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Transcranial ultrasound stimulation of the pulvinar and globus pallidus internus facilitates visual search

Hamidreza Ramezanpour, Ghazaleh Darmani, Regina Annirood, Can Sarica, Jean-Francois Nankoo, Samuel Pichardo, Jeffrey D. Schall, Andres M. Lozano, Robert Chen

iScience 2026, 29, 116316 · 10.1016/j.isci.2026.116316

human healthyhealthybehaviour

Abstract

Ultrasound offers a powerful means of modulating human cognition by noninvasively targeting subcortical structures previously accessible only via invasive procedures. While decades of research have mapped cortical circuits of attention, deep hubs such as the basal ganglia and thalamus are increasingly recognized as key nodes in attention networks. We tested whether low-intensity transcranial ultrasound stimulation (TUS) of the globus pallidus internus (GPi) and pulvinar modulates visual search, an attention-dependent task, predicting site-specific effects that reflect distinct basal ganglia-thalamic circuit functions. Focal TUS reduced reaction times, suggesting a facilitation of attention-related task performance. A dissociation emerged across sites: stimulation of both GPi and pulvinar reduced reaction times, but pulvinar yielded more robust benefits for target-present trials at peripheral eccentricities, and improved search efficiency in the same trials. These results support distinct contributions of basal ganglia and thalamic nodes to attention-related behavior and show that TUS can be used to probe circuit-level mechanisms of cognition in humans.

Abstract via europepmc.

Specieshuman
Subjects15 participants
Sessions per subject2
Randomisedyes
Blindingsingle
Sham / controlnone
Auditory controlnot reported
Readout timingoffline
Anaesthesianot applicable
Readoutsbehaviour'T among Ls' visual search task: accuracy and reaction time by set size, target eccentricity, and target presence/absence; search-efficiency (RT-set size slope)
Direction of effectexcitatoryTUS of both GPi and pulvinar reduced visual-search reaction times (facilitated attention-related performance) without affecting accuracy; pulvinar produced larger, more efficient improvements than GPi specifically for target-present trials at peripheral eccentricities.
Adverse eventsnot reportedAcoustic simulations predicted maximum temperature rises of 0.16C in brain, 0.25C in skin, and 0.30C in skull; all acoustic parameters were reported to remain within FDA and ITRUSST safety limits.

Exposures

Exposure 1: GPi TUS

Target: globus pallidus internus — “globus pallidus internus (GPi)
Device: Sonic Concepts · Sonic Concepts

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)120✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)30✓✓
Free-field Ispta (W/cm²)not reported
In-situ estimatesimulationmean or range across subjects
In-situ pressure (kPa)not reported
In-situ Isppa (W/cm²)2.5, 7swept?
In-situ Ispta (W/cm²)0.25, 0.7swept✓✓
Protocol, in the paper’s words

A theta-burst TUS (tbTUS) protocol consisting of 20 ms bursts at 50 Hz repeated every 200 ms (10% duty cycle) was delivered for 120 s to each hemisphere in turn (bilateral). Behavioral testing occurred in three blocks per session: baseline (Pre), immediately after sonicating the first hemisphere (Post-1), and after sonicating the second hemisphere (Post-2).

Exposure 2: Pulvinar TUS

Target: pulvinar — “pulvinar nucleus of the thalamus
Device: Sonic Concepts · Sonic Concepts

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)120✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)30✓✓
Free-field Ispta (W/cm²)not reported
In-situ estimatesimulationmean or range across subjects
In-situ pressure (kPa)not reported
In-situ Isppa (W/cm²)2.5, 7swept?
In-situ Ispta (W/cm²)0.25, 0.7swept✓✓
Protocol, in the paper’s words

A theta-burst TUS (tbTUS) protocol consisting of 20 ms bursts at 50 Hz repeated every 200 ms (10% duty cycle) was delivered for 120 s to each hemisphere in turn (bilateral). Behavioral testing occurred in three blocks per session: baseline (Pre), immediately after sonicating the first hemisphere (Post-1), and after sonicating the second hemisphere (Post-2).

Flags from extraction

  • exposures[0].timing.pulse_duration_msProtocol described as '20 ms bursts at 50 Hz repeated every 200 ms (10% duty cycle)'; the stated duty cycle (10%) and period (200 ms, i.e. PRF=5 Hz) are consistent with a 20 ms burst duration, but the paper also cites '50 Hz' without stating how it fits the 20 ms/200 ms burst structure; recorded pulse_duration=20 ms and PRF=5 Hz as the values consistent with the stated duty cycle, and flagged for the unresolved '50 Hz' term (put in protocol_description).
  • exposures[0].in_situ.isppa_w_cm2Methods reports in-brain ISPPA as 2.5-7 W/cm2 (with ISPTA 0.25-0.7 W/cm2), while the Discussion separately states 'ISPPA ≈ 2-8 W/cm2 in brain'; the two ranges differ slightly. The more detailed Methods range (2.5-7) was used.
  • blindingParticipants were blind to which structure (GPi vs pulvinar) was targeted in each session, but were not blinded to stimulation timing (transducer removal made stimulation offset apparent) and there was no sham condition; coded as single (blinding to stimulation target only).
  • sham_typeThe paper explicitly states there was no sham condition ('The absence of a sham condition ... leave open the possibility of expectation-related effects').
  • randomisedThe order of GPi vs pulvinar sessions was randomized across participants; there was no sham/control arm to randomize against.