Noninvasive neuromodulation and thalamic mapping with low-intensity focused ultrasound

作者：Dallapiazza Robert F; Timbie Kelsie F; Holmberg Stephen; Gatesman Jeremy; Lopes M Beatriz; Price Richard J; Miller G Wilson; Elias W Jeffrey

来源：Journal of Neurosurgery, 2018, 128(3): 875-884.

DOI：10.3171/2016.11.JNS16976

• neuromodulation
• noninvasive
• brain mapping
• low intensity focused ultrasound
• thalamus
• somatosensory evoked potentials
• functional neurosurgery

OBJECTIVE Ultrasound can be precisely focused through the intact human skull to target deep regions of the brain for stereotactic ablations. Acoustic energy at much lower intensities is capable of both exciting and inhibiting neural tissues without causing tissue heating or damage. The objective of this study was to demonstrate the effects of low-intensity focused ultrasound (LIFU) for neuromodulation and selective mapping in the thalamus of a large-brain animal.
METHODS Ten Yorkshire swine (Sus scrofa domesticus) were used in this study. In the first neuromodulation experiment, the lemniscal sensory thalamus was stereotactically targeted with LIFU, and somatosensory evoked potentials (SSEPs) were monitored. In a second mapping experiment, the ventromedial and ventroposterolateral sensory thalamic nuclei were alternately targeted with LIFU, while both trigeminal and tibial evoked SSEPs were recorded. Temperature at the acoustic focus was assessed using MR thermography. At the end of the experiments, all tissues were assessed histologically for damage.
RESULTS LIFU targeted to the ventroposterolateral thalamic nucleus suppressed SSEP amplitude to 71.6% +/- 11.4% (mean +/- SD) compared with baseline recordings. Second, we found a similar degree of inhibition with a high spatial resolution (similar to 2 mm) since adjacent thalamic nuclei could be selectively inhibited. The ventromedial thalamic nucleus could be inhibited without affecting the ventrolateral nucleus. During MR thermography imaging, there was no observed tissue heating during LIFU sonications and no histological evidence of tissue damage.
CONCLUSIONS These results suggest that LIFU can be safely used to modulate neuronal circuits in the central nervous system and that noninvasive brain mapping with focused ultrasound may be feasible in humans.

• 出版日期2018-3