Elsa Fouragnan, PhD

Key Points

• Prof. Fouragnan leads the Centre for Therapeutic Ultrasound at the University of Plymouth and is the director of the Brain Research Imaging Center. 
• Beyond her fundamental neuroscience research, she works directly with patients and clinicians to translate ultrasound neuromodulation for mental health conditions. 

Elsa Fouragnan, PhD, is a professor of Neuroscience at the University of Plymouth in the United Kingdom (UK). Her research interests include studying the neurobiology behind decision-making and learning within the framework of computational neuroscience and participating in the development of focused ultrasound neuromodulation in humans and non-human primates (NHPs). She has become passionate about using ultrasound neuromodulation to change neural activity in precise parts of the brain, especially the deep targets responsible for core cognitive and motivational processes. 

We recently spoke with Prof. Fouragnan to learn more about her recent endeavor to launch and lead the Centre for Therapeutic Ultrasound (CENTUS), the first in the UK. CENTUS brings together engineers, clinicians, and researchers to solve challenging problems in psychiatric health through basic, translational, and clinical research, centered around ultrasound neuromodulation. 

Read on to learn more about Prof. Fouragnan’s vision and the ongoing clinical work at CENTUS, including research on healthy subjects and patients with mental health disorders. 

What is your research background? 
After obtaining a degree in biomedical engineering in France, I moved to the United States to work at QUASAR as a neural data analysist on DARPA-sponsored brain–computer interface projects, where I realized I knew very little about the brain, and its complexity fascinated me. That experience prompted me to return to Europe to pursue a PhD in computational neuroscience in a field called neuro-economics. I studied how the brain assesses values in the world and makes decisions. That led me to delve into sophisticated neuroimaging methods. 

How did you first learn about focused ultrasound? 
During my postdoctoral fellowship in Oxford, I was afforded the chance to work with Jerome Sallet, PhD in NHPs, who introduced me to Jean-François Aubry, PhD, from Paris. Jean-François is a key figure in the field, and he became one of my mentors during my UK Research and Innovation (UKRI) fellowship when I began using focused ultrasound in humans. He encouraged me to think critically about safety and hardware considerations before applying the methods in practice. 

When did you open your own laboratory? 
I received a seven-year UKRI Future Leaders Fellowship in 2018. This award prompted me to open my laboratory to translate focused ultrasound neuromodulation for human use. Since then, my lab has received strong support from both local and international communities, especially from the Biotechnology and Biological Sciences Research Council (BBSRC), the Medical Research Council (MRC), and the Engineering and Physical Sciences Research Council (EPSRC). Recently, we received a grant from the UK’s Advanced Research and Invention Agency (ARIA), which funds high-risk, high-reward scientific breakthroughs. This project is a collaboration with Forest Neurotech on developing a whole-brain ultrasound-based BCI, alongside neurosurgeon Aimun Jamjoom, MBBS, PhD. 

How many people work in your laboratory? 
There are now 13 people in my lab. I would say that 75% of them are working on fundamental neuroscience and how we can use ultrasound to better understand the human brain. Another 20% are working on clinical translation for pain, addiction, and obsessive-compulsive disorder (OCD). The remaining 5% are purely developmental. 

Why do you conduct research in healthy subjects? 
It’s fascinating; despite having incredibly neurotechnologies that let us interface directly and precisely with the brain, we still don’t know where to intervene for each brain disorder! Even though we have some idea that certain cognitive processes are linked to specific brain circuits, we are still far from understanding which parts of those circuits are causally involved. And when it comes to how all this varies between individuals or how they link to symptoms, our understanding is even more limited. I am interested in impulsivity, for example, because impulsivity is quite well understood when it comes to the brain. Impulsivity is strongly linked to addiction, OCD, attention deficit hyperactivity disorder (ADHD), eating disorders, and more, but it is also observed in a general population on neurotypical individuals. So, if I use ultrasound to stimulate a brain circuit linked to impulsivity, does it simply change how people make decisions and make them less impulsive? Or can it also serve to prevent disorders? Or can it cure an establish disorder like addiction or OCD? Better understanding the brain is a strong first step toward clinical translation. Conducting studies in neurotypical subjects helps answer these questions but also others about safety, feasibility, how long an intervention should be, etc. 

