials (LFP) and multi-unit activity (MUA) from the target. We also tested the application of tFUS but with an air gap separating the transducer and the skull, as well as active stimulation of the contralateral olfactory bulb. RESULTS We observed a modest but significant increase in firing rate during hippocampal tFUS, but not during stimulation of the olfactory bulb or when an air gap was present. Importantly, the observed firing rate increase was significantly modulated by the power of baseline oscillations in the LFP, with low levels of delta (1-3 Hz) and high levels of theta (4-10 Hz) and gamma (30-250 Hz) power producing significantly larger firing rate increases. Firing rate increases were also amplified by a factor of 7× when stimulation was applied during periods of frequent sharp-wave ripple (SWR) activity. CONCLUSION Our findings suggest that baseline brain rhythms may effectively "gate" the response to tFUS.
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Affiliation(s)
- Duc T Nguyen
- Department of Biomedical Engineering, City College of New York, United States
| | - Destiny E Berisha
- Department of Biomedical Engineering, City College of New York, United States
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, United States
| | - Jacek P Dmochowski
- Department of Biomedical Engineering, City College of New York, United States.
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Vion-Bailly J, Suarez-Castellanos IM, Chapelon JY, Carpentier A, N'Djin WA. Neurostimulation success rate of repetitive-pulse focused ultrasound in an in vivo giant axon model: An acoustic parametric study. Med Phys 2021; 49:682-701. [PMID: 34796512 DOI: 10.1002/mp.15358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Focused ultrasound (FUS) is a promising tool to develop new modalities of therapeutic neurostimulation. The ability of FUS to stimulate the nervous system, in a noninvasive and spatiotemporally precise manner, has been demonstrated in animals and human subjects, but the underlying biomechanisms are not fully understood yet. The objective of the present study was to investigate the bioeffects involved in the generation of trains of action potentials (APs) by repetitive-pulse FUS stimuli in a simple invertebrate neural model. METHODS The respective influences of different acoustic parameters on the neurostimulation success rate (NSR), defined as the rate of FUS stimuli capable of evoking at least one AP, were explored using the system of afferent nerves and giant fibers of Lumbricus terrestris as neural model. Each parameter was studied independently by administering random FUS sequences while keeping all but one FUS parameter constant. The NSR was evaluated as a function of (i) the spatial-average pulse-average intensity (Isapa ); (ii) the pulse duration (PD); (iii) the pulse repetition frequency (PRF); iv) the number of cycles per pulse (Ncycles ); (v) two ultrasound frequencies, f0 = 1.1 MHz and f3 = 3.3 MHz, corresponding to the fundamental and third-harmonic resonant frequencies of the FUS transducer, respectively (spherical, radius of curvature: 50 mm); and (vi) levels of emerging stable cavitation and inertial cavitation. RESULTS The NSR associated to 1.1 MHz repetitive-pulse FUS stimuli was found to increase as a function of increasing Isapa , PD, PRF, and Ncycles . When evaluating each parameter at f = 1.1 MHz, it was observed that NSRs close to 100% were achieved when sufficiently elevating their respective values. When computing the NSR as a function of the spatial-average, temporal-average intensity (Isata ), defined as the product of PRF, PD, and Isapa , a significant elevation of the NSR from 0% to close to 100% was measured by increasing Isata from values approximate to 4 W/cm2 to values higher than 12 W/cm2 . No clear and consistent trend was observed in trials aimed at exploring the effects of different levels of stable and inertial acoustic cavitation on the NSR. Finally, the feasibility of inducing neural responses with 3.3 MHz repetitive-pulse FUS stimuli was also demonstrated with NSRs reaching up to 60%, in the range of FUS parameters studied. CONCLUSION The time-averaged value of the radiation force per unit volume of tissue is proportional to the acoustic intensity. As a result, the observations from this study suggest that the neural structure responding to the stimulus is sensitive to the mean radiation force carried by the FUS sequence, regardless of the combination of FUS parameters giving rise to such force. The results from this study further revealed the existence of a minimal activation threshold with regard to Isapa .
