Neuroimaging informed Transcranial Focused Ultrasound (tFUS)

Transcranial low-intensity focused ultrasound (FUS) is an emerging noninvasive neuromodulation tool that enables focal and highly precise stimulation of brain targets, particularly deep brain structures. Ultrasound neuromodulation can be achieved using either a wearable single ultrasound transducer or more sophisticated transducer arrays, each offering distinct technical advantages depending on the location, volume, and precision of the targeted brain area. Its clinical applications, such as in the management of chronic pain and mental disorders, are still in their early stages. Since ultrasound energy attenuates as it penetrates the skull, target planning typically relies on simulations. However, due to the inhomogeneity of skull thickness and bone density, it is desirable in clinical practice to monitor the real-time location of the FUS beam in the brain using MR-ARFI (magnetic resonance acoustic radiation force imaging) and to assess the functional engagement of the brain target with functional MRI. During my talk, I will review our recent technical developments in MR-guided FUS systems and the use of MR-ARFI for real-time tracking of the FUS beam at various brain targets. I will also discuss the exploration of FUS parameters for modulating pain circuits and their associated functional pathways in a large animal model. These preclinical studies provide a unique opportunity to identify optimal targets and refine dosage and stimulation paradigms before progressing to clinical trials.