What are your areas of research? 

1. Acoustic simulations. During the COVID-19 pandemic, we created a tool to convert a T1-weighted MR image into a computed tomography (CT) image. This conversion allows us to perform acoustic simulation through the skull, even though better methods have been developed since. 

2. Hydrophone testing. I built my first hydrophone tank during my maternity leave. I was at home with my newborn baby and missing the lab. The tank allowed me to better understand the physics behind ultrasound in order to conduct better experiments. 

3. Neuroplasticity. We were one of the first groups to show that transcranial ultrasound (TUS) can change neurochemistry for up to one hour and change brain connectivity between the regions targeted and the rest of the brain. While we had shown similar results in NHPs, there are several critical distinctions that make comparisons between NHPs and human studies non-trivial. First, skull geometry and density substantially differ between species, influencing the transmission and focality of ultrasound energy. Most importantly, the acoustic energy levels used in human studies are subject to far more conservative constraints. Prior to the development of the International Transcranial Ultrasonic Stimulation Safety and Standards (or ITRUSST) safety guidelines, the only available regulatory benchmark was the US Food and Drug Administration’s limit for diagnostic ultrasound, which imposed strict limits on energy deposition – particularly before the beam even reaches the skull. ITRUSST is an international consortium working together toward the safe and effective application of TUS for neuromodulation. As a result, early human TUS studies, including ours, used stimulation intensities far below those typically employed in NHP research. This means that any observed effects in humans occurred under markedly lower energy conditions, highlighting both the sensitivity of the approach and the need for careful, species-specific translation of TUS protocols. 

4. Probing the deep circuits related to decision making and learning. We have now used TUS in three completed studies in humans probing decision making and learning processes (Yaakub et al. BioRXiv – accepted to Nature Communications 2025; Koutsoumpari et al. BioRXiv 2025; Lojkiewiez et al., in prep). These studies have shown that TUS can: 1) reach deep brain regions and influence decision making; 2) dissociate the role of two brain regions in the same networks; 3) change how people decide whether to make risky or non-risky decisions. 

5. Clinical translation. We have now started to conduct research on people suffering from OCD and alcohol use disorder (AUD), as well mood disorders. It is our goal to move toward large, multi-site clinical trials in the UK to establish the actual generalizability of the intervention. We are also working on better understanding dose-effect relationships. 

How was CENTUS Created? 
In 2023, the university recognized therapeutic ultrasound as an area of growth and success, so I applied to create a center where various research teams would collaborate to work on the many domains linked to focused ultrasound (e.g., engineering, biomechanism, fundamental neuroscience, clinical applications, etc.). CENTUS provides a place for preclinical researchers to discuss ideas with neurologists and other clinicians, particularly because Derriford hospital, the largest in the southwest serving Cornwall and Devon, is located next door to our lab. For example, we hoped to collaborate with clinicians who are using deep brain stimulation in patients with Parkinson’s disease, and the hospital recently hired an expert in hypo- and hyperkinetic disorders (e.g., Parkinson’s, Tourette syndrome, and multiple sclerosis). 

How many laboratories make up CENTUS? 
There are now six research groups: 

• Human Cognitive Neuroscience – neuroscientific techniques for human cognition 
• Magnetic Resonance Development – imaging tools for transcranial ultrasound (TUS) 
• Metrology – studying the physics of TUS 
• Software Development – acoustic modeling of TUS 
• Clinical Trials – investigating new treatments for essential tremor, Parkinson’s disease, pain, addiction, and OCD 
• Animal Models – preclinical proof-of-concept studies and safety standards (to be started in 2026) 

Which research area do you run? 
I am the director of CENTUS and the Brain Research Imaging Centre (BRIC), however my main research lies in Human Cognitive Neuroscience. 

