Current state of clinical ultrasound neuromodulation.

Unmatched by other non-invasive brain stimulation techniques, transcranial ultrasound (TUS) offers highly focal stimulation not only on the cortical surface but also in deep brain structures. These unique attributes are invaluable in both basic and clinical research and might open new avenues for treating neurological and psychiatric diseases. Here, we provide a concise overview of the expanding volume of clinical investigations in recent years and upcoming research initiatives concerning focused ultrasound neuromodulation. Currently, clinical TUS research addresses a variety of neuropsychiatric conditions, such as pain, dementia, movement disorders, psychiatric conditions, epilepsy, disorders of consciousness, and developmental disorders. As demonstrated in sham-controlled randomized studies, TUS neuromodulation improved cognitive functions and mood, and alleviated symptoms in schizophrenia and autism. Further, preliminary uncontrolled evidence suggests relieved anxiety, enhanced motor functions in movement disorders, reduced epileptic seizure frequency, improved responsiveness in patients with minimally conscious state, as well as pain reduction after neuromodulatory TUS. While constrained by the relatively modest number of investigations, primarily consisting of uncontrolled feasibility trials with small sample sizes, TUS holds encouraging prospects for treating neuropsychiatric disorders. Larger sham-controlled randomized trials, alongside further basic research into the mechanisms of action and optimal sonication parameters, are inevitably needed to unfold the full potential of TUS neuromodulation.

Novel ultrasound neuromodulation therapy with transcranial pulse stimulation (TPS) in Parkinson's disease: a first retrospective analysis.

BACKGROUND: Transcranial Pulse Stimulation (TPS) has been recently introduced as a novel ultrasound neuromodulation therapy with the potential to stimulate the human brain in a focal and targeted manner. Here, we present a first retrospective analysis of TPS as an add-on therapy for Parkinson's disease (PD), focusing on feasibility, safety, and clinical effects. We also discuss the placebo response in non-invasive brain stimulation studies as an important context. METHODS: This retrospective clinical data analysis included 20 PD patients who received ten sessions of TPS intervention focused on the individual motor network. Safety evaluations were conducted throughout the intervention period. We analyzed changes in motor symptoms before and after TPS treatment using Unified Parkinson's Disease Rating Scale part III (UPDRS-III). RESULTS: We found significant improvement in UPDRS-III scores after treatment compared to baseline (pre-TPS: 16.70 ± 8.85, post-TPS: 12.95 ± 8.55; p < 0.001; Cohen's d = 1.38). Adverse events monitoring revealed no major side effects. CONCLUSION: These preliminary findings suggest that TPS can further improve motor symptoms in PD patients already on optimized standard therapy. Findings have to be evaluated in context with the current literature on placebo effects.

Experiencing a significant life event during the COVID-19 pandemic: The role of perceived control.

The COVID-19 pandemic represents a context that might influence how people experience significant life events (such as marriage, job change, or relocation). In the present research, we argue that one important factor of how positively or negatively the pandemic influences the experience of significant life events is how much control people perceive in the situation. An online sample of N = 882 participants aged 18-82 years reported a significant life event that occurred during the COVID-19 pandemic. The participants described whether the pandemic influenced the life event, to what extent they perceived control over the life event and how they experienced the life event in terms of valence (i.e., positively or negatively). The results showed that the self-reported pandemic influence was significantly associated with the life-event experience. Furthermore, perceived control partly mediated this association. The results persisted even after controlling for the age of the participants. The present research underscores the important role of control for experiencing significant life events in challenging times such as during the pandemic.

Safety of Clinical Ultrasound Neuromodulation.

Transcranial ultrasound holds much potential as a safe, non-invasive modality for navigated neuromodulation, with low-intensity focused ultrasound (FUS) and transcranial pulse stimulation (TPS) representing the two main modalities. While neuroscientific and preclinical applications have received much interest, clinical applications are still relatively scarce. For safety considerations, the current literature is largely based on guidelines for ultrasound imaging that uses various physical parameters to describe the ultrasound pulse form and expected bioeffects. However, the safety situation for neuromodulation is inherently different. This article provides an overview of relevant ultrasound parameters with a focus on bioeffects relevant for safe clinical applications. Further, a retrospective analysis of safety data for clinical TPS applications in patients is presented.

[Validity Study of the Cookie Theft Picture Test - Early Detection of Dementia Based on Linguistic Abnormalities]. / Validierungsstudie zum Cookie Theft Picture Test.

OBJECTIVE: Previous studies have provided inconsistent results regarding discriminatory language variables between subjects with dementia and healthy controls. In this study, using the Cookie Theft Picture Test (CTP), selected language variables are tested for predicting actual diagnoses. METHODS: 24 healthy subjects and 24 subjects with mild dementia were included in the present study. RESULTS: All language variables except repetitions, word finding difficulties and paraphasias showed significant differences between the groups. The variables pause length and clues increase significantly the likelihood of AD, while the variable sentence length decreases it. CONCLUSION: Due to the small sample size and insufficient standardization, the study can only be interpreted to a limited extent. Nevertheless, the results indicate that the CTP appears to be suitable for practical use.