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Osada T, Konishi S. Noninvasive intervention by transcranial ultrasound stimulation: Modulation of neural circuits and its clinical perspectives. Psychiatry Clin Neurosci 2024; 78:273-281. [PMID: 38505983 DOI: 10.1111/pcn.13663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 03/21/2024]
Abstract
Low-intensity focused transcranial ultrasound stimulation (TUS) is an emerging noninvasive technique capable of stimulating both the cerebral cortex and deep brain structures with high spatial precision. This method is recognized for its potential to comprehensively perturb various brain regions, enabling the modulation of neural circuits, in a manner not achievable through conventional magnetic or electrical brain stimulation techniques. The underlying mechanisms of neuromodulation are based on a phenomenon where mechanical waves of ultrasound kinetically interact with neurons, specifically affecting neuronal membranes and mechanosensitive channels. This interaction induces alterations in the excitability of neurons within the stimulated region. In this review, we briefly present the fundamental principles of ultrasound physics and the physiological mechanisms of TUS neuromodulation. We explain the experimental apparatus and procedures for TUS in humans. Due to the focality, the integration of various methods, including magnetic resonance imaging and magnetic resonance-guided neuronavigation systems, is important to perform TUS experiments for precise targeting. We then review the current state of the literature on TUS neuromodulation, with a particular focus on human subjects, targeting both the cerebral cortex and deep subcortical structures. Finally, we outline future perspectives of TUS in clinical applications in psychiatric and neurological fields.
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Affiliation(s)
- Takahiro Osada
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Seiki Konishi
- Department of Neurophysiology, Juntendo University School of Medicine, Tokyo, Japan
- Research Institute for Diseases of Old Age, Juntendo University School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University School of Medicine, Tokyo, Japan
- Advanced Research Institute for Health Science, Juntendo University School of Medicine, Tokyo, Japan
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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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Park TY, Koh H, Lee W, Park SH, Chang WS, Kim H. Real-Time Acoustic Simulation Framework for tFUS: A Feasibility Study Using Navigation System. Neuroimage 2023; 282:120411. [PMID: 37844771 DOI: 10.1016/j.neuroimage.2023.120411] [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: 06/04/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023] Open
Abstract
Transcranial focused ultrasound (tFUS), in which acoustic energy is focused on a small region in the brain through the skull, is a non-invasive therapeutic method with high spatial resolution and depth penetration. Image-guided navigation has been widely utilized to visualize the location of acoustic focus in the cranial cavity. However, this system is often inaccurate because of the significant aberrations caused by the skull. Therefore, acoustic simulations using a numerical solver have been widely adopted to compensate for this inaccuracy. Although the simulation can predict the intracranial acoustic pressure field, real-time application during tFUS treatment is almost impossible due to the high computational cost. In this study, we propose a neural network-based real-time acoustic simulation framework and test its feasibility by implementing a simulation-guided navigation (SGN) system. Real-time acoustic simulation is performed using a 3D conditional generative adversarial network (3D-cGAN) model featuring residual blocks and multiple loss functions. This network was trained by the conventional numerical acoustic simulation program (i.e., k-Wave). The SGN system is then implemented by integrating real-time acoustic simulation with a conventional image-guided navigation system. The proposed system can provide simulation results with a frame rate of 5 Hz (i.e., about 0.2 s), including all processing times. In numerical validation (3D-cGAN vs. k-Wave), the average peak intracranial pressure error was 6.8 ± 5.5%, and the average acoustic focus position error was 5.3 ± 7.7 mm. In experimental validation using a skull phantom (3D-cGAN vs. actual measurement), the average peak intracranial pressure error was 4.5%, and the average acoustic focus position error was 6.6 mm. These results demonstrate that the SGN system can predict the intracranial acoustic field according to transducer placement in real-time.
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Affiliation(s)
- Tae Young Park
- Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Division of Bio-Medical Science and Technology, KIST School, Korea University of Science and Technology, Seoul 02792, Republic of Korea
| | - Heekyung Koh
- Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - Wonhye Lee
- Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - So Hee Park
- Department of Neurosurgery, Yeungnam University Medical Center, Daegu 42415, Republic of Korea
| | - Won Seok Chang
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul 04527, Republic of Korea
| | - Hyungmin Kim
- Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Division of Bio-Medical Science and Technology, KIST School, Korea University of Science and Technology, Seoul 02792, Republic of Korea.
