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Feng R, Sheng H, Lian Y. Advances in using ultrasound to regulate the nervous system. Neurol Sci 2024; 45:2997-3006. [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] [MESH Headings] [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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2
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Kosnoff J, Yu K, Liu C, He B. Transcranial focused ultrasound to V5 enhances human visual motion brain-computer interface by modulating feature-based attention. Nat Commun 2024; 15:4382. [PMID: 38862476 PMCID: PMC11167030 DOI: 10.1038/s41467-024-48576-8] [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: 10/20/2023] [Accepted: 05/02/2024] [Indexed: 06/13/2024] Open
Abstract
A brain-computer interface (BCI) enables users to control devices with their minds. Despite advancements, non-invasive BCIs still exhibit high error rates, prompting investigation into the potential reduction through concurrent targeted neuromodulation. Transcranial focused ultrasound (tFUS) is an emerging non-invasive neuromodulation technology with high spatiotemporal precision. This study examines whether tFUS neuromodulation can improve BCI outcomes, and explores the underlying mechanism of action using high-density electroencephalography (EEG) source imaging (ESI). As a result, V5-targeted tFUS significantly reduced the error in a BCI speller task. Source analyses revealed a significantly increase in theta and alpha activities in the tFUS condition at both V5 and downstream in the dorsal visual processing pathway. Correlation analysis indicated that the connection within the dorsal processing pathway was preserved during tFUS stimulation, while the ventral connection was weakened. These findings suggest that V5-targeted tFUS enhances feature-based attention to visual motion.
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Affiliation(s)
- Joshua Kosnoff
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, 15237, USA
| | - Kai Yu
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, 15237, USA
| | - Chang Liu
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, 15237, USA
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, 15237, USA.
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, 15237, USA.
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3
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Hou JF, Nayeem MOG, Caplan KA, Ruesch EA, Caban-Murillo A, Criado-Hidalgo E, Ornellas SB, Williams B, Pearce AA, Dagdeviren HE, Surets M, White JA, Shapiro MG, Wang F, Ramirez S, Dagdeviren C. An implantable piezoelectric ultrasound stimulator (ImPULS) for deep brain activation. Nat Commun 2024; 15:4601. [PMID: 38834558 PMCID: PMC11150473 DOI: 10.1038/s41467-024-48748-6] [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: 05/13/2024] [Indexed: 06/06/2024] Open
Abstract
Precise neurostimulation can revolutionize therapies for neurological disorders. Electrode-based stimulation devices face challenges in achieving precise and consistent targeting due to the immune response and the limited penetration of electrical fields. Ultrasound can aid in energy propagation, but transcranial ultrasound stimulation in the deep brain has limited spatial resolution caused by bone and tissue scattering. Here, we report an implantable piezoelectric ultrasound stimulator (ImPULS) that generates an ultrasonic focal pressure of 100 kPa to modulate the activity of neurons. ImPULS is a fully-encapsulated, flexible piezoelectric micromachined ultrasound transducer that incorporates a biocompatible piezoceramic, potassium sodium niobate [(K,Na)NbO3]. The absence of electrochemically active elements poses a new strategy for achieving long-term stability. We demonstrated that ImPULS can i) excite neurons in a mouse hippocampal slice ex vivo, ii) activate cells in the hippocampus of an anesthetized mouse to induce expression of activity-dependent gene c-Fos, and iii) stimulate dopaminergic neurons in the substantia nigra pars compacta to elicit time-locked modulation of nigrostriatal dopamine release. This work introduces a non-genetic ultrasound platform for spatially-localized neural stimulation and exploration of basic functions in the deep brain.
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Affiliation(s)
- Jason F Hou
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | | | - Kian A Caplan
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Evan A Ruesch
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - Albit Caban-Murillo
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - Ernesto Criado-Hidalgo
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Sarah B Ornellas
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Brandon Williams
- Center for Systems Neuroscience, Neurophotonics Center, Department of Biomedical Engineering, Boston University, 610 Commonwealth Ave., Boston, MA, 02215, USA
| | - Ayeilla A Pearce
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Huseyin E Dagdeviren
- Department of Neurosurgery, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Michelle Surets
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - John A White
- Center for Systems Neuroscience, Neurophotonics Center, Department of Biomedical Engineering, Boston University, 610 Commonwealth Ave., Boston, MA, 02215, USA
| | - Mikhail G Shapiro
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Fan Wang
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Steve Ramirez
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - Canan Dagdeviren
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
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Song W, Jayaprakash N, Saleknezhad N, Puleo C, Al-Abed Y, Martin JH, Zanos S. Transspinal Focused Ultrasound Suppresses Spinal Reflexes in Healthy Rats. Neuromodulation 2024; 27:614-624. [PMID: 37530695 DOI: 10.1016/j.neurom.2023.04.476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES Low-intensity, focused ultrasound (FUS) is an emerging noninvasive neuromodulation approach, with improved spatial and temporal resolution and penetration depth compared to other noninvasive electrical stimulation strategies. FUS has been used to modulate circuits in the brain and the peripheral nervous system, however, its potential to modulate spinal circuits is unclear. In this study, we assessed the effect of trans-spinal FUS (tsFUS) on spinal reflexes in healthy rats. MATERIALS AND METHODS tsFUS targeting different spinal segments was delivered for 1 minute, under anesthesia. Monosynaptic H-reflex of the sciatic nerve, polysynaptic flexor reflex of the sural nerve, and withdrawal reflex tested with a hot plate were measured before, during, and after tsFUS. RESULTS tsFUS reversibly suppresses the H-reflex in a spinal segment-, acoustic pressure- and pulse-repetition frequency (PRF)-dependent manner. tsFUS with high PRF augments the degree of homosynaptic depression of the H-reflex observed with paired stimuli. It suppresses the windup of components of the flexor reflex associated with slower, C-afferent, but not faster, A- afferent fibers. Finally, it increases the latency of the withdrawal reflex. tsFUS does not elicit neuronal loss in the spinal cord. CONCLUSIONS Our study provides evidence that tsFUS reversibly suppresses spinal reflexes and suggests that tsFUS could be a safe and effective strategy for spinal cord neuromodulation in disorders associated with hyperreflexia, including spasticity after spinal cord injury and painful syndromes.
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Affiliation(s)
- Weiguo Song
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Naveen Jayaprakash
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nafiseh Saleknezhad
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Chris Puleo
- General Electric Research, Niskayuna, NY, USA
| | - Yousef Al-Abed
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - John H Martin
- Department of Molecular, Cellular, and Biomedical Sciences, Center for Discovery and Innovation, City University of New York School of Medicine, New York, NY, USA
| | - Stavros Zanos
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; Elmezzi Graduate School of Molecular Medicine, Manhasset, NY.
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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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Ma X, Wang X, Zhu K, Ma R, Chu F, Liu X, Zhang S, Yin T, Zhou X, Liu Z. Study on the Role of Physical Fields in TMAS to Modulate Synaptic Plasticity in Mice. IEEE Trans Biomed Eng 2024; 71:1531-1541. [PMID: 38117631 DOI: 10.1109/tbme.2023.3342012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE Transcranial magneto-acoustic stimulation (TMAS) is a composite technique combining static magnetic and coupled electric fields with transcranial ultrasound stimulation (TUS) and has shown advantages in neuromodulation. However, the role of these physical fields in neuromodulation is unclear. Synaptic plasticity is the cellular basis for learning and memory. In this paper, we varied the intensity of static magnetic, electric and ultrasonic fields respectively to investigate the modulation of synaptic plasticity by these physical fields. METHODS There are control, static magnetic field (0.1 T/0.2 T), TUS (0.15/0.3 MPa), and TMAS (0.15 MPa + 0.2 V/m, 0.3 MPa + 0.2 V/m, 0.3 MPa + 0.4 V/m) groups. Hippocampal areas were stimulated at 5 min daily for 7 days and in vivo electrophysiological experiments were performed. RESULTS TMAS induced greater LTP, LTD, and paired-pulse ratio (PPR) than TUS, reflecting that TMAS has a more significant modulation in both long- and short- term synaptic plasticity. In TMAS, a doubling of the electric field amplitude increases LTP, LTD and PPR to a greater extent than a doubling of the acoustic pressure. Increasing the static magnetic field intensity has no significant effect on the modulation of synaptic plasticity. CONCLUSION This paper argues that electric fields should be the main reason for the difference in modulation between TMAS and TUS and that changing the amplitude of the electric field affected the modulation of TMAS more than changing the acoustic pressure. SIGNIFICANCE This study elucidates the roles of the physical fields in TMAS and provides a parameterisation way to guide TMAS applications based on the dominant roles of the physical fields.
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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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Kim S, Kwon N, Hossain MM, Bendig J, Konofagou EE. Functional ultrasound (fUS) imaging of displacement-guided focused ultrasound (FUS) neuromodulation in mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.29.587355. [PMID: 38617295 PMCID: PMC11014490 DOI: 10.1101/2024.03.29.587355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Focused ultrasound (FUS) stimulation is a promising neuromodulation technique with the merits of non-invasiveness, high spatial resolution, and deep penetration depth. However, simultaneous imaging of FUS-induced brain tissue displacement and the subsequent effect of FUS stimulation on brain hemodynamics has proven challenging thus far. In addition, earlier studies lack in situ confirmation of targeting except for the magnetic resonance imaging-guided FUS system-based studies. The purpose of this study is 1) to introduce a fully ultrasonic approach to in situ target, modulate neuronal activity, and monitor the resultant neuromodulation effect by respectively leveraging displacement imaging, FUS, and functional ultrasound (fUS) imaging, and 2) to investigate FUS-evoked cerebral blood volume (CBV) response and the relationship between CBV and displacement. We performed displacement imaging on craniotomized mice to confirm the in targeting for neuromodulation site. We recorded hemodynamic responses evoked by FUS and fUS revealed an ipsilateral CBV increase that peaks at 4 s post-FUS. We saw a stronger hemodynamic activation in the subcortical region than cortical, showing good agreement with the brain elasticity map that can also be obtained using a similar methodology. We observed dose-dependent CBV response with peak CBV, activated area, and correlation coefficient increasing with ultrasonic dose. Furthermore, by mapping displacement and hemodynamic activation, we found that displacement colocalizes and linearly correlates with CBV increase. The findings presented herein demonstrated that FUS evokes ipsilateral hemodynamic activation in cortical and subcortical depths and the evoked hemodynamic responses colocalized and correlate with FUS-induced displacement. We anticipate that our findings will help consolidate accurate targeting as well as an understanding of how FUS displaces brain tissue and affects cerebral hemodynamics.
