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Therapeutic potential of low-intensity transcranial focused ultrasound targeting the motor thalamus for motor impairment after basal ganglia stroke

Zhongfei Bai, Dan Yu, Jack Jiaqi Zhang, Feifei Zhu, Shan Liang, Minxia Jin, Ke Zeng, Jiani Lu, Wenting Qin, Ulf Ziemann, Lingjing Jin

Clinical Neurophysiology 2026, 185, 2111707 · 10.1016/j.clinph.2026.2111707

human patientstrokebehavioureeg meg
Specieshuman
Subjects1 participants
Sessions per subject20
Randomisedno
Blindingnot reported
Sham / controlnone
Auditory controlnot reported
Readout timingoffline
Anaesthesianot applicable
Readoutsbehaviour, eeg megFugl-Meyer Assessment for Upper Extremity (FMA-UE); Wolf Motor Function Test (WMFT); locomotion/gait analysis; single-pulse TMS-EEG (TMS-evoked potentials, global mean field power, source current density/scattering, PCI-lz, weighted phase lag index)
Direction of effectexcitatoryUpper and lower extremity motor function improved (FMA-UE 54 to 59, WMFT 21 to 24, increased step length and walking speed) after VLp tFUS. TMS-EEG showed increased late TEP amplitudes, enhanced TEP propagation to more distal regions (SCS), increased PCI-lz complexity, and strengthened beta-band phase coupling, interpreted as enhanced excitability and communication within the cerebello-thalamo-cortical loop.
Adverse eventsnone observedNo adverse events or discomfort were reported.

Exposures

Exposure 1: tFUS theta-burst stimulation of the VLp

Target: ventral lateral nucleus — “ventral lateral posterior (VLp) nucleus
Device: Sonic Concepts · Sonic Concepts Inc. · four-element transducer (DPX500) with TPO201-80 programmable radiofrequency amplifier

Pulse timing
Waveformtheta burst
Fundamental frequency (kHz)500✓✓
Pulse duration (ms)20✓✓
Pulse repetition frequency (Hz)5✓✓
Duty cycle (%)not reportedpulse duration × PRF gives 10%
Sonication duration (s)120✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)17.3✓✓
Free-field Ispta (W/cm²)not reported
In-situ estimatesimulationsingle value
In-situ pressure (kPa)not reported
In-situ Isppa (W/cm²)2.26✓✓
In-situ Ispta (W/cm²)0.23✓✓
Protocol, in the paper’s words

tFUS was initiated over four weeks, comprising a total of 20 sessions, five sessions per week, following two baseline assessments (Pre1 and Pre2) separated by a two-week interval; post-intervention assessments were conducted at two weeks (Post1) and at the end of the four-week intervention (Post2).

Flags from extraction

  • n_subjectsSingle-patient case study; n_subjects=1 by design.
  • exposures[0].timing.duty_cycle_pctNot stated as a percentage; 20 ms pulses at 5 Hz would imply 10% duty cycle but this is not computed here per instructions.
  • randomisedNot explicitly labelled in the text; inferred from this being a single case study and the authors' statement that a randomized controlled trial 'is currently underway'.
  • exposures[0].device.familyTransducer (DPX500) manufacturer is not stated; classified as sonic_concepts because the driving amplifier (TPO201-80) is explicitly attributed to Sonic Concepts Inc.