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Affiliation(s)
- Jérémy Vion-Bailly
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
| | | | - Jean-Yves Chapelon
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
| | - Alexandre Carpentier
- AP-HP, Neurosurgery department, Pitié-Salpêtrière Hospital, Paris, France.,Sorbonne University, GRC23, Interface Neuro Machine Team, Sorbonne University, Paris, France
| | - W Apoutou N'Djin
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
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Zhang T, Pan N, Wang Y, Liu C, Hu S. Transcranial Focused Ultrasound Neuromodulation: A Review of the Excitatory and Inhibitory Effects on Brain Activity in Human and Animals. Front Hum Neurosci 2021; 15:749162. [PMID: 34650419 PMCID: PMC8507972 DOI: 10.3389/fnhum.2021.749162] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/06/2021] [Indexed: 12/15/2022] Open
Abstract
Non-invasive neuromodulation technology is important for the treatment of brain diseases. The effects of focused ultrasound on neuronal activity have been investigated since the 1920s. Low intensity transcranial focused ultrasound (tFUS) can exert non-destructive mechanical pressure effects on cellular membranes and ion channels and has been shown to modulate the activity of peripheral nerves, spinal reflexes, the cortex, and even deep brain nuclei, such as the thalamus. It has obvious advantages in terms of security and spatial selectivity. This technology is considered to have broad application prospects in the treatment of neurodegenerative disorders and neuropsychiatric disorders. This review synthesizes animal and human research outcomes and offers an integrated description of the excitatory and inhibitory effects of tFUS in varying experimental and disease conditions.
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Affiliation(s)
- Tingting Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Na Pan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Center of Epilepsy, Institute of Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
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Prieto ML, Firouzi K, Khuri-Yakub BT, Madison DV, Maduke M. Spike frequency-dependent inhibition and excitation of neural activity by high-frequency ultrasound. J Gen Physiol 2021; 152:182190. [PMID: 33074301 PMCID: PMC7534904 DOI: 10.1085/jgp.202012672] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023] Open
Abstract
Ultrasound can modulate action potential firing in vivo and in vitro, but the mechanistic basis of this phenomenon is not well understood. To address this problem, we used patch-clamp recording to quantify the effects of focused, high-frequency (43 MHz) ultrasound on evoked action potential firing in CA1 pyramidal neurons in acute rodent hippocampal brain slices. We find that ultrasound can either inhibit or potentiate firing in a spike frequency–dependent manner: at low (near-threshold) input currents and low firing frequencies, ultrasound inhibits firing, while at higher input currents and higher firing frequencies, ultrasound potentiates firing. The net result of these two competing effects is that ultrasound increases the threshold current for action potential firing, the slope of frequency-input curves, and the maximum firing frequency. In addition, ultrasound slightly hyperpolarizes the resting membrane potential, decreases action potential width, and increases the depth of the after-hyperpolarization. All of these results can be explained by the hypothesis that ultrasound activates a sustained potassium conductance. According to this hypothesis, increased outward potassium currents hyperpolarize the resting membrane potential and inhibit firing at near-threshold input currents but potentiate firing in response to higher-input currents by limiting inactivation of voltage-dependent sodium channels during the action potential. This latter effect is a consequence of faster action potential repolarization, which limits inactivation of voltage-dependent sodium channels, and deeper (more negative) after-hyperpolarization, which increases the rate of recovery from inactivation. Based on these results, we propose that ultrasound activates thermosensitive and mechanosensitive two-pore-domain potassium (K2P) channels through heating or mechanical effects of acoustic radiation force. Finite-element modeling of the effects of ultrasound on brain tissue suggests that the effects of ultrasound on firing frequency are caused by a small (<2°C) increase in temperature, with possible additional contributions from mechanical effects.
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Affiliation(s)
- Martin Loynaz Prieto
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, CA
| | - Kamyar Firouzi
- E.L. Ginzton Laboratory, Stanford University, Stanford, CA
| | | | - Daniel V Madison
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, CA
| | - Merritt Maduke
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, CA
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Baek H, Yang Y, Pacia CP, Xu L, Yue Y, Bruchas MR, Chen H. Mechanical and mechanothermal effects of focused ultrasound elicited distinct electromyographic responses in mice. Phys Med Biol 2021; 66. [PMID: 34098539 DOI: 10.1088/1361-6560/ac08b1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/07/2021] [Indexed: 11/11/2022]
Abstract
The objective of this study was to compare focused ultrasound (FUS) neuromodulation-induced motor responses under two physical mechanisms: mechanical and mechanothermal effects. Mice were divided into two groups. One group was subjected to short-duration FUS stimulation (0.3 s) that induced mechanical effects (mechanical group). The other group underwent long-duration FUS stimulation (15 s) that produced not only mechanical but also thermal effects (mechanothermal group). FUS was targeted at the deep cerebellar nucleus in the cerebellum to induce motor responses, which were evaluated by recording the evoked electromyographic (EMG) signals and tail movements. Brain tissue temperature rise associated with the FUS stimulation was quantified by noninvasive magnetic resonance thermometryin vivo. Temperature rise was negligible for the mechanical group (0.2 °C ± 0.1 °C) but did rise within the range of 0.6 °C ± 0.2 °C-3.3 °C ± 0.9 °C for the mechanothermal group. The elongated FUS beam also induced heating in the dorsal brain (below the top skull) and ventral brain (above the bottom skull) along the beam path for the mechanothermal group. Both mechanical and mechanothermal groups achieved successful FUS neuromodulation. EMG response latencies were within the range of 0.03-0.1 s at different intensity levels for the mechanical group. The mechanothermal effect of FUS could induce both short-latency EMG (0.2-1.4 s) and long-latency EMG (8.7-13.0 s) under the same intensity levels as the mechanical group. The different temporal dynamics of evoked EMG suggested that FUS-induced mechanical and mechanothermal effects could evoke different responses in the brain.