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Affiliation(s)
- Seongyeon Kim
- Department of Biomedical Engineering, Columbia University
| | - Nancy Kwon
- Department of Biomedical Engineering, Columbia University
| | | | - Jonas Bendig
- Department of Biomedical Engineering, Columbia University
| | - Elisa E. Konofagou
- Department of Biomedical Engineering, Columbia University
- Department of Radiology, Columbia University
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Lin CW, Cheng MH, Fan CH, Chen HH, Yeh CK. Focused ultrasound stimulation of infralimbic cortex attenuates reinstatement of methamphetamine-induced conditioned place preference in rats. Neurotherapeutics 2024; 21:e00328. [PMID: 38355360 PMCID: PMC10937235 DOI: 10.1016/j.neurot.2024.e00328] [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: 10/24/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
Methamphetamine (MA) use disorder poses significant challenges to both the affected individuals and society. Current non-drug therapies like transcranial direct-current stimulation and transcranial magnetic stimulation have limitations due to their invasive nature and limited reach to deeper brain areas. Transcranial focused ultrasound (FUS) is gaining attention as a noninvasive option with precise spatial targeting, able to affect deeper areas of the brain. This research focused on assessing the effectiveness of FUS in influencing the infralimbic cortex (IL) to prevent the recurrence of MA-seeking behavior, using the conditioned place preference (CPP) method in rats. The study involved twenty male Sprague-Dawley rats. Neuronal activation by FUS was first examined via electromyography (EMG). Rats received alternately with MA or saline, and confined to one of two distinctive compartments in a three compartment apparatus over a 4-day period. After CPP test, extinction, the first reinstatement, and extinction again, FUS was applied to IL prior to the second MA priming-induced reinstatement. Safety assessments were conducted through locomotor and histological function examinations. EMG data confirmed the effectiveness of FUS in activating neurons. Significant attenuation of reinstatement of MA CPP was found, along with successful targeting of the IL region, confirmed through acoustic field scanning, c-Fos immunohistochemistry, and Evans blue dye staining. No damage to brain tissue or impaired locomotor activity was observed. The results of the study indicate that applying FUS to the IL markedly reduced the recurrence of MA seeking behavior, without harming brain tissue or impairing motor skills. This suggests that FUS could be a promising method for treating MA use disorder, with the infralimbic cortex being an effective target for FUS in preventing MA relapse.
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Affiliation(s)
- Chia-Wei Lin
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Min-Hsuan Cheng
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Ching-Hsiang Fan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Hwei-Hsien Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan; Institute of Neuroscience, National Chengchi University, Taipei, Taiwan; Graduate Program for Aging, China Medical University, Taichung, Taiwan.
| | - Chih-Kuang Yeh
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.
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10
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Fan WY, Chen YM, Wang YF, Wang YQ, Hu JQ, Tang WX, Feng Y, Cheng Q, Xue L. L-Type Calcium Channel Modulates Low-Intensity Pulsed Ultrasound-Induced Excitation in Cultured Hippocampal Neurons. Neurosci Bull 2024:10.1007/s12264-024-01186-2. [PMID: 38498092 DOI: 10.1007/s12264-024-01186-2] [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: 07/06/2023] [Accepted: 12/06/2023] [Indexed: 03/19/2024] Open
Abstract
As a noninvasive technique, ultrasound stimulation is known to modulate neuronal activity both in vitro and in vivo. The latest explanation of this phenomenon is that the acoustic wave can activate the ion channels and further impact the electrophysiological properties of targeted neurons. However, the underlying mechanism of low-intensity pulsed ultrasound (LIPUS)-induced neuro-modulation effects is still unclear. Here, we characterize the excitatory effects of LIPUS on spontaneous activity and the intracellular Ca2+ homeostasis in cultured hippocampal neurons. By whole-cell patch clamp recording, we found that 15 min of 1-MHz LIPUS boosts the frequency of both spontaneous action potentials and spontaneous excitatory synaptic currents (sEPSCs) and also increases the amplitude of sEPSCs in hippocampal neurons. This phenomenon lasts for > 10 min after LIPUS exposure. Together with Ca2+ imaging, we clarified that LIPUS increases the [Ca2+]cyto level by facilitating L-type Ca2+ channels (LTCCs). In addition, due to the [Ca2+]cyto elevation by LIPUS exposure, the Ca2+-dependent CaMKII-CREB pathway can be activated within 30 min to further regulate the gene transcription and protein expression. Our work suggests that LIPUS regulates neuronal activity in a Ca2+-dependent manner via LTCCs. This may also explain the multi-activation effects of LIPUS beyond neurons. LIPUS stimulation potentiates spontaneous neuronal activity by increasing Ca2+ influx.
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Affiliation(s)
- Wen-Yong Fan
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, China
- Department of Physiology and Neurobiology, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Yi-Ming Chen
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, 200092, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, 200070, China
| | - Yi-Fan Wang
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, 200092, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, 200070, China
| | - Yu-Qi Wang
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, China
- Department of Physiology and Neurobiology, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Jia-Qi Hu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, China
- Department of Physiology and Neurobiology, School of Life Sciences, Fudan University, Shanghai, 200438, China
- Center for Rehabilitation Medicine, Department of Pain Management, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Wen-Xu Tang
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, China
- Department of Physiology and Neurobiology, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Yi Feng
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China
| | - Qian Cheng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, 200092, China.
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, 200070, China.
- Shanghai Research Institute for Intelligent Autonomous Systems, Tongji University, Shanghai, 201210, China.
| | - Lei Xue
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, China.
- Department of Physiology and Neurobiology, School of Life Sciences, Fudan University, Shanghai, 200438, China.
- Research Institute of Intelligent Complex Systems, Fudan University, Shanghai, 200433, China.
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11
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Mesik L, Parkins S, Severin D, Grier BD, Ewall G, Kotha S, Wesselborg C, Moreno C, Jaoui Y, Felder A, Huang B, Johnson MB, Harrigan TP, Knight AE, Lani SW, Lemaire T, Kirkwood A, Hwang GM, Lee HK. Transcranial Low-Intensity Focused Ultrasound Stimulation of the Visual Thalamus Produces Long-Term Depression of Thalamocortical Synapses in the Adult Visual Cortex. J Neurosci 2024; 44:e0784232024. [PMID: 38316559 PMCID: PMC10941064 DOI: 10.1523/jneurosci.0784-23.2024] [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: 04/30/2023] [Revised: 12/13/2023] [Accepted: 01/30/2024] [Indexed: 02/07/2024] Open
Abstract
Transcranial focused ultrasound stimulation (tFUS) is a noninvasive neuromodulation technique, which can penetrate deeper and modulate neural activity with a greater spatial resolution (on the order of millimeters) than currently available noninvasive brain stimulation methods, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). While there are several studies demonstrating the ability of tFUS to modulate neuronal activity, it is unclear whether it can be used for producing long-term plasticity as needed to modify circuit function, especially in adult brain circuits with limited plasticity such as the thalamocortical synapses. Here we demonstrate that transcranial low-intensity focused ultrasound (LIFU) stimulation of the visual thalamus (dorsal lateral geniculate nucleus, dLGN), a deep brain structure, leads to NMDA receptor (NMDAR)-dependent long-term depression of its synaptic transmission onto layer 4 neurons in the primary visual cortex (V1) of adult mice of both sexes. This change is not accompanied by large increases in neuronal activity, as visualized using the cFos Targeted Recombination in Active Populations (cFosTRAP2) mouse line, or activation of microglia, which was assessed with IBA-1 staining. Using a model (SONIC) based on the neuronal intramembrane cavitation excitation (NICE) theory of ultrasound neuromodulation, we find that the predicted activity pattern of dLGN neurons upon sonication is state-dependent with a range of activity that falls within the parameter space conducive for inducing long-term synaptic depression. Our results suggest that noninvasive transcranial LIFU stimulation has a potential for recovering long-term plasticity of thalamocortical synapses in the postcritical period adult brain.
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Affiliation(s)
- Lukas Mesik
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Samuel Parkins
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Cell Molecular Developmental Biology and Biophysics Graduate Program, Johns Hopkins University, Baltimore, Maryland 21218
| | - Daniel Severin
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
| | - Bryce D Grier
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Gabrielle Ewall
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Sumasri Kotha
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
| | - Christian Wesselborg
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Cell Molecular Developmental Biology and Biophysics Graduate Program, Johns Hopkins University, Baltimore, Maryland 21218
| | - Cristian Moreno
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
| | - Yanis Jaoui
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
| | - Adrianna Felder
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
| | - Brian Huang
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
| | - Marina B Johnson
- Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland 20723
| | - Timothy P Harrigan
- Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland 20723
| | - Anna E Knight
- Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland 20723
| | - Shane W Lani
- Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland 20723
| | - Théo Lemaire
- Neuroscience Institute, New York University Langone Health, New York, New York 10016
| | - Alfredo Kirkwood
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Grace M Hwang
- Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Johns Hopkins Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland 20723
| | - Hey-Kyoung Lee
- Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, Maryland 21218
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
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12
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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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13
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Wen Y, Lin M, Liu J, Tang J, Qi X. Low-intensity ultrasound activates transmembrane chloride flow through CFTR. Biochem Biophys Rep 2024; 37:101604. [PMID: 38188360 PMCID: PMC10767314 DOI: 10.1016/j.bbrep.2023.101604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Ultrasound has been demonstrated to activate mechanosensitive channels, which is considered the main mechanism of ultrasound neuromodulation. Currently, all channels that have been shown to be sensitive to ultrasound are cation channels. In addition to cation channels, anion channels also play indispensable roles in neural function. However, there have been no research on ultrasound regulation of anion channels until now. If anion channels can be activated by ultrasound as well, they will inevitably lead to more versatility in ultrasound neuromodulation. Cystic fibrosis transmembrane transduction regulator (CFTR) has been demonstrated to be a mechanically sensitive channel, mediating anionic transmembrane flow. To identify that CFTR is sensitive to ultrasound, CFTR was exogenously expressed in HEK293T cells and was stimulated by low intensity ultrasound. Outward currents in CFTR-expressed HEK293T cells were observed by using whole-cell patch clamp when ultrasound (0.8 MHz, 0.20 MPa) was delivered to these cells. These currents were abolished when the CFTR inhibitor (GlyH101) was applied to the solution or chloride ions was cleared from the solution. Meanwhile, the amplitude of these currents increased when the CFTR agonist (Forskolin) was applied. These results suggest that ultrasound stimuli can activate the CFTR to mediate transmembrane flowing of chloride ions at the single cell level. These findings may expand the application of ultrasound in the neuromodulation field.
