Transcranial Focused Ultrasound for Noninvasive Neuromodulation of the Visual Cortex

Label free, capillary-scale blood flow mapping in vivo reveals that low intensity focused ultrasound evokes persistent dilation in cortical microvasculature

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 following sonication without the use of microbubbles. 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.

A systematic review of preclinical and clinical transcranial ultrasound neuromodulation and opportunities for functional connectomics

BACKGROUND

Low-intensity transcranial ultrasound has surged forward as a non-invasive and disruptive tool for neuromodulation with applications in basic neuroscience research and the treatment of neurological and psychiatric conditions.

OBJECTIVE

To provide a comprehensive overview and update of preclinical and clinical transcranial low intensity ultrasound for neuromodulation and emphasize the emerging role of functional brain mapping to guide, better understand, and predict responses.

METHODS

A systematic review was conducted by searching the Web of Science and Scopus databases for studies on transcranial ultrasound neuromodulation, both in humans and animals.

RESULTS

187 relevant studies were identified and reviewed, including 116 preclinical and 71 clinical reports with subjects belonging to diverse cohorts. Milestones of ultrasound neuromodulation are described within an overview of the broader landscape. General neural readouts and outcome measures are discussed, potential confounds are noted, and the emerging use of functional magnetic resonance imaging is highlighted.

CONCLUSION

Ultrasound neuromodulation has emerged as a powerful tool to study and treat a range of conditions and its combination with various neural readouts has significantly advanced this platform. In particular, the use of functional magnetic resonance imaging has yielded exciting inferences into ultrasound neuromodulation and has the potential to advance our understanding of brain function, neuromodulatory mechanisms, and ultimately clinical outcomes. It is anticipated that these preclinical and clinical trials are the first of many; that transcranial low intensity focused ultrasound, particularly in combination with functional magnetic resonance imaging, has the potential to enhance treatment for a spectrum of neurological conditions.

Visual Neuroprosthesis - Stimulation of Visual Cortical Centers in The Brain. Design of Non-Invasive Transcranial Stimulation of Functional Neurons

PURPOSE

The purpose of the article is to present the history and current status of visual cortical neuroprostheses, and to present a new method of stimulating intact visual cortex cells.

METHODS

This paper contains an overview of the history and current status of visual cortex stimulation in severe visual impairment, but also highlights its shortcomings. These include mainly the stimulation of currently damaged cortical cells over a small area and, from a morphological point of view, possible damage to the stimulated neurons by the electrodes and their encapsulation by gliotic tissue.

RESULTS

The paper also presents a proposal for a new technology of image processing and its transformation into a form of non-invasive transcranial stimulation of undamaged parts of the brain, which is protected by a national and international patent.

CONCLUSION

The paper presents a comprehensive review of the current options for compensating for lost vision at the level of the cerebral cortex and a proposal for a new non-invasive method of stimulating the functional neurons of the visual cortex.

An improved Fourier Ptychography algorithm for ultrasonic array imaging

Inspired by the optical imaging algorithm, the Fourier Ptychography (FP) algorithm is adopted to improve the resolution of ultrasonic array imaging. In the FP algorithm, the steady-state spectrum is utilized to recover the high-resolution ultrasonic images. Meanwhile, the parameters of FP algorithm are empirical, which can affect the imaging quality of ultrasonic array. Then the particle swarm optimization (PSO) algorithm is used to optimize the parameters of FP algorithm to further improve the imaging quality of ultrasonic array. The tungsten imaging experiments and pig eye imaging experiments are conducted to demonstrate the feasibility and effectiveness of the developed algorithm. In addition, the proposed algorithm and the coherent wave superposition (CWS) algorithm are both based on single plane wave (SPW) algorithms and they are then compared. The results show that the CWS algorithm and FP algorithm have good longitudinal and lateral resolutions, respectively. The particle swarm optimization-based FP (PSOFP) imaging algorithm has both excellent lateral and longitudinal resolutions. The average lateral resolution of PSOFP imaging algorithm is improved by 34.47% compared with CWS imaging algorithm in the tungsten wires experiments, and the lateral boundary structure width of the lens is improved by 49.48% in the pig eye experiments. The proposed algorithm can effectively improve the ultrasonic imaging quality for medical application.

