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Multicenter Study
. 2025 Jan;28(1):146-154.
doi: 10.1016/j.neurom.2024.03.004. Epub 2024 Apr 29.

A Low-Intensity Transcranial Focused Ultrasound Parameter Exploration Study of the Ventral Capsule/Ventral Striatum

Tina Chou  1 , Brian J Kochanowski  2 , Ashley Hayden  2 , Benjamin M Borron  2 , Miguel C Barbeiro  2 , Junqian Xu  3 , Joo-Won Kim  3 , Xuefeng Zhang  4 , Richard R Bouchard  5 , Kinh Luan Phan  6 , Wayne K Goodman  4 , Darin D Dougherty  2
Affiliations
Multicenter Study

A Low-Intensity Transcranial Focused Ultrasound Parameter Exploration Study of the Ventral Capsule/Ventral Striatum

Tina Chou et al. Neuromodulation. 2025 Jan.

Abstract

Objectives: Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is effective for treatment-resistant obsessive-compulsive disorder (OCD); however, DBS is associated with neurosurgical risks. Transcranial focused ultrasound (tFUS) is a newer form of noninvasive (ie, nonsurgical) stimulation that can modulate deeper regions, such as the VC/VS. tFUS parameters have just begun to be studied and have often not been compared in the same participants. We explored the effects of three VC/VS tFUS protocols and an entorhinal cortex (ErC) tFUS session on the VC/VS and cortico-striato-thalamo-cortical circuit (CSTC) in healthy individuals for later application to patients with OCD.

Materials and methods: Twelve individuals participated in a total of 48 sessions of tFUS in this exploratory multisite, within-subject parameter study. We collected resting-state, reward task, and arterial spin-labeled (ASL) magnetic resonance imaging scans before and after ErC tFUS and three VC/VS tFUS sessions with different pulse repetition frequencies (PRFs), pulse widths (PWs), and duty cycles (DCs).

Results: VC/VS protocol A (PRF = 10 Hz, PW = 5 ms, 5% DC) was associated with increased putamen activation during a reward task (p = 0.003), and increased VC/VS resting-state functional connectivity (rsFC) with the anterior cingulate cortex (p = 0.022) and orbitofrontal cortex (p = 0.004). VC/VS protocol C (PRF = 125 Hz, PW = 4 ms, 50% DC) was associated with decreased VC/VS rsFC with the putamen (p = 0.017), and increased VC/VS rsFC with the globus pallidus (p = 0.008). VC/VS protocol B (PRF = 125 Hz, PW = 0.4 ms, 5% DC) was not associated with changes in task-related CSTC activation or rsFC. None of the protocols affected CSTC ASL perfusion.

Conclusions: This study began to explore the multidimensional parameter space of an emerging form of noninvasive brain stimulation, tFUS. Our preliminary findings in a small sample suggest that VC/VS tFUS should continue to be investigated for future noninvasive treatment of OCD.

Keywords: Cortico-striato-thalamo-cortical circuit; obsessive-compulsive disorder; reward; transcranial focused ultrasound; ventral striatum.

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Conflict of interest statement

Conflict of Interest Tina Chou reports consulting fees from Kintsugi Mindful Wellness. Darin D. Dougherty reports research support and honoraria from Medtronic, an advisory role at Celanese, Sage, and Boehringer Ingelheim, and equity and an advisory role at Innercosmos, Intrinsic Powers, and Neurable. Wayne K. Goodman reports consulting fees from Biohaven, royalties from nView LLC and OCD scales, LLC, and funding from National Institutes of Health, The Robert and Janice McNair Foundation, and International Obsessive Compulsive Disorder Foundation. The remaining authors reported no conflict of interest.

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