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Affiliation(s)
- Yinchuan Wen
- Department of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China
| | - Manjia Lin
- Department of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China
| | - Jing Liu
- Department of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China
| | - Jie Tang
- Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xiaofei Qi
- Department of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China
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14
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Bao S, Kim H, Shettigar NB, Li Y, Lei Y. Personalized depth-specific neuromodulation of the human primary motor cortex via ultrasound. J Physiol 2024; 602:933-948. [PMID: 38358314 DOI: 10.1113/jp285613] [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: 08/31/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
Non-invasive brain stimulation has the potential to boost neuronal plasticity in the primary motor cortex (M1), but it remains unclear whether the stimulation of both superficial and deep layers of the human motor cortex can effectively promote M1 plasticity. Here, we leveraged transcranial ultrasound stimulation (TUS) to precisely target M1 circuits at depths of approximately 5 mm and 16 mm from the cortical surface. Initially, we generated computed tomography images from each participant's individual anatomical magnetic resonance images (MRI), which allowed for the generation of accurate acoustic simulations. This process ensured that personalized TUS was administered exactly to the targeted depths within M1 for each participant. Using long-term depression and long-term potentiation (LTD/LTP) theta-burst stimulation paradigms, we examined whether TUS over distinct depths of M1 could induce LTD/LTP plasticity. Our findings indicated that continuous theta-burst TUS-induced LTD-like plasticity with both superficial and deep M1 stimulation, persisting for at least 30 min. In comparison, sham TUS did not significantly alter M1 excitability. Moreover, intermittent theta-burst TUS did not result in the induction of LTP- or LTD-like plasticity with either superficial or deep M1 stimulation. These findings suggest that the induction of M1 plasticity can be achieved with ultrasound stimulation targeting distinct depths of M1, which is contingent on the characteristics of TUS. KEY POINTS: The study integrated personalized transcranial ultrasound stimulation (TUS) with electrophysiology to determine whether TUS targeting superficial and deep layers of the human motor cortex (M1) could elicit long-term depression (LTD) or long-term potentiation (LTP) plastic changes. Utilizing acoustic simulations derived from individualized pseudo-computed tomography scans, we ensured the precision of TUS delivery to the intended M1 depths for each participant. Continuous theta-burst TUS targeting both the superficial and deep layers of M1 resulted in the emergence of LTD-like plasticity, lasting for at least 30 min. Administering intermittent theta-burst TUS to both the superficial and deep layers of M1 did not lead to the induction of LTP- or LTD-like plastic changes. We suggest that theta-burst TUS targeting distinct depths of M1 can induce plasticity, but this effect is dependent on specific TUS parameters.
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Affiliation(s)
- Shancheng Bao
- Program of Motor Neuroscience, Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas, USA
| | - Hakjoo Kim
- Program of Motor Neuroscience, Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas, USA
| | - Nandan B Shettigar
- Program of Motor Neuroscience, Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas, USA
- Department of Mechanical Engineering, Texas A&M University, College Station, Texas, USA
| | - Yue Li
- Department of Neuroscience & Experimental Therapeutics, Texas A&M University, College Station, Texas, USA
| | - Yuming Lei
- Program of Motor Neuroscience, Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas, USA
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15
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Riis TS, Losser AJ, Kassavetis P, Moretti P, Kubanek J. Noninvasive modulation of essential tremor with focused ultrasonic waves. J Neural Eng 2024; 21:016033. [PMID: 38335553 DOI: 10.1088/1741-2552/ad27ef] [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: 10/25/2023] [Accepted: 02/09/2024] [Indexed: 02/12/2024]
Abstract
Objective: Transcranial focused low-intensity ultrasound has the potential to noninvasively modulate confined regions deep inside the human brain, which could provide a new tool for causal interrogation of circuit function in humans. However, it has been unclear whether the approach is potent enough to modulate behavior.Approach: To test this, we applied low-intensity ultrasound to a deep brain thalamic target, the ventral intermediate nucleus, in three patients with essential tremor.Main results: Brief, 15 s stimulations of the target at 10% duty cycle with low-intensity ultrasound, repeated less than 30 times over a period of 90 min, nearly abolished tremor (98% and 97% tremor amplitude reduction) in 2 out of 3 patients. The effect was observed within seconds of the stimulation onset and increased with ultrasound exposure time. The effect gradually vanished following the stimulation, suggesting that the stimulation was safe with no harmful long-term consequences detected.Significance: This result demonstrates that low-intensity focused ultrasound can robustly modulate deep brain regions in humans with notable effects on overt motor behavior.
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Affiliation(s)
- Thomas S Riis
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, United States of America
| | - Adam J Losser
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, United States of America
| | - Panagiotis Kassavetis
- Department of Neurology, University of Utah, Salt Lake City, UT 84132, United States of America
| | - Paolo Moretti
- Department of Neurology, University of Utah, Salt Lake City, UT 84132, United States of America
- George E. Wahlen, VA, Salt Lake City Health Care System, Salt Lake City, UT 84148, United States of America
| | - Jan Kubanek
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, United States of America
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16
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Shen Y, Jethe JV, Hehir J, Amaral MM, Ren C, Hao S, Zhou C, Fisher JAN. Label free, capillary-scale blood flow mapping in vivo reveals that low intensity focused ultrasound evokes persistent dilation in cortical microvasculature. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.08.579513. [PMID: 38370686 PMCID: PMC10871316 DOI: 10.1101/2024.02.08.579513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Non-invasive, low intensity focused ultrasound (FUS) is an emerging neuromodulation technique that offers the potential for precision, personalized therapy. An increasing body of research has identified mechanosensitive ion channels that can be modulated by FUS and support acute electrical activity in neurons. However, neuromodulatory effects that persist from hours to days have also been reported. The brain's ability to provide targeted blood flow to electrically active regions involve a multitude of non-neuronal cell types and signaling pathways in the cerebral vasculature; an open question is whether persistent effects can be attributed, at least partly, to vascular mechanisms. Using a novel in vivo optical approach, we found that microvascular responses, unlike larger vessels which prior investigations have explored, exhibit persistent dilation. This finding and approach offers a heretofore unseen aspect of the effects of FUS in vivo and indicate that concurrent changes in neurovascular function may partially underly persistent neuromodulatory effects.
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17
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Legon W, Strohman A, In A, Payne B. Noninvasive neuromodulation of subregions of the human insula differentially affect pain processing and heart-rate variability: a within-subjects pseudo-randomized trial. Pain 2024:00006396-990000000-00514. [PMID: 38314779 DOI: 10.1097/j.pain.0000000000003171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/26/2023] [Indexed: 02/07/2024]
Abstract
ABSTRACT The insula is an intriguing target for pain modulation. Unfortunately, it lies deep to the cortex making spatially specific noninvasive access difficult. Here, we leverage the high spatial resolution and deep penetration depth of low-intensity focused ultrasound (LIFU) to nonsurgically modulate the anterior insula (AI) or posterior insula (PI) in humans for effect on subjective pain ratings, electroencephalographic (EEG) contact heat-evoked potentials, as well as autonomic measures including heart-rate variability (HRV). In a within-subjects, repeated-measures, pseudo-randomized trial design, 23 healthy volunteers received brief noxious heat pain stimuli to the dorsum of their right hand during continuous heart-rate, electrodermal, electrocardiography and EEG recording. Low-intensity focused ultrasound was delivered to the AI (anterior short gyrus), PI (posterior longus gyrus), or under an inert Sham condition. The primary outcome measure was pain rating. Low-intensity focused ultrasound to both AI and PI similarly reduced pain ratings but had differential effects on EEG activity. Low-intensity focused ultrasound to PI affected earlier EEG amplitudes, whereas LIFU to AI affected later EEG amplitudes. Only LIFU to the AI affected HRV as indexed by an increase in SD of N-N intervals and mean HRV low-frequency power. Taken together, LIFU is an effective noninvasive method to individually target subregions of the insula in humans for site-specific effects on brain biomarkers of pain processing and autonomic reactivity that translates to reduced perceived pain to a transient heat stimulus.
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Affiliation(s)
- Wynn Legon
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
- Center for Human Neuroscience Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
| | - Andrew Strohman
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, United States
| | - Alexander In
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
| | - Brighton Payne
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
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18
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Liu J, You Q, Liang F, Ma L, Zhu L, Wang C, Yang Y. Ultrasound-nanovesicles interplay for theranostics. Adv Drug Deliv Rev 2024; 205:115176. [PMID: 38199256 DOI: 10.1016/j.addr.2023.115176] [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: 12/04/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024]
Abstract
Nanovesicles (NVs) are widely used in the treatment and diagnosis of diseases due to their excellent vascular permeability, good biocompatibility, high loading capacity, and easy functionalization. However, their yield and in vivo penetration depth limitations and their complex preparation processes still constrain their application and development. Ultrasound, as a fundamental external stimulus with deep tissue penetration, concentrated energy sources, and good safety, has been proven to be a patient-friendly and highly efficient strategy to overcome the restrictions of traditional clinical medicine. Recent research has shown that ultrasound can drive the generation of NVs, increase their yield, simplify their preparation process, and provide direct therapeutic effects and intelligent control to enhance the therapeutic effect of NVs. In addition, NVs, as excellent drug carriers, can enhance the targeting efficiency of ultrasound-based sonodynamic therapy or sonogenetic regulation and improve the accuracy of ultrasound imaging. This review provides a detailed introduction to the classification, generation, and modification strategies of NVs, emphasizing the impact of ultrasound on the formation of NVs and summarizing the enhanced treatment and diagnostic effects of NVs combined with ultrasound for various diseases.
