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Neuromodulation with single‐element transcranial focused ultrasound in human thalamus

Wynn Legon, Leo Ai, Priya Bansal, Jerel K. Mueller

Human Brain Mapping 2018, 39, 1995-2006 · 10.1002/hbm.23981

human healthyhealthyeeg megbehaviour

Abstract

Transcranial focused ultrasound (tFUS) has proven capable of stimulating cortical tissue in humans. tFUS confers high spatial resolutions with deep focal lengths and as such, has the potential to noninvasively modulate neural targets deep to the cortex in humans. We test the ability of single-element tFUS to noninvasively modulate unilateral thalamus in humans. Participants (N = 40) underwent either tFUS or sham neuromodulation targeted at the unilateral sensory thalamus that contains the ventro-posterior lateral (VPL) nucleus of thalamus. Somatosensory evoked potentials (SEPs) were recorded from scalp electrodes contralateral to median nerve stimulation. Activity of the unilateral sensory thalamus was indexed by the P14 SEP generated in the VPL nucleus and cortical somatosensory activity by subsequent inflexions of the SEP and through time/frequency analysis. Participants also under went tactile behavioral assessment during either the tFUS or sham condition in a separate experiment. A detailed acoustic model using computed tomography (CT) and magnetic resonance imaging (MRI) is also presented to assess the effect of individual skull morphology for single-element deep brain neuromodulation in humans. tFUS targeted at unilateral sensory thalamus inhibited the amplitude of the P14 SEP as compared to sham. There is evidence of translation of this effect to time windows of the EEG commensurate with SI and SII activities. These results were accompanied by alpha and beta power attenuation as well as time-locked gamma power inhibition. Furthermore, participants performed significantly worse than chance on a discrimination task during tFUS stimulation.

Abstract via europepmc.

Specieshuman
Subjects40 participants
Sessions per subject1
Randomisedyes
Blindingnot reported
Sham / controlinactive transducer
Auditory controlmatched device sound
Readout timingonline
Anaesthesianot applicable
Readoutseeg meg, behaviourSomatosensory evoked potential (P14, N20, P27, N33, P50, N70, P100, N140, LP) peak-to-peak amplitude/latency, FFT and Morlet wavelet time-frequency EEG analysis; two-point tactile discrimination task performance
Direction of effectinhibitorytFUS to the VPL nucleus of thalamus attenuated the P14/N20 SEP peak-to-peak amplitude and EEG time series activity at 14-21 ms, inhibited early negativity around 35 ms, decreased alpha and beta spectral power and time-locked gamma power, and impaired performance below chance on a threshold two-point tactile discrimination task relative to sham.
Adverse eventsnot reportedThe authors state they restricted acoustic intensity and mechanical index well below FDA diagnostic ultrasound limits (Isppa 190 W/cm2, MI 1.9) and used a pulsing strategy to avoid standing waves; no participant-level adverse event monitoring data are reported for this study.

Exposures

Exposure 1: Unilateral sensory thalamus (VPL nucleus), EEG and behavioural experiments

Target: ventral posterolateral nucleus — “unilateral sensory thalamus that contains the ventro-posterior lateral (VPL) nucleus of thalamus
Device: Ultran · Ultran Group, Inc., State College, PA

Pulse timing
Waveformpulsed
Fundamental frequency (kHz)500✓✓
Pulse duration (ms)0.36✓✓
Pulse repetition frequency (Hz)1,000✓✓
Duty cycle (%)36pulse duration × PRF gives 36%✓✓
Sonication duration (s)0.5✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)14.56✓✓
Free-field Ispta (W/cm²)not reported
In-situ estimatemeasurementsingle value
In-situ pressure (kPa)137.8✓✓
In-situ Isppa (W/cm²)7.03✓✓
In-situ Ispta (W/cm²)not reported
Protocol, in the paper’s words

Channel 1 was used to gate channel 2 that was a 500 kHz sine wave. Channel 1 was a 5Vp-p square wave burst of 1 kHz (N=500) with a pulse width of 360 ms (as printed; see flag); this resulted in a 0.5 s duration waveform with a duty cycle of 36%. A total of 300 ultrasonic waveforms were delivered at an inter-stimulus interval (ISI) of 4 s for the EEG experiment; for the behavioural experiment, tFUS onset (500 ms duration) occurred 100 ms before pin application to the fingertip.

Consistency checks: intensity pressure inconsistent in situ.

Flags from extraction

  • exposures[0].timing.pulse_duration_msText states a pulse width of '360 ms', but this is inconsistent with the stated 1 kHz PRF and 36% duty cycle, which imply a pulse duration of 0.36 ms (360 microseconds); recorded as printed per the burst-duration rule.
  • exposures[0].in_situPaper also reports an intracranial peak pressure of 137.79 kPa obtained from a separate k-Wave simulation (a different method, on a generic Visible Human skull) using the same transducer/waveform; only the empirically measured through-skull intensity (method=measurement) is recorded here because the schema allows only one method per in_situ block.
  • auditory_controlThe paper does not use a standard auditory-control vocabulary term; it describes the sham (attenuating disk) as producing an audible sensation identical to the active condition, which is recorded here as 'other'.