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Effects of the motor cortical theta‐burst transcranial‐focused ultrasound stimulation on the contralateral motor cortex

Xue Xia, Zhen Wang, Ke Zeng, Jean‐François Nankoo, Ghazaleh Darmani, Stephanie Tran, Mandy Yi Rong Ding, Robert Chen

The Journal of Physiology 2024, 602, 2931-2943 · 10.1113/jp285139

human healthyhealthyemg mep

Abstract

Theta-burst transcranial ultrasound stimulation (tbTUS) increases primary motor cortex (M1) excitability for at least 30 min. However, the remote effects of focal M1 tbTUS on the excitability of other cortical areas are unknown. Here, we examined the effects of left M1 tbTUS on right M1 excitability. An 80 s train of active or sham tbTUS was delivered to the left M1 in 20 healthy subjects. Before and after the tbTUS, we measured: (1) corticospinal excitability using motor-evoked potential (MEP) amplitudes from single-pulse transcranial magnetic stimulation (TMS) of left and right M1; (2) interhemispheric inhibition (IHI) from left to right M1 and from right to left M1 using a dual-site paired-pulse TMS paradigm; and (3) intracortical circuits of the right M1 with short-interval intracortical inhibition and intracortical facilitation (ICF) using paired-pulse TMS. Left M1 tbTUS decreased right M1 excitability as shown by decreased MEP amplitudes, increased right M1 ICF and decreased short-interval IHI from left to right hemisphere at interstimulus interval (ISI) of 10 ms but not long-interval IHI at interstimulus interval of 40 ms. The study showed that left M1 tbTUS can change the excitability of remote cortical areas with decreased right M1 excitability and interhemispheric inhibition. The remote effects of tbTUS should be considered when it is used in neuroscience research and as a potential neuromodulation treatment for brain disorders. KEY POINTS: Transcranial ultrasound stimulation (TUS) is a novel non-invasive brain stimulation technique for neuromodulation with the advantages of being able to achieve high spatial resolution and target deep brain structures. A repetitive TUS protocol, with an 80 s train of theta burst patterned TUS (tbTUS), has been shown to increase primary motor cortex (M1) excitability, as well as increase alpha and beta movement-related spectral power in distinct brain regions. In this study, we examined on the effects of the motor cortical tbTUS on the excitability of contralateral M1 measured with MEPs elicited by transcranial magnetic stimulation. We showed that left M1 tbTUS decreased right M1 excitability and left-to-right M1 interhemispheric inhibition, and increased intracortical facilitation of right M1. These results lead to better understand the effects of tbTUS and can help the development of tbTUS for the treatment of neurological and psychiatric disorders and in neuroscience research.

Abstract via europepmc.

Specieshuman
Subjects20 participants
Sessions per subject2
Randomisednot reported
Blindingnot reported
Sham / controlinactive transducer
Auditory controlmasking sound
Readout timingboth
Anaesthesianot applicable
Readoutsemg mepMotor-evoked potentials (MEP), interhemispheric inhibition (IHI), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) measured with single- and paired-pulse TMS
Direction of effectbidirectionalLeft M1 tbTUS increased ipsilateral (left) M1 excitability (excitatory) but decreased contralateral (right) M1 excitability, increased left-to-right short-interval interhemispheric inhibition and increased right M1 intracortical facilitation (inhibitory/remote effect).
Adverse eventsnot reported

Exposures

Exposure 1: Left M1 tbTUS

Target: primary motor cortex — “left M1
Device: Sonic Concepts · Sonic Concepts Inc. · H246

Pulse timing
Waveformtheta burst
Fundamental frequency (kHz)500✓✓
Pulse duration (ms)20✓✓
Pulse repetition frequency (Hz)5✓✓
Duty cycle (%)10pulse duration × PRF gives 10%✓✓
Sonication duration (s)80✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)11.73✓✓
Free-field Ispta (W/cm²)1.17✓✓
In-situ estimatederatingsingle value
In-situ pressure (kPa)not reported
In-situ Isppa (W/cm²)2.93✓✓
In-situ Ispta (W/cm²)0.29✓✓
Protocol, in the paper’s words

tbTUS consisted of an 80 s train of 20 ms ultrasound bursts repeated every 200 ms, with a total of 400 bursts. The sonication depth was set at 30 mm, power was set at 20 W, with 5 Hz pulse repetition frequency and 10% duty cycle.

Flags from extraction

  • randomisedPaper states order was counterbalanced across subjects but does not explicitly state randomisation method
  • adverse_eventsPaper does not explicitly report on adverse events beyond confirming no participant heard anything besides the masking noise