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Affiliation(s)
- Jingyi Liu
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Qing You
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Fuming Liang
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China; Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Lilusi Ma
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ling Zhu
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Chen Wang
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Yanlian Yang
- CAS Key Laboratory of Standardization and Measurement for Nanotechnology, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China; University of Chinese Academy of Sciences, Beijing 100049, China.
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19
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Yu K, Schmitt S, Ni Y, Crane EC, Smith MA, He B. Transcranial Focused Ultrasound Remotely Modulates Extrastriate Visual Cortex with Subregion Specificity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.20.576476. [PMID: 38328120 PMCID: PMC10849517 DOI: 10.1101/2024.01.20.576476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Low-intensity transcranial focused ultrasound (tFUS) has emerged as a powerful neuromodulation tool characterized by its deep penetration and precise spatial targeting to influence neural activity. Our study directed low-intensity tFUS stimulation onto a region of prefrontal cortex (the frontal eye field, or FEF) of a rhesus macaque to examine its impact on a remote site, the extrastriate visual cortex (area V4). This pair of cortical regions form a top-down modulatory circuit that has been studied extensively with electrical microstimulation. To measure the impact of tFUS stimulation, we recorded local field potentials (LFPs) and multi-unit spiking activities from a multi-electrode array implanted in the visual cortex. To deliver tFUS stimulation, we leveraged a customized 128-element random array ultrasound transducer with improved spatial targeting. We observed that tFUS stimulation in FEF produced modulation of V4 neuronal activity, either through enhancement or suppression, dependent on the pulse repetition frequency of the tFUS stimulation. Electronically steering the transcranial ultrasound focus through the targeted FEF cortical region produced changes in the level of modulation, indicating that the tFUS stimulation was spatially targeted within FEF. Modulation of V4 activity was confined to specific frequency bands, and this modulation was dependent on the presence or absence of a visual stimulus during tFUS stimulation. A control study targeting the insula produced no effect, emphasizing the region-specific nature of tFUS neuromodulation. Our findings shed light on the capacity of tFUS to modulate specific neural pathways and provide a comprehensive understanding of its potential applications for neuromodulation within brain networks.
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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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21
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Hwang S, Jun SB. Ultrasound neuromodulation of cultured hippocampal neurons. Biomed Eng Lett 2024; 14:79-89. [PMID: 38186947 PMCID: PMC10769976 DOI: 10.1007/s13534-023-00314-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/24/2023] [Accepted: 08/14/2023] [Indexed: 01/09/2024] Open
Abstract
Ultrasound is becoming an emerging and promising method for neuromodulation due to its advantage of noninvasiveness and its high spatial resolution. However, the underlying principles of ultrasound neuromodulation have not yet been elucidated. We have herein developed a new in vitro setup to study the ultrasonic neuromodulation, and examined various parameters of ultrasound to verify the effective conditions to evoke the neural activity. Neurons were stimulated with 0.5 MHz center frequency ultrasound, and the action potentials were recorded from rat hippocampal neural cells cultured on microelectrode arrays. As the intensity of ultrasound increased, the neuronal activity also increased. There was a notable and significant increase in both the spike rate and the number of bursts at 50% duty cycle, 1 kHz pulse repetition frequency, and the acoustic intensities of 7.6 W/cm2 and 3.8 W/cm2 in terms of spatial-peak pulse-average intensity and spatial-peak temporal-average intensity, respectively. In addition, the impact of ultrasonic neuromodulation was assessed in the presence of a gamma-aminobutyric acid A (GABAA) receptor antagonist to exclude the effect of activated inhibitory neurons. Interestingly, it is noteworthy that the predominant neuromodulatory effects of ultrasound disappeared when the GABAA blocker was introduced, suggesting the potential of ultrasonic stimulation specifically targeting inhibitory neurons. The experimental setup proposed herein could serve as a useful tool for the clarification of the mechanisms underlying the electrophysiological effects of ultrasound.
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Affiliation(s)
- Seoyoung Hwang
- Department of Electronic and Electrical Engineering, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760 Republic of Korea
- Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Beom Jun
- Department of Electronic and Electrical Engineering, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760 Republic of Korea
- Graduate Program in Smart Factory, Ewha Womans University, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, Republic of Korea
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22
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Guo H, Salahshoor H, Wu D, Yoo S, Sato T, Tsao DY, Shapiro MG. Effects of focused ultrasound in a "clean" mouse model of ultrasonic neuromodulation. iScience 2023; 26:108372. [PMID: 38047084 PMCID: PMC10690554 DOI: 10.1016/j.isci.2023.108372] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Recent studies on ultrasonic neuromodulation (UNM) in rodents have shown that focused ultrasound (FUS) can activate peripheral auditory pathways, leading to off-target and brain-wide excitation, which obscures the direct activation of the target area by FUS. To address this issue, we developed a new mouse model, the double transgenic Pou4f3+/DTR × Thy1-GCaMP6s, which allows for inducible deafening using diphtheria toxin and minimizes off-target effects of UNM while allowing effects on neural activity to be visualized with fluorescent calcium imaging. Using this model, we found that the auditory confounds caused by FUS can be significantly reduced or eliminated within a certain pressure range. At higher pressures, FUS can result in focal fluorescence dips at the target, elicit non-auditory sensory confounds, and damage tissue, leading to spreading depolarization. Under the acoustic conditions we tested, we did not observe direct calcium responses in the mouse cortex. Our findings provide a cleaner animal model for UNM and sonogenetics research, establish a parameter range within which off-target effects are confidently avoided, and reveal the non-auditory side effects of higher-pressure stimulation.
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Affiliation(s)
- Hongsun Guo
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Hossein Salahshoor
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
- Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA 91125, USA
| | - Di Wu
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Sangjin Yoo
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Tomokazu Sato
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Doris Y. Tsao
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
- Howard Hughes Medical Institute, Pasadena, CA 91125, USA
| | - Mikhail G. Shapiro
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
- Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA 91125, USA
- Howard Hughes Medical Institute, Pasadena, CA 91125, USA
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23
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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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24
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Badawe HM, El Hassan RH, Khraiche ML. Modeling ultrasound modulation of neural function in a single cell. Heliyon 2023; 9:e22522. [PMID: 38046165 PMCID: PMC10686887 DOI: 10.1016/j.heliyon.2023.e22522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/10/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023] Open
Abstract
Background Low intensity ultrasound stimulation has been shown to non-invasively modulate neural function in the central nervous system (CNS) and peripheral nervous system (PNS) with high precision. Ultrasound sonication is capable of either excitation or inhibition, depending on the ultrasound parameters used. On the other hand, the mode of interaction of ultrasonic waves with the neural tissue for effective neuromodulation remains ambiguous. New method Here within we propose a numerical model that incorporates the mechanical effects of ultrasound stimulation on the Hodgkin-Huxley (HH) neuron by incorporating the relation between increased external pressure and the membrane induced tension, with a stress on the flexoelectric effect on the neural membrane. The external pressure causes an increase in the total tension of the membrane thus affecting the probability of the ion channels being open after the conformational changes that those channels undergo. Results The interplay between varying the acoustic intensities and frequencies depicts different action potential suppression rates, whereby a combination of low intensity and low frequency ultrasound sonication proved to be the most effective in modulating neural function.Comparison with Existing Methods: Our method solely depends on the HH model of a single neuron and the linear flexoelectric effect of the dielectric neural membrane, when under an ultrasound-induced mechanical strain, while varying the ion-channels conductances based on different sonication frequencies and intensities. We study the effect of ultrasound parameters on the firing rate, latency, and action potential amplitude of a HH neuron for a better understanding of the neuromodulation modality of ultrasound stimulation (in the continuous and pulsed modes). Conclusions This simulation work confirms the published experimental data that low intensity and low frequency ultrasound sonication has a higher success rate of modulating neural firing.
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Affiliation(s)
- Heba M. Badawe
- Neural Engineering and Nanobiosensors Group, Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Rima H. El Hassan
- Neural Engineering and Nanobiosensors Group, Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Massoud L. Khraiche
- Neural Engineering and Nanobiosensors Group, Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
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25
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AIUM Official Statement for the Statement on Biological Effects of Therapeutic Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:E68-E73. [PMID: 37584480 DOI: 10.1002/jum.16315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
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26
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Schafer SF, Croke H, Kriete A, Ayaz H, Lewin PA, von Reyn CR, Schafer ME. A Miniature Ultrasound Source for Neural Modulation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1544-1553. [PMID: 37812556 PMCID: PMC10751802 DOI: 10.1109/tuffc.2023.3322963] [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] [Indexed: 10/11/2023]
Abstract
This work describes a unique ultrasound (US) exposure system designed to create very localized ( [Formula: see text]) sound fields at operating frequencies that are currently being used for preclinical US neuromodulation. This system can expose small clusters of neuronal tissue, such as cell cultures or intact brain structures in target animal models, opening up opportunities to examine possible mechanisms of action. We modified a dental descaler and drove it at a resonance frequency of 96 kHz, well above its nominal operating point of 28 kHz. A ceramic microtip from an ultrasonic wire bonder was attached to the end of the applicator, creating a 100- [Formula: see text] point source. The device was calibrated with a polyvinylidene difluoride (PVDF) membrane hydrophone, in a novel, air-backed, configuration. The experimental results were confirmed by simulation using a monopole model. The results show a consistent decaying sound field from the tip, well-suited to neural stimulation. The system was tested on an existing neurological model, Drosophila melanogaster, which has not previously been used for US neuromodulation experiments. The results show brain-directed US stimulation induces or suppresses motor actions, demonstrated through synchronized tracking of fly limb movements. These results provide the basis for ongoing and future studies of US interaction with neuronal tissue, both at the level of single neurons and intact organisms.