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Sigona MK, Manuel TJ, Anthony Phipps M, Boroujeni KB, Treuting RL, Womelsdorf T, Caskey CF. Generating Patient-Specific Acoustic Simulations for Transcranial Focused Ultrasound Procedures Based on Optical Tracking Information. IEEE OPEN JOURNAL OF ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 3:146-156. [PMID: 38222464 PMCID: PMC10785958 DOI: 10.1109/ojuffc.2023.3318560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Optical tracking is a real-time transducer positioning method for transcranial focused ultrasound (tFUS) procedures, but the predicted focus from optical tracking typically does not incorporate subject-specific skull information. Acoustic simulations can estimate the pressure field when propagating through the cranium but rely on accurately replicating the positioning of the transducer and skull in a simulated space. Here, we develop and characterize the accuracy of a workflow that creates simulation grids based on optical tracking information in a neuronavigated phantom with and without transmission through an ex vivo skull cap. The software pipeline could replicate the geometry of the tFUS procedure within the limits of the optical tracking system (transcranial target registration error (TRE): 3.9 ± 0.7 mm). The simulated focus and the free-field focus predicted by optical tracking had low Euclidean distance errors of 0.5±0.1 and 1.2±0.4 mm for phantom and skull cap, respectively, and some skull-specific effects were captured by the simulation. However, the TRE of simulation informed by optical tracking was 4.6±0.2, which is as large or greater than the focal spot size used by many tFUS systems. By updating the position of the transducer using the original TRE offset, we reduced the simulated TRE to 1.1 ± 0.4 mm. Our study describes a software pipeline for treatment planning, evaluates its accuracy, and demonstrates an approach using MR-acoustic radiation force imaging as a method to improve dosimetry. Overall, our software pipeline helps estimate acoustic exposure, and our study highlights the need for image feedback to increase the accuracy of tFUS dosimetry.
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Affiliation(s)
- Michelle K Sigona
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232, USA
| | - Thomas J Manuel
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232, USA
| | - M Anthony Phipps
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | | | - Robert Louie Treuting
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA
| | - Thilo Womelsdorf
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA
| | - Charles F Caskey
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212, USA
- Vanderbilt University Institute of Imaging Science, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37212, USA
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Liu H, Sigona MK, Manuel TJ, Chen LM, Dawant BM, Caskey CF. Evaluation of synthetically generated computed tomography for use in transcranial focused ultrasound procedures. J Med Imaging (Bellingham) 2023; 10:055001. [PMID: 37744953 PMCID: PMC10514703 DOI: 10.1117/1.jmi.10.5.055001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 07/06/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose Transcranial focused ultrasound (tFUS) is a therapeutic ultrasound method that focuses sound through the skull to a small region noninvasively and often under magnetic resonance imaging (MRI) guidance. CT imaging is used to estimate the acoustic properties that vary between individual skulls to enable effective focusing during tFUS procedures, exposing patients to potentially harmful radiation. A method to estimate acoustic parameters in the skull without the need for CT is desirable. Approach We synthesized CT images from routinely acquired T1-weighted MRI using a 3D patch-based conditional generative adversarial network and evaluated the performance of synthesized CT (sCT) images for treatment planning with tFUS. We compared the performance of sCT with real CT (rCT) images for tFUS planning using Kranion and simulations using the acoustic toolbox, k-Wave. Simulations were performed for 3 tFUS scenarios: (1) no aberration correction, (2) correction with phases calculated from Kranion, and (3) phase shifts calculated from time reversal. Results From Kranion, the skull density ratio, skull thickness, and number of active elements between rCT and sCT had Pearson's correlation coefficients of 0.94, 0.92, and 0.98, respectively. Among 20 targets, differences in simulated peak pressure between rCT and sCT were largest without phase correction (12.4 % ± 8.1 % ) and smallest with Kranion phases (7.3 % ± 6.0 % ). The distance between peak focal locations between rCT and sCT was < 1.3 mm for all simulation cases. Conclusions Real and synthetically generated skulls had comparable image similarity, skull measurements, and acoustic simulation metrics. Our work demonstrated similar results for 10 testing cases comparing MR-sCTs and rCTs for tFUS planning. Source code and a docker image with the trained model are available at https://github.com/han-liu/SynCT_TcMRgFUS.
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Affiliation(s)
- Han Liu
- Vanderbilt University, Department of Computer Science, Nashville, Tennessee, United States
| | - Michelle K. Sigona
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Vanderbilt University, Institute of Imaging Science, Nashville, Tennessee, United States
| | - Thomas J. Manuel
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Vanderbilt University, Institute of Imaging Science, Nashville, Tennessee, United States
| | - Li Min Chen
- Vanderbilt University, Institute of Imaging Science, Nashville, Tennessee, United States
- Vanderbilt University, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
| | - Benoit M. Dawant
- Vanderbilt University, Department of Electrical and Computer Engineering, Nashville, Tennessee, United States
| | - Charles F. Caskey
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Vanderbilt University, Institute of Imaging Science, Nashville, Tennessee, United States
- Vanderbilt University, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
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Yaakub SN, White TA, Kerfoot E, Verhagen L, Hammers A, Fouragnan EF. Pseudo-CTs from T1-weighted MRI for planning of low-intensity transcranial focused ultrasound neuromodulation: An open-source tool. Brain Stimul 2023; 16:75-78. [PMID: 36669697 DOI: 10.1016/j.brs.2023.01.838] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/14/2023] [Indexed: 01/19/2023] Open
Affiliation(s)
- Siti N Yaakub
- Brain Research & Imaging Centre, Faculty of Health, University of Plymouth, Plymouth, UK; School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK; King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
| | - Tristan A White
- Brain Research & Imaging Centre, Faculty of Health, University of Plymouth, Plymouth, UK; School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Eric Kerfoot
- Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Lennart Verhagen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Alexander Hammers
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Elsa F Fouragnan
- Brain Research & Imaging Centre, Faculty of Health, University of Plymouth, Plymouth, UK; School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK
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