A 2D Ultrasound Phased-Array Transmitter ASIC for High-Frequency US Stimulation and Powering

Ultrasound (US) neuromodulation and ultrasonic power transfer to implanted devices demand novel ultrasound transmitters capable of steering focused ultrasound waves in 3D with high spatial resolution and US pressure, while having a miniaturized form factor. Meeting these requirements needs a 2D array of ultrasound transducers directly integrated with a high-frequency 2D phased-array ASIC. However, this imposes severe challenges on the design of the ASIC. In order to avoid the generation of grating lobes, the elements in the 2D phased-array should have a pitch of half of the ultrasound wavelength, which, as frequency increases, highly reduces the area available for the design of high-voltage beamforming channels. This article addresses these challenges by presenting the system-level optimization and implementation of a high-frequency 2D phased-array ASIC. The system-level study focuses on the optimization of the US transmitter toward high-frequency operation while minimizing power consumption. This study resulted in the implementation of two ASICs in TSMC 180 nm BCD technology: firstly, an individual beamforming channel was designed to demonstrate the tradeoffs between frequency, driving voltage, and beamforming capabilities. Finally, a 12-MHz pitch matched 12 × 12 phased-array ASIC working at 20-V amplitude and 3-bit phasing was designed and experimentally validated, to demonstrate high-frequency phased-array operation. The measurement results verify the phasing functionality of the ASIC with a maximum DNL of 0.35 LSB. The CMOS chip consumes 130 mW and 26.6 mW average power during the continuous pulsing and delivering 200-pulse bursts with a PRF of 1 kHz, respectively.

Non-Invasive Hybrid Ultrasound Stimulation of Visual Cortex In Vivo

The optic nerve is the second cranial nerve (CN II) that connects and transmits visual information between the retina and the brain. Severe damage to the optic nerve often leads to distorted vision, vision loss, and even blindness. Such damage can be caused by various types of degenerative diseases, such as glaucoma and traumatic optic neuropathy, and result in an impaired visual pathway. To date, researchers have not found a viable therapeutic method to restore the impaired visual pathway; however, in this paper, a newly synthesized model is proposed to bypass the damaged portion of the visual pathway and set up a direct connection between a stimulated visual input and the visual cortex (VC) using Low-frequency Ring-transducer Ultrasound Stimulation (LRUS). In this study, by utilizing and integrating various advanced ultrasonic and neurological technologies, the following advantages are achieved by the proposed LRUS model: 1. This is a non-invasive procedure that uses enhanced sound field intensity to overcome the loss of ultrasound signal due to the blockage of the skull. 2. The simulated visual signal generated by LRUS in the visual-cortex-elicited neuronal response in the visual cortex is comparable to light stimulation of the retina. The result was confirmed by a combination of real-time electrophysiology and fiber photometry. 3. VC showed a faster response rate under LRUS than light stimulation through the retina. These results suggest a potential non-invasive therapeutic method for restoring vision in optic-nerve-impaired patients using ultrasound stimulation (US).

3D Printing and processing of miniaturized transducers with near-pristine piezoelectric ceramics for localized cavitation

The performance of ultrasonic transducers is largely determined by the piezoelectric properties and geometries of their active elements. Due to the brittle nature of piezoceramics, existing processing tools for piezoelectric elements only achieve simple geometries, including flat disks, cylinders, cubes and rings. While advances in additive manufacturing give rise to free-form fabrication of piezoceramics, the resultant transducers suffer from high porosity, weak piezoelectric responses, and limited geometrical flexibility. We introduce optimized piezoceramic printing and processing strategies to produce highly responsive piezoelectric microtransducers that operate at ultrasonic frequencies. The 3D printed dense piezoelectric elements achieve high piezoelectric coefficients and complex architectures. The resulting piezoelectric charge constant, d₃₃, and coupling factor, k_t, of the 3D printed piezoceramic reach 583 pC/N and 0.57, approaching the properties of pristine ceramics. The integrated printing of transducer packaging materials and 3D printed piezoceramics with microarchitectures create opportunities for miniaturized piezoelectric ultrasound transducers capable of acoustic focusing and localized cavitation within millimeter-sized channels, leading to miniaturized ultrasonic devices that enable a wide range of biomedical applications.