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27
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Bian N, Long A, Yuan Y. Desynchronization of neuronal firing in multiparameter ultrasound stimulation. Biomed Phys Eng Express 2023; 9:065023. [PMID: 37820600 DOI: 10.1088/2057-1976/ad023f] [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: 06/23/2023] [Accepted: 10/11/2023] [Indexed: 10/13/2023]
Abstract
Low-intensity transcranial ultrasound stimulation, a novel neuromodulation technique, that possesses the advantages of non-invasiveness, high penetration depth, and high spatial resolution, has achieved positive neuromodulation effects in animal studies. But the regulatory mechanism remains controversial. The intramembrane cavitation effect is considered one of the mechanisms for ultrasound neuromodulation. In this study, the modified equations of ultrasonic cavitation bubble dynamics were coupled with the dual-coupled neuron Hindmarsh-Rose model, small-world neural network model, and the Jansen-Rit neural mass model, which simulate simple coupled neurons, complex neuronal networks, and discharge signals in epileptic disorders respectively. The results demonstrated that ultrasound stimulation has an appreciable modulatory effect on neuronal firing desynchronization in Hindmarsh-Rose model and small-world neural network model. The desynchronization effect is related to the stimulation frequency and intensity. Furthermore, ultrasound stimulation has an inhibitory effect on epileptic seizures, and the effect is enhanced by increasing ultrasound frequency from 0.1-1.0 MHz. This is the first combination of ultrasonic intramembrane cavitation effect theory with neurons and neural network firing desynchronization, which can provide guidance of parametric and theories support for the studies of neurological diseases such as epilepsy and Parkinson's disease.
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Affiliation(s)
- Nannan Bian
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Ai Long
- Xiangtan Big Data and Industrial Innovation Development Center, Xiangtan 411104, People's Republic of China
| | - Yi Yuan
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China
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28
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Lee K, Lee JM, Phan TT, Lee CJ, Park JM, Park J. Ultrasonocoverslip: In-vitro platform for high-throughput assay of cell type-specific neuromodulation with ultra-low-intensity ultrasound stimulation. Brain Stimul 2023; 16:1533-1548. [PMID: 37909109 DOI: 10.1016/j.brs.2023.08.002] [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: 04/19/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 11/02/2023] Open
Abstract
Brain stimulation with ultra-low-intensity ultrasound has rarely been investigated due to the lack of a reliable device to measure small neuronal signal changes made by the ultra-low intensity range. We propose Ultrasonocoverslip, an ultrasound-transducer-integrated-glass-coverslip that determines the minimum intensity for brain cell activation. Brain cells can be cultured directly on Ultrasonocoverslip to simultaneously deliver uniform ultrasonic pressure to hundreds of cells with real-time monitoring of cellular responses using fluorescence microscopy and single-cell electrophysiology. The sensitivity for detecting small responses to ultra-low-intensity ultrasound can be improved by averaging simultaneously obtained responses. Acoustic absorbers can be placed under Ultrasonocoverslip, and stimuli distortions are substantially reduced to precisely deliver user-intended acoustic stimulations. With the proposed device, we discover the lowest acoustic threshold to induce reliable neuronal excitation releasing glutamate. Furthermore, mechanistic studies on the device show that the ultra-low-intensity ultrasound stimulation induces cell type-specific neuromodulation by activating astrocyte-mediated neuronal excitation without direct neuronal involvement. The performance of ultra-low-intensity stimulation is validated by in vivo experiments demonstrating improved safety and specificity in motor modulation of tail movement compared to that with supra-watt-intensity.
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Affiliation(s)
- Keunhyung Lee
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jung Moo Lee
- Center for Cognition and Sociality, Institute for Basic Science, Daejeon, Republic of Korea
| | - Tien Thuy Phan
- IBS School, University of Science and Technology (UST), Daejeon, Republic of Korea
| | - C Justin Lee
- Center for Cognition and Sociality, Institute for Basic Science, Daejeon, Republic of Korea
| | - Joo Min Park
- Center for Cognition and Sociality, Institute for Basic Science, Daejeon, Republic of Korea; IBS School, University of Science and Technology (UST), Daejeon, Republic of Korea.
| | - Jinhyoung Park
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea; Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
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29
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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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30
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Liu M, Yuan Y, Wang X, Wang T, Bian N, Zhao L, Cui G, Liu W, Ma Z, Yang X, Liang S, Liu Z. Low-intensity transcranial ultrasound stimulation modulates neural activities in mice under propofol anaesthesia. BMC Neurosci 2023; 24:48. [PMID: 37648991 PMCID: PMC10466774 DOI: 10.1186/s12868-023-00817-0] [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: 12/14/2022] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Previous studies have reported that transcranial focused ultrasound stimulation can significantly decrease the time to emergence from intraperitoneal ketamine-xylazine anaesthesia in rats. However, how transcranial focused ultrasound stimulation modulates neural activity in anaesthetized rats is unclear. METHODS In this study, to answer this question, we used low-intensity transcranial ultrasound stimulation (TUS) to stimulate the brain tissue of propofol-anaesthetized mice, recorded local field potentials (LFPs) in the mouse motor cortex and electromyography (EMG) signals from the mouse neck, and analysed the emergence and recovery time, mean absolute power, relative power and entropy of local field potentials. RESULTS We found that the time to emergence from anaesthesia in the TUS group (20.3 ± 1.7 min) was significantly less than that in the Sham group (32 ± 2.6 min). We also found that compared with the Sham group, 20 min after low-intensity TUS during recovery from anaesthesia, (1) the absolute power of local field potentials in mice was significantly reduced in the [1-4 Hz] and [13-30 Hz] frequency bands and significantly increased in the [55-100 Hz], [100-140 Hz] and [140-200 Hz] frequency bands; (2) the relative power of local field potentials in mice was enhanced at [30-45 Hz], [100-140 Hz] and [140-200 Hz] frequency bands; (3) the entropy of local field potentials ([1-200 Hz]) was increased. CONCLUSION These results demonstrate that low-intensity TUS can effectively modulate neural activities in both awake and anaesthetized mice and has a positive effect on recovery from propofol anaesthesia in mice.
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Affiliation(s)
- Meiqi Liu
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Yi Yuan
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Xingran Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Teng Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Nannan Bian
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Li Zhao
- Department of Thoracic Surgery, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Guangying Cui
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Wenchao Liu
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Zhongfeng Ma
- Department of General Surgery, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Xiaochun Yang
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Shujuan Liang
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Zhuo Liu
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China.
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31
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Fan B, Goodman W, Cho RY, Sheth SA, Bouchard RR, Aazhang B. Computational modeling and minimization of unintended neuronal excitation in a LIFU stimulation. Sci Rep 2023; 13:13403. [PMID: 37591991 PMCID: PMC10435497 DOI: 10.1038/s41598-023-40522-w] [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: 02/09/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023] Open
Abstract
The neuromodulation effect of low-intensity focused ultrasound (LIFU) is highly target-specific. Unintended off-target neuronal excitation can be elicited when the beam focusing accuracy and resolution are limited, whereas the resulted side effect has not been evaluated quantitatively. There is also a lack of methods addressing the minimization of such side effects. Therefore, this work introduces a computational model of unintended neuronal excitation during LIFU neuromodulation, which evaluates the off-target activation area (OTAA) by integrating an ultrasound field model with the neuronal spiking model. In addition, a phased array beam focusing scheme called constrained optimal resolution beamforming (CORB) is proposed to minimize the off-target neuronal excitation area while ensuring effective stimulation in the target brain region. A lower bound of the OTAA is analytically approximated in a simplified homogeneous medium, which could guide the selection of transducer parameters such as aperture size and operating frequency. Simulations in a human head model using three transducer setups show that CORB markedly reduces the OTAA compared with two benchmark beam focusing methods. The high neuromodulation resolution demonstrates the capability of LIFU to effectively limit the side effects during neuromodulation, allowing future clinical applications such as treatment of neuropsychiatric disorders.
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Affiliation(s)
- Boqiang Fan
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77005, USA.
| | - Wayne Goodman
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77005, USA
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Sameer A Sheth
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77005, USA
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Richard R Bouchard
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Behnaam Aazhang
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77005, USA
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32
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Kubanek J, Wilson M, Rabbitt RD, Armstrong CJ, Farley AJ, Ullah HMA, Shcheglovitov A. Stem cell-derived brain organoids for controlled studies of transcranial neuromodulation. Heliyon 2023; 9:e18482. [PMID: 37576248 PMCID: PMC10412769 DOI: 10.1016/j.heliyon.2023.e18482] [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: 07/24/2022] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Transcranial neuromodulation methods have the potential to diagnose and treat brain disorders at their neural source in a personalized manner. However, it has been difficult to investigate the direct effects of transcranial neuromodulation on neurons in human brain tissue. Here, we show that human brain organoids provide a detailed and artifact-free window into neuromodulation-evoked electrophysiological effects. We derived human cortical organoids from induced pluripotent stem cells and implanted 32-channel electrode arrays. Each organoid was positioned in the center of the human skull and subjected to low-intensity transcranial focused ultrasound. We found that ultrasonic stimuli modulated network activity in the gamma and delta ranges of the frequency spectrum. The effects on the neural networks were a function of the ultrasound stimulation frequency. High gamma activity remained elevated for at least 20 minutes following stimulation offset. This approach is expected to provide controlled studies of the effects of ultrasound and other transcranial neuromodulation modalities on human brain tissue.
