Key Points
- Low-intensity focused ultrasound (LIFUS) neuromodulation is a rapidly emerging technology being studied to treat neurologic and psychiatric disorders, including epilepsy.
- A recent literature review concluded that LIFUS may be a promising treatment for epilepsy because it can reach the lateral cortex and deep brain structures.
- An ongoing epilepsy clinical trial at Brigham and Women’s Hospital is using LIFUS for serial treatments of the hippocampus in patients with drug-resistant epilepsy.
Low Intensity Focused Ultrasound for Epilepsy – A New Approach to Neuromodulation
A new form of transcranial neuromodulation, low intensity focused ultrasound (LIFUS), is rapidly emerging and being studied to treat a wide variety of neurologic and psychiatric disorders, including epilepsy. Researchers at Brigham and Women’s Hospital (BWH) conducted a literature review to summarize the preclinical and clinical studies that pertain specifically to epilepsy.
LIFUS is noninvasive and painless. It uses highly focused, millimeter-precision, acoustic energy to produce an effect only at the geometric focus of the transducer. Studies conducted over the past 60 years have proven its safety and documented the modulatory effects of LIFUS in various regions of the brain for motor, sensory, and visual neuromodulation. Although there are other noninvasive forms of neuromodulation, such as transcranial magnetic stimulation and electroconvulsive therapy, their effects have been limited by their penetration depth. LIFUS, however, can reach the hippocampus and deeper structures in the brain where seizures originate.
In a wide variety of preclinical studies, LIFUS safely suppressed seizure activity in epilepsy animal models. In human studies, when researchers sonicated the anteromesial lobe of the brain and then resected the treated tissue, they found effective sonication results and no other pathology in the treated tissues.
An ongoing trial at BWH (NCT03868293) is using LIFUS for serial treatments of the hippocampus in participants with drug-resistant epilepsy, and the results from the first patient were described in a case report published in Ultrasound in Medicine and Biology.
While offering a comprehensive list of current challenges and future directions, the group concluded that LIFUS may be a promising and novel, incisionless, radiation-free form of neuromodulation that could provide new treatments for epilepsy because it can be used to target the lateral cortex and deep brain structures. LIFUS may also help patients with drug-resistant epilepsy who are not candidates for surgery or implantable devices.