Feasibility and Safety of Transcranial Focused Ultrasound on Language Impairment in a Patient with Autism Spectrum Disorder: A Case Report
Chaoshan Yan, Guoli Zhu, Shan Liang, Yanpin Zhao, Weimin Chen, Qing Xia, Jing Jian, Zheng Wang, Beihua Zhang, Lijuan Ao
International Medical Case Reports Journal 2026 · 10.2147/imcrj.s653087
Abstract
Background Autism spectrum disorder (ASD) is defined by persistent difficulties with social communication and language, and a subset of children stay minimally verbal despite intensive interventions. The left amygdala and ventral-anterior superior temporal sulcus (STSva) form a key circuit for social-language integration, but how transcranial focused ultrasound (tFUS) might modulate in minimally verbal ASD has not been explored. Case presentation An 11-year-old minimally verbal ASD boy received 4 weeks of sequential tFUS stimulation (0.5 MHz). The treatment targeted the left amygdala and STSva, five times per week. Outcome assessments included the Mandarin Clinical Evaluation of Language for Preschoolers' Core Scale (MCELP-CS), Autism Behavior Checklist (ABC), and functional near-infrared spectroscopy (fNIRS) at pre-tFUS, post-tFUS, and a 4-week follow-up. The boy tolerated the intervention well, with no adverse events. Significant improvements in key language skills (vocabulary naming +10%, sentence structure imitation +22%) and reduced ASD symptoms (ABC language -40%, social interaction -26%) were observed post-tFUS and sustained at follow-up. fNIRS confirmed altered cortical activation and reorganized functional connectivity in language-related brain regions. Conclusion This single-case observational report describes acceptable tolerance to sequential tFUS targeting the left amygdala-STSva circuit in a minimally verbal child with ASD, alongside concomitant behavioural and neuroimaging changes. These preliminary observations provide descriptive, hypothesis-generating data for this circuit-directed intervention strategy and highlight the necessity of larger controlled trials to further evaluate its potential clinical utility.
Abstract via europepmc.
Exposures
Exposure 1: Left amygdala (sequential, first)
Target: amygdala — “left amygdala”
Device: NeuroFUS · Sonic Concepts (sold by Brainbox) · NeuroFUS PRO ✓
| Waveform | pulsed | |
|---|---|---|
| Fundamental frequency (kHz) | 500 | ✓✓✓ |
| Pulse duration (ms) | 0.4 | ✓✓✓ |
| Pulse repetition frequency (Hz) | 40 | ✓✓✓ |
| Duty cycle (%) | 1.6pulse duration × PRF gives 1.6% | ✓✓✓ |
| Sonication duration (s) | 0.4 | ✓✓✓⚑ |
| Free-field pressure (kPa) | not reported | |
|---|---|---|
| Free-field Isppa (W/cm²) | not reported | |
| Free-field Ispta (W/cm²) | not reported | |
| In-situ estimate | not reported | |
| In-situ pressure (kPa) | not reported | |
| In-situ Isppa (W/cm²) | not reported | |
| In-situ Ispta (W/cm²) | not reported | |
| Isppa, domain unspecified (W/cm²) | 30 | ✓✓✓⚑ |
| Ispta, domain unspecified (W/cm²) | 0.48 | ✓✓✓ |
PRF 40 Hz, DC 1.6%, pulse train duration 400 ms, single pulse 0.4 ms, pulse repetition interval 25 ms, 30 min per session; delivered first, then the STSva; daily Monday to Friday for 4 weeks.
Exposure 2: Left STSva (sequential, second)
Target: superior temporal gyrus — “left ventral-anterior superior temporal sulcus (STSva)”
Device: NeuroFUS · Sonic Concepts (sold by Brainbox) · NeuroFUS PRO ✓
| Waveform | pulsed | |
|---|---|---|
| Fundamental frequency (kHz) | 500 | ✓✓✓ |
| Pulse duration (ms) | 0.3 | ✓✓✓ |
| Pulse repetition frequency (Hz) | 200 | ✓✓✓ |
| Duty cycle (%) | 6pulse duration × PRF gives 6% | ✓✓✓ |
| Sonication duration (s) | 1 | ✓✓✓⚑ |
| Free-field pressure (kPa) | not reported | |
|---|---|---|
| Free-field Isppa (W/cm²) | not reported | |
| Free-field Ispta (W/cm²) | not reported | |
| In-situ estimate | not reported | |
| In-situ pressure (kPa) | not reported | |
| In-situ Isppa (W/cm²) | not reported | |
| In-situ Ispta (W/cm²) | not reported | |
| Isppa, domain unspecified (W/cm²) | 12 | ✓✓✓⚑ |
| Ispta, domain unspecified (W/cm²) | 0.72 | ✓✓✓ |
PRF 200 Hz, DC 6%, pulse train duration 1000 ms, single pulse 0.3 ms, pulse repetition interval 5 ms, 20 min per session; delivered after the amygdala; daily Monday to Friday for 4 weeks.
Flags from extraction
exposures[0].unspecified_domain.isppa_w_cm2— Isppa and Ispta listed with the BabelBrain-planned parameters, but the paper does not say whether they are free-field or in-situ values.exposures[1].unspecified_domain.isppa_w_cm2— Same domain ambiguity as exposure 0.exposures[0].timing.sonication_duration_s— Recorded as the stated pulse train duration (400 ms); session length is 30 min.exposures[1].timing.sonication_duration_s— Recorded as the stated pulse train duration (1000 ms); session length is 20 min.blinding— Case report; outcome scales scored by two blinded raters; no sham.n_subjects— Single-case report.