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Affiliation(s)
- Jan Kubanek
- University of Utah, Department of Biomedical Engineering, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America
| | - Matthew Wilson
- University of Utah, Department of Biomedical Engineering, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America
| | - Richard D. Rabbitt
- University of Utah, Department of Biomedical Engineering, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America
| | - Celeste J. Armstrong
- University of Utah, Department of Neurobiology, 20 South 2030 East, Salt Lake City, UT 84112, United States of America
| | - Alexander J. Farley
- University of Utah, Department of Biomedical Engineering, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America
| | - H. M. Arif Ullah
- University of Utah, Department of Neurobiology, 20 South 2030 East, Salt Lake City, UT 84112, United States of America
| | - Alex Shcheglovitov
- University of Utah, Department of Neurobiology, 20 South 2030 East, Salt Lake City, UT 84112, United States of America
- University of Utah, Department of Biomedical Engineering, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America
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Seo J, Shin H, Cho S, Lee S, Ryu W, Han SC, Kim DH, Kang GH. A phased array ultrasound system with a robotic arm for neuromodulation. Med Eng Phys 2023; 118:104023. [PMID: 37536829 DOI: 10.1016/j.medengphy.2023.104023] [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: 02/24/2023] [Revised: 07/09/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Ultrasonic neuromodulation (UNMOD) provides a non-invasive brain stimulation. However, the high-resolution region-specificity of UNMOD with a single element transducer combined with a mechanical positioning system could have limits due to the intrinsic positioning error from mechanical systems. OBJECTIVE/HYPOTHESIS A phased array system could lead to highly selective neuromodulation with electronic control. METHODS A specialized phased-array system with a robotic arm is implemented for a rhesus monkey model. Various primary motor cortex areas related to tail, hand, and mouth were stimulated with a 200 μm step size. The ultrasonic parameters were ISPTA of 840 mW/cm2, pulse repetition frequency of 100 Hz, and a 5% duty factor at 600 kHz. The induced movement were recorded and analyzed. RESULTS Separate digits, mouth, and tongue motions were successfully induced by electronically controlling the focus. The identical body part movement could be induced when the focus was moved back to the identical primary motor cortex with electronic control. Accordingly, the reproducibility of UNMOD could be partially validated with rhesus monkey model. CONCLUSION A phased-array system appears to have a potential for the non-invasive and region-selective neuromodulation method.
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Affiliation(s)
- Jongbum Seo
- Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Korea.
| | - Hyunsoo Shin
- School of Electrical Engineering, Hanyang University (ERICA Campus), Ansan Gyeonggi-do, Korea
| | - Sungtaek Cho
- School of Electrical Engineering, Hanyang University (ERICA Campus), Ansan Gyeonggi-do, Korea
| | - Sungon Lee
- School of Electrical Engineering, Hanyang University (ERICA Campus), Ansan Gyeonggi-do, Korea
| | - Wooseok Ryu
- School of Mechanical Engineering, Yonsei University, Seoul, Korea
| | - Su-Cheol Han
- Jeonbuk Department of Inhalation Research, KIT, KRICT, Korea
| | - Da Hee Kim
- Jeonbuk Department of Inhalation Research, KIT, KRICT, Korea
| | - Goo Hwa Kang
- Jeonbuk Department of Inhalation Research, KIT, KRICT, Korea
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Ferreira Felloni Borges Y, Cheyuo C, Lozano AM, Fasano A. Essential Tremor - Deep Brain Stimulation vs. Focused Ultrasound. Expert Rev Neurother 2023; 23:603-619. [PMID: 37288812 DOI: 10.1080/14737175.2023.2221789] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/01/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Essential Tremor (ET) is one of the most common tremor syndromes typically presented as action tremor, affecting mainly the upper limbs. In at least 30-50% of patients, tremor interferes with quality of life, does not respond to first-line therapies and/or intolerable adverse effects may occur. Therefore, surgery may be considered. AREAS COVERED In this review, the authors discuss and compare unilateral ventral intermedius nucleus deep brain stimulation (VIM DBS) and bilateral DBS with Magnetic Resonance-guided Focused Ultrasound (MRgFUS) thalamotomy, which comprises focused acoustic energy generating ablation under real-time MRI guidance. Discussion includes their impact on tremor reduction and their potential complications. Finally, the authors provide their expert opinion. EXPERT OPINION DBS is adjustable, potentially reversible and allows bilateral treatments; however, it is invasive requires hardware implantation, and has higher surgical risks. Instead, MRgFUS is less invasive, less expensive, and requires no hardware maintenance. Beyond these technical differences, the decision should also involve the patient, family, and caregivers.
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Affiliation(s)
- Yuri Ferreira Felloni Borges
- Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, University of Toronto, Toronto, ON, Canada
| | - Cletus Cheyuo
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, Toronto, ON, Canada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
- Department of Parkinson's Disease & Movement Disorders Rehabilitation, Moriggia-Pelascini Hospital, Gravedona Ed Uniti, Como, Italy
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Tsehay Y, Zeng Y, Weber-Levine C, Awosika T, Kerensky M, Hersh AM, Ou Z, Jiang K, Bhimreddy M, Bauer SJ, Theodore JN, Quiroz VM, Suk I, Alomari S, Sun J, Tong S, Thakor N, Doloff JC, Theodore N, Manbachi A. Low-Intensity Pulsed Ultrasound Neuromodulation of a Rodent's Spinal Cord Suppresses Motor Evoked Potentials. IEEE Trans Biomed Eng 2023; 70:1992-2001. [PMID: 37018313 PMCID: PMC10510849 DOI: 10.1109/tbme.2022.3233345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Here we investigate the ability of low-intensity ultrasound (LIUS) applied to the spinal cord to modulate the transmission of motor signals. METHODS Male adult Sprague-Dawley rats (n = 10, 250-300 g, 15 weeks old) were used in this study. Anesthesia was initially induced with 2% isoflurane carried by oxygen at 4 L/min via a nose cone. Cranial, upper extremity, and lower extremity electrodes were placed. A thoracic laminectomy was performed to expose the spinal cord at the T11 and T12 vertebral levels. A LIUS transducer was coupled to the exposed spinal cord, and motor evoked potentials (MEPs) were acquired each minute for either 5- or 10-minutes of sonication. Following the sonication period, the ultrasound was turned off and post-sonication MEPs were acquired for an additional 5 minutes. RESULTS Hindlimb MEP amplitude significantly decreased during sonication in both the 5- (p < 0.001) and 10-min (p = 0.004) cohorts with a corresponding gradual recovery to baseline. Forelimb MEP amplitude did not demonstrate any statistically significant changes during sonication in either the 5- (p = 0.46) or 10-min (p = 0.80) trials. CONCLUSION LIUS applied to the spinal cord suppresses MEP signals caudal to the site of sonication, with recovery of MEPs to baseline after sonication. SIGNIFICANCE LIUS can suppress motor signals in the spinal cord and may be useful in treating movement disorders driven by excessive excitation of spinal neurons.
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Brinker ST, Yoon K, Benveniste H. Global sonication of the human intracranial space via a jumbo planar transducer. ULTRASONICS 2023; 134:107062. [PMID: 37343366 DOI: 10.1016/j.ultras.2023.107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023]
Abstract
Contrary to conditioning a Focused Ultrasound (FUS) beam to sonicate a localized region of the human brain, the goal of this investigation was to explore the prospect of distributing homogeneous ultrasound energy over the entire brain space with a large cranium-wide ultrasound beam. Recent ultrasound preclincal studies utilizing large or whole brain stimulation regions create a demand for expanding the treatment envelope of transcranial pulsed-low intensity ultrasound towards Global Brain Sonication (GBS) for potential human investigation. Here, we conduct ultrasound field characterizations when transmitting pulsed ultrasound through human skull specimens using a 1-3 piezocomposite planar transducer operating at 464 kHz with an active single-element surface of 30 × 30 cm. Through computational simulation and hydrophone scanning methodology, ultrasound wave behavior and dose homogeneity in the brain space were evaluated under various trajectories of sonication using the planar transducer. Clinically relevant pulse parameters used for transcranial therapeutic ultrasound applications were used in the experiments. Simulations and empirical testing revealed that dose homogeneity and acoustic intensity over the brain space are influenced by sonication trajectory, skull lens effects, and acoustic wave reflections. The transducer can emit a spatial peak pulse average intensity of 4.03 W/cm2 (0.24 MPa) measured in the free-field at 464 kHz with electrical power of 1 kW. The simulation showed that approximately 99 % of the cranial volume was exposed with <30 % of the maximum external acoustic intensity being transmitted into the skull. The transmission loss across all sonication trajectories is similar to previously reported FUS studies. A marker for GBS dose homogeneity is introduced to score the ultrasound pressure field uniformity in the intracranial space. Results of this study identify the initial challenges of exposing the entire human brain space with ultrasound using a large cranium-wide sonication beam intended for global brain therapeutic modulation.
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Affiliation(s)
- Spencer T Brinker
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.
| | - Kyungho Yoon
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul, South Korea
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, 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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Strohman A, In A, Stebbins K, Legon W. Evaluation of a Novel Acoustic Coupling Medium for Human Low-Intensity Focused Ultrasound Neuromodulation Applications. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1422-1430. [PMID: 36889994 DOI: 10.1016/j.ultrasmedbio.2023.02.003] [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: 10/24/2022] [Revised: 01/19/2023] [Accepted: 02/07/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Single-element low-intensity focused ultrasound (LIFU) is an emerging form of human neuromodulation. Current coupling methods are impractical for clinical bedside use. Here, we evaluate commercially available high-viscosity gel polymer matrices as couplants for human LIFU neuromodulation applications. METHODS We first empirically tested the acoustic transmission of three densities at 500 kHz and then subjected the gel with the least acoustic attenuation to further tests of the effect of thickness, frequency, de-gassing and production variability. RESULTS The highest-density gel had the lowest acoustic attenuation (3.3%) with low lateral (<0.5 mm) and axial (<2 mm) beam distortion. Different thicknesses of the gel up to 10 mm did not appreciably affect results. The gel polymers exhibited frequency-dependent attenuation at 1 and 3 MHz up to 86.6%, as well as significant beam distortion >4 mm. Poor de-gassing methods also increased pressure attenuation at 500 kHz up to 59.6%. Standardized methods of making these gels should be established to reduce variability. CONCLUSION Commercially available de-gassed, high-density gel matrices are a low-cost, easily malleable, low-attenuation and distortion medium for the coupling of single-element LIFU transducers for human neuromodulation applications at 500 kHz.