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Affiliation(s)
- Hongchae Baek
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Yaoheng Yang
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Christopher Pham Pacia
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Lu Xu
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Yimei Yue
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Michael R Bruchas
- Department of Anesthesiology and Pain Medicine. Center for Neurobiology of Addiction, Pain, and Emotion. University of Washington, Seattle, WA 98195, United States of America
| | - Hong Chen
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America.,Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63108, United States of America
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Stern JM, Spivak NM, Becerra SA, Kuhn TP, Korb AS, Kronemyer D, Khanlou N, Reyes SD, Monti MM, Schnakers C, Walshaw P, Keselman I, Cohen MS, Yong W, Fried I, Jordan SE, Schafer ME, Engel J, Bystritsky A. Safety of focused ultrasound neuromodulation in humans with temporal lobe epilepsy. Brain Stimul 2021; 14:1022-1031. [PMID: 34198105 DOI: 10.1016/j.brs.2021.06.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Transcranial Focused Ultrasound (tFUS) is a promising new potential neuromodulation tool. However, the safety of tFUS neuromodulation has not yet been assessed adequately. Patients with refractory temporal lobe epilepsy electing to undergo an anterior temporal lobe resection present a unique opportunity to evaluate the safety and efficacy of tFUS neuromodulation. Histological changes in tissue after tFUS can be examined after surgical resection, while further potential safety concerns can be assessed using neuropsychological testing. METHODS Neuropsychological functions were assessed in eight patients before and after focused ultrasound sonication of the temporal lobe at intensities up to 5760 mW/cm2. Using the BrainSonix Pulsar 1002, tFUS was delivered under MR guidance, using the Siemens Magnetom 3T Prisma scanner. Neuropsychological changes were assessed using various batteries. Histological changes were assessed using hematoxylin and eosin staining, among others. RESULTS With respect to safety, the histological analysis did not reveal any detectable damage to the tissue, except for one subject for whom the histology findings were inconclusive. In addition, neuropsychological testing did not show any statistically significant changes in any test, except for a slight decrease in performance on one of the tests after tFUS. SIGNIFICANCE This study supports the hypothesis that low-intensity Transcranial Focused Ultrasound (tFUS) used for neuromodulation of brain circuits at intensities up to 5760 mW/cm2 may be safe for use in human research. However, due to methodological limitations in this study and inconclusive findings, more work is warranted to establish the safety. Future directions include greater number of sonications as well as longer exposure at higher intensity levels to further assess the safety of tFUS for modulation of neuronal circuits.
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Affiliation(s)
- John M Stern
- Department of Neurology, UCLA School of Medicine, USA
| | - Norman M Spivak
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA; Department of Neurosurgery, UCLA School of Medicine, USA
| | - Sergio A Becerra
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA
| | - Taylor P Kuhn
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA
| | - Alexander S Korb
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA; BrainSonix Inc., Los Angeles, CA, USA
| | - David Kronemyer
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA
| | - Négar Khanlou
- Department of Pathology and Laboratory Medicine, UCLA School of Medicine, USA
| | - Samuel D Reyes
- Department of Neurosurgery, UCLA School of Medicine, USA
| | - Martin M Monti
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA; Department of Neurosurgery, UCLA School of Medicine, USA; Department of Psychology, UCLA College of Letters and Science, USA; Brain Research Institute, UCLA, USA
| | | | - Patricia Walshaw
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA
| | - Inna Keselman
- Department of Neurology, UCLA School of Medicine, USA
| | - Mark S Cohen
- Department of Neurology, UCLA School of Medicine, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA; Department of Psychology, UCLA College of Letters and Science, USA; Department of Radiology, UCLA School of Medicine, USA; Department of Biomedical Physics, UCLA School of Medicine, USA; Department of Bioengineering, UCLA School of Engineering, USA; California Nanosystems Institute, UCLA, USA; Brain Research Institute, UCLA, USA
| | - William Yong
- Department of Pathology and Laboratory Medicine, UCLA School of Medicine, USA
| | - Itzhak Fried
- Department of Neurosurgery, UCLA School of Medicine, USA; Brain Research Institute, UCLA, USA
| | - Sheldon E Jordan
- Neurology Management Associates- Los Angeles, Santa Monica, CA, USA
| | - Mark E Schafer
- BrainSonix Inc., Los Angeles, CA, USA; School of Biomedical Engineering, Drexel University, Philadelphia, PA, USA
| | - Jerome Engel
- Department of Neurology, UCLA School of Medicine, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA; Department of Neurobiology, UCLA School of Medicine, USA; Brain Research Institute, UCLA, USA
| | - Alexander Bystritsky
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, USA; BrainSonix Inc., Los Angeles, CA, USA.
