Low-intensity focused ultrasound for a child with chronic disorders of consciousness: a promising case report

Xiao Zhang, Guo-Li Zhu, Zheng Wang, Dan Gao, Xiao-Hui Sun, Li-juan Ao

Brain Injury 2026 · 10.1080/02699052.2026.2673988

human patientdisorders of consciousnessfmriclinical scale

Abstract

Purpose Low-intensity focused ultrasound (LIFU) is an emerging neuromodulation technique. We report the first application of thalamic LIFU in a pediatric patient with prolonged disorder of consciousness (pDOC) to evaluate its safety and efficacy. Methods A single pediatric patient with pDOC received 12 sessions of neuroimaging-guided LIFU targeting the left thalamus. Clinical scales (Pediatric Glasgow Coma Scale, Coma Recovery Scale - Revised, activities of daily living, functional oral intake) were assessed longitudinally. Resting-state fMRI was acquired before and after intervention to analyze whole-brain and seed-based functional connectivity. Results After LIFU, the patient showed significant clinical improvement: full score on PGCS, CRS-R increased from 8 to 20, and enhanced swallowing and daily function. No adverse events occurred. fMRI revealed strengthened connectivity within the default mode and task-positive networks, alongside reduced non-essential couplings, indicating functional network reorganization. Conclusion Thalamic LIFU appears safe and potentially effective in this pediatric pDOC case, with clinical gains possibly mediated by reorganized brain connectivity. These findings support further investigation of LIFU as a novel treatment for pediatric consciousness disorders.

Abstract via europepmc.

Specieshuman

Subjects1 participants

Sessions per subject12

Randomisedno

Blindingnot reported

Sham / controlnone

Auditory controlnot reported

Readout timingoffline

Anaesthesianot applicable

Readoutsfmri, clinical scale — PGCS; CRS-R; ADL; FOIS; Rancho Los Amigos; resting-state fMRI functional connectivity (CONN, PCC seed)

Direction of effectmixed or unclearSingle paediatric patient improved clinically (PGCS 8 to 15, CRS-R 8 to 20 by week 4); fMRI showed strengthened default-mode and task-positive connectivity with some weakened couplings. No control condition.

Adverse eventsnone observedNo adverse events were reported throughout the intervention.

Exposures

Exposure 1: Thalamic LIFU, 12 sessions

Target: thalamus — “left thalamus”
Device: NeuroFUS · Sonic Concepts (sold by Brainbox) · NeuroFUS TPO-203 ✓

Pulse timing
Waveform	pulsed
Fundamental frequency (kHz)	not reported	⚑
Pulse duration (ms)	0.3	✓✓✓
Pulse repetition frequency (Hz)	200	✓✓✓
Duty cycle (%)	6pulse duration × PRF gives 6%	✓✓✓
Sonication duration (s)	1	✓✓✓

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 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	✓✓✓

Protocol, in the paper’s words

20-minute sessions three times per week for 12 sessions; TBD 0.3 ms, PRP 5 ms, PRF 200 Hz, sonication duration 1 s, stimulation period 6 s, DC 6%.

Flags from extraction

exposures[0].device.family — Paper names the device 'NeuroFUS TPO-203 (BrainSonix)'; classified neurofus because NeuroFUS/TPO is named, but the paper attributes it to BrainSonix.
exposures[0].fundamental_frequency_khz — Carrier frequency not stated.
exposures[0].unspecified_domain.isppa_w_cm2 — Intensities given without saying whether free-field or in situ.