Toward focused ultrasound neuromodulation in deep brain stimulator implanted patients: Ex-vivo thermal, kinetic and targeting feasibility assessment

Abstract

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Low-Intensity Focused Ultrasound Neuromodulation for Stroke Recovery: A Novel Deep Brain Stimulation Approach for Neurorehabilitation?

“…240 It becomes clear that TUS has excellent properties for targeting deep brain regions, perhaps even combinable and applicable in DBS patients and beyond. 157 Sarica et al (2022) recently published their work in an ex-vivo setting regarding appropriate parameters for TUS to enhance adaptability of such applications and to not produce hazardous temperatures on DBS lead. 157 Alternatively, non-invasive stimulation 65,241,242 but also invasive 63,65,242 stimulation of the cerebellum has been tried out for post-stroke recovery.…”

“…157 Sarica et al (2022) recently published their work in an ex-vivo setting regarding appropriate parameters for TUS to enhance adaptability of such applications and to not produce hazardous temperatures on DBS lead. 157 Alternatively, non-invasive stimulation 65,241,242 but also invasive 63,65,242 stimulation of the cerebellum has been tried out for post-stroke recovery. Preclinical studies proved DBS stimulation to the cerebellum for post-stroke conditions to be effective in rodents.…”

“…Below this threshold, mechanical bioeffects are deemed safe for any tissue type. Of importance, first human safety studies were conducted showing that intensities with up to 5 W/cm 2 did no harm to the tissue in histological evaluation, making TUS neuromodulation a valid therapeutic tool [153] provided current safety work in temporal lobe epilepsy patients who underwent sonication prior to resection of anterior-mesial temporal lobe [90] . Their results suggest that TUS at intensities up to 5760 mW/cm 2 may be safe for neuromodulation in humans [90] .…”

Low Intensity Focused Ultrasound for Epilepsy— A New Approach to Neuromodulation

“…TMS was recently used to verify target engagement and modulation of lateral cortex with LIFUS, and another study used DBS recordings in an ex-vivo model for confirmation. 33 , 44 More safety data are needed before recordings from implanted devices such as RNS or DBS in human subjects can be used to verify LIFUS’ effects. One can envision how this method may also be used for noninvasive mapping of the human brain given its ability to transcranially elicit neurophysiologic and/or clinical responses from innumerable brain regions.…”

Ultrasound stimulation for non-invasive visual prostheses

“…Nowadays, low-intensity focused ultrasound (LIFUS) becomes widely used as a non-thermal, non-invasive approach for generating neuromodulation toward vision restoration ( Baek et al, 2017 ; Fomenko et al, 2018 ; Jiang et al, 2018 , 2019 ; Yuan et al, 2019 ). It has been repeatedly demonstrated that FUS can effectively stimulate the neurons in vitro ( Menz et al, 2017 ; Cafarelli et al, 2021 ), ex vivo ( Blackmore et al, 2019 ; Menz et al, 2019 ; Sarica et al, 2022 ), and in vivo ( Naor et al, 2012 ; Lee et al, 2015 ). For the vision restoration purpose, an acoustic retinal prosthesis (ARP) had been proposed for the first time by demonstrating a FUS neurostimulation of the retinal cells in anesthetized wild-type rats ( Naor et al, 2012 ).…”