Ultrasound stimulation for non-invasive visual prostheses

Globally, it is estimated there are more than 2.2 billion visually impaired people. Visual diseases such as retinitis pigmentosa, age-related macular degeneration, glaucoma, and optic neuritis can cause irreversible profound vision loss. Many groups have investigated different approaches such as microelectronic prostheses, optogenetics, stem cell therapy, and gene therapy to restore vision. However, these methods have some limitations such as invasive implantation surgery and unknown long-term risk of genetic manipulation. In addition to the safety of ultrasound as a medical imaging modality, ultrasound stimulation can be a viable non-invasive alternative approach for the sight restoration because of its ability to non-invasively control neuronal activities. Indeed, recent studies have demonstrated ultrasound stimulation can successfully modulate retinal/brain neuronal activities without causing any damage to the nerve cells. Superior penetration depth and high spatial resolution of focused ultrasound can open a new avenue in neuromodulation researches. This review summarizes the latest research results about neural responses to ultrasound stimulation. Also, this work provides an overview of technical viewpoints in the future design of a miniaturized ultrasound transducer for a non-invasive acoustic visual prosthesis for non-surgical and painless restoration of vision.

Visual neuroprosthesis: present and possible perspectives

The purpose of this study is to provide an overview of the replacements used in lost vision in the form of the bionic eye, to show their deficiencies and outline other possibilities for non-invasive stimulation of functional areas of the visual cortex. The review highlights the damage not only to the primary altered cellular structures, but also to all other horizontally and vertically localised structures. Based on the results of a large number of functional magnetic resonance imaging and electrophysiological methods, the authors focus on the pathology of the entire visual pathway in pigmentary retinopathy (PR) and age-related macular degeneration (AMD). This study provides a recent overview of the possible systems used to replace lost vision. These range from stimulation with intraocular implants, through stimulation of the optic nerve and lateral geniculate nucleus to the visual cortex. The second part deals with the design of image processing technology and its transformation into the form of transcranial stimulation of undamaged parts of the brain, which is protected by a patent. This is comprehensive overview of the current possibilities of replacement of lost vision and a proposal for a new non-invasive methods of stimulation of functional neurons of the visual cortex.

Echo Signal Receiving and Data Conversion Integrated Circuits for Portable High-Frequency Ultrasonic Imaging System

Ultrasonic imaging has become a very promising technology, and it has been widely applied in biomedicine, geology, and other fields due to its advantages of safety, nondamaging, and real time. Especially, the portable high-frequency (>20 MHz) ultrasonic imaging system (UIS) has been generally used in biomedical detection and diagnosis. In the complex actual environment, the effect of integrated circuits (ICs) on the performance of portable high-frequency UIS is obvious. In the echo signal transmission link, the analog front end (AFE) and the analog-to-digital converter (ADC) are the two most critical modules, where AFE is used to receive and preprocess the analog ultrasonic echo signals and ADC to convert the analog signals from the AFE output to digital. The structure and performance of the ICs integrated into terminal equipment and in-probe for the portable high-frequency UIS are introduced and discussed. Some typical commercial ICs are also summarized. Based on the requirements and challenges of portable high-frequency UIS, the future development directions of ICs mainly include high integration, ultralow power consumption, high speed, and high precision, which can provide valuable reference and advice for the design of AFE and ADC for portable high-frequency UIS.