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Affiliation(s)
- Andrew Strohman
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, USA.
| | - Alexander In
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Katelyn Stebbins
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, USA
| | - Wynn Legon
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Center for Human Neuroscience Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Guo H, Salahshoor H, Wu D, Yoo S, Sato T, Tsao DY, Shapiro MG. Effects of focused ultrasound in a "clean" mouse model of ultrasonic neuromodulation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.22.541780. [PMID: 37293117 PMCID: PMC10245917 DOI: 10.1101/2023.05.22.541780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Recent studies on ultrasonic neuromodulation (UNM) in rodents have shown that focused ultrasound (FUS) can activate peripheral auditory pathways, leading to off-target and brain-wide excitation, which obscures the direct activation of the target area by FUS. To address this issue, we developed a new mouse model, the double transgenic Pou4f3+/DTR × Thy1-GCaMP6s, which allows for inducible deafening using diphtheria toxin and minimizes off-target effects of UNM while allowing effects on neural activity to be visualized with fluorescent calcium imaging. Using this model, we found that the auditory confounds caused by FUS can be significantly reduced or eliminated within a certain pressure range. At higher pressures, FUS can result in focal fluorescence dips at the target, elicit non-auditory sensory confounds, and damage tissue, leading to spreading depolarization. Under the acoustic conditions we tested, we did not observe direct calcium responses in the mouse cortex. Our findings provide a cleaner animal model for UNM and sonogenetics research, establish a parameter range within which off-target effects are confidently avoided, and reveal the non-auditory side effects of higher-pressure stimulation.
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Fan CH, Tsai HC, Tsai YS, Wang HC, Lin YC, Chiang PH, Wu N, Chou MH, Ho YJ, Lin ZH, Yeh CK. Selective Activation of Cells by Piezoelectric Molybdenum Disulfide Nanosheets with Focused Ultrasound. ACS NANO 2023; 17:9140-9154. [PMID: 37163347 DOI: 10.1021/acsnano.2c12438] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
An accurate method for neural stimulation within the brain could be very useful for treating brain circuit dysfunctions and neurological disorders. With the aim of developing such a method, this study investigated the use of piezoelectric molybdenum disulfide nanosheets (MoS2 NS) to remotely convert ultrasound energy into localized electrical stimulation in vitro and in vivo. The application of ultrasound to cells surrounding MoS2 NS required only a single pulse of 2 MHz ultrasound (400 kPa, 1,000,000 cycles, and 500 ms pulse duration) to elicit significant responses in 37.9 ± 7.4% of cells in terms of fluxes of calcium ions without detectable cellular damage. The proportion of responsive cells was mainly influenced by the acoustic pressure, number of ultrasound cycles, and concentration of MoS2 NS. Tests using appropriate blockers revealed that voltage-gated membrane channels were activated. In vivo data suggested that, with ultrasound stimulation, neurons closest to the MoS2 NS were 3-fold more likely to present c-Fos expression than cells far from the NS. The successful activation of neurons surrounding MoS2 NS suggests that this represents a method with high spatial precision for selectively modulating one or several targeted brain circuits.
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Affiliation(s)
- Ching-Hsiang Fan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan City 701401, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan City 701401, Taiwan
| | - Hong-Chieh Tsai
- Division of Neurosurgery, Linkou Chang Gung Memorial Hospital, Taoyuan City 333423, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yi-Sheng Tsai
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu City 300044, Taiwan
| | - Hsien-Chu Wang
- Department of Medical Science, Institute of Molecular Medicine, National Tsing Hua University, Hsinchu City 300044, Taiwan
| | - Yu-Chun Lin
- Department of Medical Science, Institute of Molecular Medicine, National Tsing Hua University, Hsinchu City 300044, Taiwan
| | - Po-Han Chiang
- Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan
| | - Nan Wu
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu City 300044, Taiwan
| | - Min-Hwa Chou
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu City 300044, Taiwan
| | - Yi-Ju Ho
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu City 30010, Taiwan
| | - Zong-Hong Lin
- Department of Biomedical Engineering, National Taiwan University, Taipei City 10617, Taiwan
| | - Chih-Kuang Yeh
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu City 300044, Taiwan
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Legon W, Strohman A, In A, Stebbins K, Payne B. Non-invasive neuromodulation of sub-regions of the human insula differentially affect pain processing and heart-rate variability. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.05.539593. [PMID: 37205396 PMCID: PMC10187309 DOI: 10.1101/2023.05.05.539593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The insula is a portion of the cerebral cortex folded deep within the lateral sulcus covered by the overlying opercula of the inferior frontal lobe and superior portion of the temporal lobe. The insula has been parsed into sub-regions based upon cytoarchitectonics and structural and functional connectivity with multiple lines of evidence supporting specific roles for each of these sub-regions in pain processing and interoception. In the past, causal interrogation of the insula was only possible in patients with surgically implanted electrodes. Here, we leverage the high spatial resolution combined with the deep penetration depth of low-intensity focused ultrasound (LIFU) to non-surgically modulate either the anterior insula (AI) or posterior insula (PI) in humans for effect on subjective pain ratings, electroencephalographic (EEG) contact head evoked potentials (CHEPs) and time-frequency power as well as autonomic measures including heart-rate variability (HRV) and electrodermal response (EDR). N = 23 healthy volunteers received brief noxious heat pain stimuli to the dorsum of their right hand during continuous heart-rate, EDR and EEG recording. LIFU was delivered to either the AI (anterior short gyrus), PI (posterior longus gyrus) or under an inert sham condition time-locked to the heat stimulus. Results demonstrate that single-element 500 kHz LIFU is capable of individually targeting specific gyri of the insula. LIFU to both AI and PI similarly reduced perceived pain ratings but had differential effects on EEG activity. LIFU to PI affected earlier EEG amplitudes around 300 milliseconds whereas LIFU to AI affected EEG amplitudes around 500 milliseconds. In addition, only LIFU to the AI affected HRV as indexed by an increase in standard deviation of N-N intervals (SDNN) and mean HRV low frequency power. There was no effect of LIFU to either AI or PI on EDR or blood pressure. Taken together, LIFU looks to be an effective method to individually target sub-regions of the insula in humans for site-specific effects on brain biomarkers of pain processing and autonomic reactivity that translates to reduced perceived pain to a transient heat stimulus. These data have implications for the treatment of chronic pain and several neuropsychological diseases like anxiety, depression and addiction that all demonstrate abnormal activity in the insula concomitant with dysregulated autonomic function.
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Affiliation(s)
- Wynn Legon
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA
- Center for Human Neuroscience Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
| | - Andrew Strohman
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, 24016, USA
| | - Alexander In
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
| | - Katelyn Stebbins
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, VA, 24016, USA
| | - Brighton Payne
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
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Webb TD, Wilson MG, Odéen H, Kubanek J. Sustained modulation of primate deep brain circuits with focused ultrasonic waves. Brain Stimul 2023; 16:798-805. [PMID: 37080427 PMCID: PMC10330836 DOI: 10.1016/j.brs.2023.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Transcranial focused ultrasound has the potential to noninvasively modulate deep brain circuits and impart sustained, neuroplastic effects. OBJECTIVE Bring the approach closer to translations by demonstrating sustained modulation of deep brain circuits and choice behavior in task-performing non-human primates. METHODS Low-intensity transcranial ultrasound of 30 s in duration was delivered in a controlled manner into deep brain targets (left or right lateral geniculate nucleus; LGN) of non-human primates while the subjects decided whether a left or a right visual target appeared first. While the animals performed the task, we recorded intracranial EEG from occipital screws. The ultrasound was delivered into the deep brain targets daily for a period of more than 6 months. RESULTS The brief stimulation induced effects on choice behavior that persisted up to 15 minutes and were specific to the sonicated target. Stimulation of the left/right LGN increased the proportion of rightward/leftward choices. These effects were accompanied by an increase in gamma activity over visual cortex. The contralateral effect on choice behavior and the increase in gamma, compared to sham stimulation, suggest that the stimulation excited the target neural circuits. There were no detrimental effects on the animals' discrimination performance over the months-long course of the stimulation. CONCLUSION This study demonstrates that brief, 30-s ultrasonic stimulation induces neuroplastic effects specifically in the target deep brain circuits, and that the stimulation can be applied daily without detrimental effects. These findings encourage repeated applications of transcranial ultrasound to malfunctioning deep brain circuits in humans with the goal of providing a durable therapeutic reset.
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Affiliation(s)
- Taylor D Webb
- Department of Biomedical Engineering, University of Utah, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America.
| | - Matthew G Wilson
- Department of Biomedical Engineering, University of Utah, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America
| | - Henrik Odéen
- Department of Radiology and Imaging Sciences, University of Utah, 729 Arapeen Drive, Salt Lake City, UT 84108, United States of America
| | - Jan Kubanek
- Department of Biomedical Engineering, University of Utah, 36 South Wasatch Dr, Salt Lake City, UT 84112, United States of America.