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Yu K, Liu C, Niu X, He B. Transcranial Focused Ultrasound Neuromodulation of Voluntary Movement-Related Cortical Activity in Humans. IEEE Trans Biomed Eng 2021; 68:1923-1931. [PMID: 33055021 PMCID: PMC8046844 DOI: 10.1109/tbme.2020.3030892] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Transcranial focused ultrasound (tFUS) is an emerging non-invasive brain stimulation tool for safely and reversibly modulating brain circuits. The effectiveness of tFUS on human brain has been demonstrated, but how tFUS influences the human voluntary motor processing in the brain remains unclear. METHODS We apply low-intensity tFUS to modulate the movement-related cortical potential (MRCP) originating from human subjects practicing a voluntary foot tapping task. 64-channel electroencephalograph (EEG) is recorded concurrently and further used to reconstruct the brain source activity specifically at the primary leg motor cortical area using the electrophysiological source imaging (ESI). RESULTS The ESI illustrates the ultrasound modulated MRCP source dynamics with high spatiotemporal resolutions. The MRCP source is imaged and its source profile is further evaluated for assessing the tFUS neuromodulatory effects on the voluntary MRCP. Moreover, the effect of ultrasound pulse repetition frequency (UPRF) is further assessed in modulating the MRCP. The ESI results show that tFUS significantly increases the MRCP source profile amplitude (MSPA) comparing to a sham ultrasound condition, and further, a high UPRF enhances the MSPA more than a low UPRF does. CONCLUSION The present results demonstrate the neuromodulatory effects of the low-intensity tFUS on enhancing the human voluntary movement-related cortical activities evidenced through the ESI. SIGNIFICANCE This work provides the first evidence of tFUS enhancing the human endogenous motor cortical activities through excitatory modulation.
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Affiliation(s)
- Kai Yu
- Carnegie Mellon University, Pittsburgh, PA, USA
| | | | - Xiaodan Niu
- Carnegie Mellon University, Pittsburgh, PA, USA
| | - Bin He
- Carnegie Mellon University, Pittsburgh, PA, USA
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Park C, Chen M, Kim T. Implication of auditory confounding in interpreting somatosensory and motor responses in low-intensity focused transcranial ultrasound stimulation. J Neurophysiol 2021; 125:2356-2360. [PMID: 33978511 DOI: 10.1152/jn.00701.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Low-intensity transcranial focused ultrasound (LI-tFUS) stimulation is a noninvasive neuromodulation tool that demonstrates high target localization accuracy and depth penetration. It has been shown to modulate activities in the primary motor and somatosensory cortex. Previous studies in animals as well as in humans, illustrated in the recently published paper in Brain Stimulation by Braun et al. [Braun V, Blackmore J, Cleveland RO, Butler CR. Brain Stimul 13: 1527-1534, 2020], acknowledged the possibility of indirect stimulation of the peripheral auditory pathway that could confound the somatosensory and motor responses observed with LI-tFUS stimulation. Here, we discuss the implications and interpretations of auditory confounding in the context of neuromodulation.