Current State of Potential Mechanisms Supporting Low Intensity Focused Ultrasound for Neuromodulation

Low intensity focused ultrasound (LIFU) has been gaining traction as a non-invasive neuromodulation technology due to its superior spatial specificity relative to transcranial electrical/magnetic stimulation. Despite a growing literature of LIFU-induced behavioral modifications, the mechanisms of action supporting LIFU's parameter-dependent excitatory and suppressive effects are not fully understood. This review provides a comprehensive introduction to the underlying mechanics of both acoustic energy and neuronal membranes, defining the primary variables for a subsequent review of the field's proposed mechanisms supporting LIFU's neuromodulatory effects. An exhaustive review of the empirical literature was also conducted and studies were grouped based on the sonication parameters used and behavioral effects observed, with the goal of linking empirical findings to the proposed theoretical mechanisms and evaluating which model best fits the existing data. A neuronal intramembrane cavitation excitation model, which accounts for differential effects as a function of cell-type, emerged as a possible explanation for the range of excitatory effects found in the literature. The suppressive and other findings need additional theoretical mechanisms and these theoretical mechanisms need to have established relationships to sonication parameters.

A Spatial Multitarget Ultrasound Neuromodulation System Using High-Powered 2-D Array Transducer

Transcranial focused ultrasound (tFUS) is increasingly used in experimental neuroscience due to its neuromodulatory effectiveness in animal studies. However, achieving multitarget tFUS in small animals is typically limited by transducer size, energy transfer efficiency, and brain volume. The objective of this work was to construct an ultrasound system for multitarget neuromodulation in small animals. First, a miniaturized high-powered 2-D array transducer was developed. The phase delay of each array element was calculated based on the multifocal time-reversal method, generating multiple foci simultaneously in a 3-D field. The effects of the axial focal length, interfocus spacing (lateral distance between the two focal centers), and the number of foci on the focal properties of the pressure field were examined through numerical simulations. In-vitro ultrasonic measurements and transcranial simulations on a rat skull were conducted. The minimum interfocus spacing separating two -6-dB foci and the peak full-width at half-maximum were positively correlated with axial focal length; the relative relationship between the interfocus spacing and pressure field properties was similar for each axial focal length. The maximum acoustic pressure and spatial average intensity at focus in deionized water were 2.21 MPa and 133 W/cm², respectively. The simulated and experimental results were compared, demonstrating agreement in both peak position and focus shape. The ultrasound system can provide a neuroscientific platform for evaluating the feasibility of multitarget ultrasound stimulation treatment protocols, thus improving the understanding of functional neuroanatomy.

Ultrasound Activation of Mechanosensory Ion Channels in Caenorhabditis Elegans

Ultrasound is capable of noninvasive transcranial focusing and activating the targeted neurons in brain regions, receiving increasing attention. Ion channel, acting as a nano-ionic switch, enables to modulate the ion flow across cellular membranes and it is of importance to control the firing frequency of a neuron. In this article, we demonstrate the behavioral response of Caenorhabditis elegans (C. elegans) in response to ultrasound stimulation mediated by the activation of mechanical sensitive MEC-4 and MEC-6 ion channels. By specific mutation of MEC-4 and MEC-6 ion channels, mutant worms show a significant decrease in the percentage of reversal behavior (30% ± 10.5% and 10% ± 6.9%, respectively), compared with wild type (85% ± 8.2%). Furthermore, ALM and PLM neurons expressing MEC-4 and MEC-6 ion channels could be evoked directly by ultrasound stimulation, indicating MEC-4 and MEC-6 may pave a new way for sonogenetics.

Ultrasonic Retinal Neuromodulation and Acoustic Retinal Prosthesis

Ultrasound is an emerging method for non-invasive neuromodulation. Studies in the past have demonstrated that ultrasound can reversibly activate and inhibit neural activities in the brain. Recent research shows the possibility of using ultrasound ranging from 0.5 to 43 MHz in acoustic frequency to activate the retinal neurons without causing detectable damages to the cells. This review recapitulates pilot studies that explored retinal responses to the ultrasound exposure, discusses the advantages and limitations of the ultrasonic stimulation, and offers an overview of engineering perspectives in developing an acoustic retinal prosthesis. For comparison, this article also presents studies in the ultrasonic stimulation of the visual cortex. Despite that, the summarized research is still in an early stage; ultrasonic retinal stimulation appears to be a viable technology that exhibits enormous therapeutic potential for non-invasive vision restoration.