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Xu RS, Wu XM, Xiong ZQ. Low-intensity ultrasound directly modulates neural activity of the cerebellar cortex. Brain Stimul 2023; 16:918-926. [PMID: 37245844 DOI: 10.1016/j.brs.2023.05.012] [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: 02/23/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Low-intensity ultrasound is a noninvasive neuromodulation technique with the potential to focally manipulate deep brain activity at millimeter-scale resolution. However, there have been controversies over the direct influence of ultrasound on neurons, due to an indirect auditory activation. Besides, the capacity of ultrasound to stimulate the cerebellum remains underestimated. OBJECTIVE To validate the direct neuromodulation effects of ultrasound on the cerebellar cortex from both cellular and behavioral levels. METHODS Two-photon calcium imaging were used to measure the neuronal responses of cerebellar granule cells (GrCs) and Purkinje cells (PCs) to ultrasound application in awake mice. And a mouse model of paroxysmal kinesigenic dyskinesia (PKD), in which direct activation of the cerebellar cortex leads to dyskinetic movements, was used to assess the ultrasound-induced behavioral responses. RESULTS Low-intensity ultrasound stimulus (0.1 W/cm2) evoked rapidly increased and sustained neural activity in GrCs and PCs at targeted region, while no significant changes in calcium signals were observed responding to off-target stimulus. The efficacy of ultrasonic neuromodulation relies on acoustic dose modified by ultrasonic duration and intensity. In addition, transcranial ultrasound reliably triggered dyskinesia attacks in proline-rich transmembrane protein 2 (Prrt2) mutant mice, suggesting that the intact cerebellar cortex were activated by ultrasound. CONCLUSION Low-intensity ultrasound directly activates the cerebellar cortex in a dose-dependent manner, and thus serves as a promising tool for cerebellar manipulation.
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Affiliation(s)
- Ruo-Shui Xu
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, 200031, Shanghai, China; University of Chinese Academy of Sciences, 100049, Beijing, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Xue-Mei Wu
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, 200031, Shanghai, China; University of Chinese Academy of Sciences, 100049, Beijing, China; School of Life Science and Technology, ShanghaiTech University, 201210, Shanghai, China
| | - Zhi-Qi Xiong
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, 200031, Shanghai, China; University of Chinese Academy of Sciences, 100049, Beijing, China; School of Life Science and Technology, ShanghaiTech University, 201210, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Intelligence Technology, 201210, Shanghai, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, China.
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44
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Li Z, Chen R, Liu D, Wang X, Yuan W. Effect of low-intensity transcranial ultrasound stimulation on theta and gamma oscillations in the mouse hippocampal CA1. Front Psychiatry 2023; 14:1151351. [PMID: 37151980 PMCID: PMC10157252 DOI: 10.3389/fpsyt.2023.1151351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Previous studies have demonstrated that low-intensity transcranial ultrasound stimulation (TUS) can eliminate hippocampal neural activity. However, until now, it has remained unclear how ultrasound modulates theta and gamma oscillations in the hippocampus under different behavioral states. In this study, we used ultrasound to stimulate the CA1 in mice in anesthesia, awake and running states, and we simultaneously recorded the local field potential of the stimulation location. We analyzed the power spectrum, phase-amplitude coupling (PAC) of theta and gamma oscillations, and their relationship with ultrasound intensity. The results showed that (i) TUS significantly enhanced the absolute power of theta and gamma oscillations under anesthesia and in the awake state. (ii) The PAC strength between theta and gamma oscillations is significantly enhanced under the anesthesia and awake states but is weakened under the running state with TUS. (iii) Under anesthesia, the relative power of theta decreases and that of gamma increases as ultrasound intensity increases, and the result under the awake state is opposite that under the anesthesia state. (iv) The PAC index between theta and gamma increases as ultrasound intensity increases under the anesthesia and awake states. The above results demonstrate that TUS can modulate theta and gamma oscillations in the CA1 and that the modulation effect depends on behavioral states. Our study provides guidance for the application of ultrasound in modulating hippocampal function.
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Affiliation(s)
- Zhen Li
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Rong Chen
- Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dachuan Liu
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xizhe Wang
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Yuan
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
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45
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Yuan Y, Wu Q, Wang X, Liu M, Yan J, Ji H. Low-intensity ultrasound stimulation modulates time-frequency patterns of cerebral blood oxygenation and neurovascular coupling of mouse under peripheral sensory stimulation state. Neuroimage 2023; 270:119979. [PMID: 36863547 DOI: 10.1016/j.neuroimage.2023.119979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/03/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023] Open
Abstract
Previous studies have demonstrated that transcranial ultrasound stimulation (TUS) not only modulates cerebral hemodynamics, neural activity, and neurovascular coupling characteristics in resting samples but also exerts a significant inhibitory effect on the neural activity in task samples. However, the effect of TUS on cerebral blood oxygenation and neurovascular coupling in task samples remains to be elucidated. To answer this question, we first used forepaw electrical stimulation of the mice to elicit the corresponding cortical excitation, and then stimulated this cortical region using different modes of TUS, and simultaneously recorded the local field potential using electrophysiological acquisition and hemodynamics using optical intrinsic signal imaging. The results indicate that for the mice under peripheral sensory stimulation state, TUS with a duty cycle of 50% can (1) enhance the amplitude of cerebral blood oxygenation signal, (2) reduce the time-frequency characteristics of evoked potential, (3) reduce the strength of neurovascular coupling in time domain, (4) enhance the strength of neurovascular coupling in frequency domain, and (5) reduce the time-frequency cross-coupling of neurovasculature. The results of this study indicate that TUS can modulate the cerebral blood oxygenation and neurovascular coupling in peripheral sensory stimulation state mice under specific parameters. This study opens up a new area of investigation for potential applicability of TUS in brain diseases related to cerebral blood oxygenation and neurovascular coupling.
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Affiliation(s)
- Yi Yuan
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, China; Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, China.
| | - Qianqian Wu
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, China; Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, China
| | - Xingran Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, China; Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, China
| | - Mengyang Liu
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna 1090, Austria
| | - Jiaqing Yan
- College of Electrical and Control Engineering, North China University of Technology, Beijing 100041, China.
| | - Hui Ji
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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46
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Liang W, Guo H, Mittelstein DR, Shapiro MG, Shimojo S, Shehata M. Auditory Mondrian masks the airborne-auditory artifact of focused ultrasound stimulation in humans. Brain Stimul 2023; 16:604-606. [PMID: 36898575 PMCID: PMC10314733 DOI: 10.1016/j.brs.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Affiliation(s)
- William Liang
- Division of Biology and Biological Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA.
| | - Hongsun Guo
- Division of Chemistry and Chemical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA.
| | - David R Mittelstein
- Division of Chemistry and Chemical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA; Keck School of Medicine of the University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
| | - Mikhail G Shapiro
- Division of Chemistry and Chemical Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA; Howard Hughes Medical Institute, Pasadena, CA, 91125, USA.
| | - Shinsuke Shimojo
- Division of Biology and Biological Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA.
| | - Mohammad Shehata
- Division of Biology and Biological Engineering, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA, 91125, USA; Electronics-Inspired Interdisciplinary Research Institute, Toyohashi University of Technology, 1-1 Hibarigaoka, Tempaku-cho, Toyohashi, Aichi, 441-8580, Japan.
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47
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Nandi T, Johnstone A, Martin E, Zich C, Cooper R, Bestmann S, Bergmann TO, Treeby B, Stagg CJ. Ramped V1 transcranial ultrasonic stimulation modulates but does not evoke visual evoked potentials. Brain Stimul 2023; 16:553-555. [PMID: 36754118 DOI: 10.1016/j.brs.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Affiliation(s)
- Tulika Nandi
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK; Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany.
| | - Ainslie Johnstone
- Department for Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Eleanor Martin
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Wellcome/EPSRC Centre for Interventional & Surgical Sciences, University College London, London, UK
| | - Catharina Zich
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK; Department for Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Robert Cooper
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Sven Bestmann
- Department for Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Til Ole Bergmann
- Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany; Leibniz Institute for Resilience Research, Wallstraße 7-9, 55122, Mainz, Germany
| | - Bradley Treeby
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Charlotte J Stagg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK; Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK
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48
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Noureddine R, Surget A, Iazourene T, Audebrand M, Eliwa H, Brizard B, Nassereddine M, Mofid Y, Charara J, Bouakaz A. Guidelines for successful motor cortex ultrasonic neurostimulation in mice. ULTRASONICS 2023; 128:106888. [PMID: 36402114 DOI: 10.1016/j.ultras.2022.106888] [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: 10/30/2021] [Revised: 10/04/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Ultrasound neurostimulation (USNS) is a non-invasive neuromodulation technique that might hold promise for treating neuropsychiatric disorders with regards to its noninvasiveness, penetration depth, and high resolution. OBJECTIVE We sought in this experimental study to provide detailed and optimized protocol and methodology for a successful ultrasonic neurostimulation of the Primary Motor Cortex (M1) in mice addressed to young researchers/students beginning their research in the field of ultrasonic neurostimulation and encountering practical challenges. METHODS A 500 kHz single-element transducer was used for stimulating the primary motor cortex at different acoustic pressures in C57BL/6 mice at various anesthesia levels. To further illustrate the effect of anesthesia, real time visual observations of motor responses validated with video recordings as well as electromyography were employed for evaluating the success and reliability of the stimulations. RESULTS Detailed experimental procedure for a successful stimulations including targeting and anesthesia is presented. Our study demonstrates that we can achieve high stimulation success rates (91 % to 100 %) at acoustic pressures ranging from 330 kPa to 550 kPa at anesthesia washout period. CONCLUSIONS This study shows a reliable and detailed methodology for successful USNS in mice addressed to beginners in ultrasonic brain stimulation topic. We showed an effective USNS protocol. We offered a simple and consistent non-invasive technique for locating and targeting brain zones. Moreover, we illustrated the acoustic pressure and stimulation success relationship and focused on the effect of anesthesia level for successful stimulation.
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Affiliation(s)
- Rasha Noureddine
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Lebanese University, Doctoral School of Science & Technology, Hadath, Lebanon
| | | | - Tarik Iazourene
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Marie Audebrand
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Hoda Eliwa
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Department of Cell Biology, Medical Research Institute, Alexandria University, Egypt
| | - Bruno Brizard
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Mohamad Nassereddine
- Lebanese University, Faculty of Sciences I - Department of Physics - Electronics, Hadath, Lebanon
| | - Yassine Mofid
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Jamal Charara
- Lebanese University, Faculty of Sciences I - Department of Physics - Electronics, Hadath, Lebanon
| | - Ayache Bouakaz
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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49
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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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50
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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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