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Affiliation(s)
- Christine Park
- Department of Neurology, Duke University Medical Center, Durham, North Carolina
| | - Mengyue Chen
- Department of Mechanical & Aerospace Engineering, North Carolina State University, Raleigh, North Carolina
| | - Taewon Kim
- Department of Neurology, Duke University Medical Center, Durham, North Carolina
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49
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Nam CS, Traylor Z, Chen M, Jiang X, Feng W, Chhatbar PY. Direct Communication Between Brains: A Systematic PRISMA Review of Brain-To-Brain Interface. Front Neurorobot 2021; 15:656943. [PMID: 34025383 PMCID: PMC8138057 DOI: 10.3389/fnbot.2021.656943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/22/2021] [Indexed: 12/28/2022] Open
Abstract
This paper aims to review the current state of brain-to-brain interface (B2BI) technology and its potential. B2BIs function via a brain-computer interface (BCI) to read a sender's brain activity and a computer-brain interface (CBI) to write a pattern to a receiving brain, transmitting information. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to systematically review current literature related to B2BI, resulting in 15 relevant publications. Experimental papers primarily used transcranial magnetic stimulation (tMS) for the CBI portion of their B2BI. Most targeted the visual cortex to produce phosphenes. In terms of study design, 73.3% (11) are unidirectional and 86.7% (13) use only a 1:1 collaboration model (subject to subject). Limitations are apparent, as the CBI method varied greatly between studies indicating no agreed upon neurostimulatory method for transmitting information. Furthermore, only 12.4% (2) studies are more complicated than a 1:1 model and few researchers studied direct bidirectional B2BI. These studies show B2BI can offer advances in human communication and collaboration, but more design and experiments are needed to prove potential. B2BIs may allow rehabilitation therapists to pass information mentally, activating a patient's brain to aid in stroke recovery and adding more complex bidirectionality may allow for increased behavioral synchronization between users. The field is very young, but applications of B2BI technology to neuroergonomics and human factors engineering clearly warrant more research.
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Affiliation(s)
- Chang S Nam
- Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC, United States
| | - Zachary Traylor
- Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, NC, United States
| | - Mengyue Chen
- Department of Electrical & Computer Engineering, North Carolina State University, Raleigh, NC, United States
| | - Xiaoning Jiang
- Department of Electrical & Computer Engineering, North Carolina State University, Raleigh, NC, United States
| | - Wuwei Feng
- Department of Neurology, Duke University, Durham, NC, United States
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50
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Kim T, Park C, Chhatbar PY, Feld J, Mac Grory B, Nam CS, Wang P, Chen M, Jiang X, Feng W. Effect of Low Intensity Transcranial Ultrasound Stimulation on Neuromodulation in Animals and Humans: An Updated Systematic Review. Front Neurosci 2021; 15:620863. [PMID: 33935626 PMCID: PMC8079725 DOI: 10.3389/fnins.2021.620863] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/15/2021] [Indexed: 12/09/2022] Open
Abstract
Background: Although low-intensity transcranial ultrasound stimulation (LI-TUS) has received more recognition for its neuromodulation potential, there remains a crucial knowledge gap regarding the neuromodulatory effects of LI-TUS and its potential for translation as a therapeutic tool in humans. Objective: In this review, we summarized the findings reported by recently published studies regarding the effect of LI-TUS on neuromodulation in both animals and humans. We also aim to identify challenges and opportunities for the translation process. Methods: A literature search of PubMed, Medline, EMBASE, and Web of Science was performed from January 2019 to June 2020 with the following keywords and Boolean operators: [transcranial ultrasound OR transcranial focused ultrasound OR ultrasound stimulation] AND [neuromodulation]. The methodological quality of the animal studies was assessed by the SYRCLE's risk of bias tool, and the quality of human studies was evaluated by the PEDro score and the NIH quality assessment tool. Results: After applying the inclusion and exclusion criteria, a total of 26 manuscripts (24 animal studies and two human studies) out of 508 reports were included in this systematic review. Although both inhibitory (10 studies) and excitatory (16 studies) effects of LI-TUS were observed in animal studies, only inhibitory effects have been reported in primates (five studies) and human subjects (two studies). The ultrasonic parameters used in animal and human studies are different. The SYRCLE quality score ranged from 25 to 43%, with a majority of the low scores related to performance and detection bias. The two human studies received high PEDro scores (9/10). Conclusion: LI-TUS appears to be capable of targeting both superficial and deep cerebral structures to modulate cognitive or motor behavior in both animals and humans. Further human studies are needed to more precisely define the effective modulation parameters and thereby translate this brain modulatory tool into the clinic.
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Affiliation(s)
- Taewon Kim
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States
| | - Christine Park
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States
| | - Pratik Y Chhatbar
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States
| | - Jody Feld
- Physical Therapy Division, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, United States
| | - Brian Mac Grory
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States
| | - Chang S Nam
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, United States
| | - Pu Wang
- Department of Rehabilitation Medicine, Seventh Affiliated Hospital, Sun Yat-sen University, Shengzhen, China
| | - Mengyue Chen
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, United States
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, United States
| | - Wuwei Feng
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States
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