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Thalamic tFUS for Post-Stroke Motor Recovery: A Pilot Multimodal Neurobehavioral Study

Simeng Wu, Xin Zhang, Jixuan Kang, Yan Chen, Heng Wang, Hehe Chen, Luhan Zhang, Weixin Zhu, Xiao Zhang

2026 · 10.64898/2026.07.07.26357338

human patientstrokeeeg megfmribehaviour

Abstract

Effective modulation of cortical–subcortical motor circuits is essential for post-stroke recovery, yet progress has been constrained by the absence of non-invasive tools capable of precisely targeting deep brain structures. In this pilot proof-of-concept study, we explored the feasibility and preliminary neuromodulatory effects of a 12-minute transcranial focused ultrasound (tFUS) protocol targeting the ipsilesional ventral lateral posterior (VLp) thalamus in ischemic stroke patients. Six individuals with upper-limb hemiparesis received individualized, neuronavigation-guided tFUS. Sensorimotor tracking performance improved significantly after a single session. Concurrent EEG revealed reversible beta-power suppression over the ipsilesional motor cortex and enhanced theta-phase synchronization in frontoparietal networks, both of which were associated with behavioral gains. Resting-state fMRI indicated rebalancing of inter-hemispheric motor networks. These preliminary findings suggest that thalamic tFUS can modulate both local and network-level neural activity and is associated with immediate functional improvement, highlighting its potential as a feasible neuromodulation approach for deep motor circuit engagement in post-stroke rehabilitation.

Abstract via europepmc.

Specieshuman
Subjects6 participants
Sessions per subject2
Randomisedno
Blindingnone
Sham / controlnone
Auditory controlnot reported
Readout timingboth
Anaesthesianot applicable
Readoutseeg meg, fmri, behaviour — pursuit-tracking task; resting-state EEG power and phase-locking value; resting-state fMRI (ReHo, ALFF, seed connectivity)
Direction of effectmixed or unclearSingle-arm. Beta power at CP3 fell during tFUS and recovered after, theta PLV rose in frontoparietal pairs, pursuit-tracking error fell after a single session, and fMRI showed reduced contralesional motor hyperactivity.
Adverse eventsnone observedParticipants were interviewed about adverse effects; no adverse reactions were reported. Thermal simulation predicted a maximum rise of 0.2 C.

Exposures

Exposure 1: Ipsilesional VLp thalamus tFUS (two 12-min sessions)

Target: ventral lateral nucleus — “ipsilesional ventral lateral posterior (VLp) thalamus”
Device: NeuroFUS · Sonic Concepts (sold by Brainbox) · NeuroFUS TPO and DPX-500 transducer ✓

Pulse timing
Waveformpulsed
Fundamental frequency (kHz)500✓✓✓
Pulse duration (ms)not reportedimplied by duty cycle ÷ PRF: 0.2 ms (not stated by the paper)⚑
Pulse repetition frequency (Hz)1,000✓✓✓
Duty cycle (%)20✓✓✓
Sonication duration (s)0.5✓✓✓
Pressure and intensity, by domain
Free-field pressure (kPa)not reported
Free-field Isppa (W/cm²)not reported
Free-field Ispta (W/cm²)not reported
In-situ estimatesimulationsingle value
In-situ pressure (kPa)not reported
In-situ Isppa (W/cm²)8✓✓✓⚑
In-situ Ispta (W/cm²)not reported
Protocol, in the paper’s words

PRF 1000 Hz, duty cycle 20%, sonication duration 0.5 s, inter-stimulus interval 1 s; 480 pulse trains over 12 minutes. Two 12-minute sessions at least one hour apart, the second followed by resting-state fMRI.

Flags from extraction

  • exposures[0].timing.pulse_duration_ms — Pulse duration not stated in the text; left not_reported.
  • exposures[0].in_situ.isppa_w_cm2 — Stated as 'maintained at 8 W/cm2' and estimated by individualised BabelBrain simulation; method recorded as simulation.
  • sham_type — Single-arm design without sham; authors acknowledge this.
  • n_sessions_per_subject — Two 12-min tFUS sessions on the same day-block after a baseline visit; session 1 with EEG, session 2 with fMRI.