Are all of the laboratories in the same building? 
BRIC has its own building with eight labs. Most of the animal labs are within the Derriford Research Facility, which is right next to BRIC. Clinical studies will be conducted at University Hospitals Plymouth clinical trial unit. There is also a Science Park in Plymouth for startups that contains many 3D printers, which comes in handy for small engineering work. 

What makes the Software Development group unique? 
This group has access to the Lovelace System, the university’s new high-performance computer. It is a supercomputer that is usually used for quantum physics, but it is also available for our acoustic simulation work. Simulations that would take normally hours can be run in less than one minute! It also allows us to use precision medicine (on large scale data) to refine treatment for each individual participant using AI. 

What clinical studies have been conducted through CENTUS thus far? 
To date, we have launched or planned clinical work for OCD, AUD, and mood disorders. 

OCD 
This clinical study (NCT06722339) was conducted with the Attune device. The southwest part of the UK is particularly affected by mental health disorders and drug use, so we had almost 500 inquiries within 2 days of the study being launched. It enrolled 30 participants who each underwent five sonications to different parts of the brain after the initial skull MRI scan visit. The MRI image was converted into a computed tomography (CT) image, which was used to create a personalized acoustic simulation so we could determine the optimal brain region for each participant. We eventually determined that targeting one particular region for about 40 minutes seemed to be more effective in reducing symptom severity than others, and some effects lasted 2 to 3 weeks. That manuscript should be published soon. 

AUD 
The AUD research study (NCT06894966) is enrolling 30 participants to test whether low-intensity transcranial focused ultrasound neuromodulation applied with the Sonic Concepts NeuroFUS device is a safe and effective method for addressing the neural and behavioral mechanisms underlying AUD. The study involves modulating the regions of the brain involved in compulsive alcohol use and cognitive control to reduce symptoms. 

Mood Disorders 
This new study, which has not yet started, will tackle issues related to rumination and mood disorders. 

What future clinical trials are planned? 
Because of our work on OCD and AUD, we plan to lead the first multicenter addiction clinical trial in the UK. The protocol will be quite unique. We hope to answer the question of whether successful neuromodulation is related to the target location, the parameters used, or both. The work that I am doing now through the ARIA grant is fascinating because it may create a different vision of the future. 

Do you have a role in educating the next generation of researchers? 
We are developing a Master’s in Human Neuroscience Program that will have a complete module on TUS. We also organize an annual international training program with Brainbox each May. It is a great opportunity to work with industry and partners that are implementing real-world medical solutions. Our team is always looking for collaborators who are interested in research partnerships and fellowship opportunities across industry and research. 

Who are your external collaborators? 
Besides collaborating with BrainBox, as mentioned above, we also work with some startup companies. For example, I serve as an advisor for Attune Neurosciences. 

I also work with a Focused Research Organization called Forest Neurotech that is developing a whole-Brain Computer Interface (wBCI) based on ultrasound. It is a wearable neural interface that supports both imaging (Norman et al., Neuron 2021) and neuromodulation over large volumes of the human brain intraoperatively, or in patients with a craniotomy or sonolucent cranioplasty. Interfacing with the whole-human brain is what distinguishes Forest’s technology; the wBCI provides the potential to understand, diagnose, and treat many indications in parallel at the level of full circuits and systems. 

What are your funding sources? 
As mentioned, we receive funds from the BBSRC, the MRC, and the EPSRC. More recently, we were awarded a grant in collaboration with ARIA, which supports high-risk, high-reward scientific breakthroughs. 

What is on your research wish list? 
I want to show the world how ultrasound neuromodulation works, better understand the parameter space, and learn the relationship between the different types of cells in the brain and ultrasound, including the glial cells. I am excited about the real possibilities of clinical translation. People are so desperate for improved health, and it is possible that we are going to provide them with a transformative tool for healing. It feels like we may witness a complete shift in the years to come. 

Watch Videos Featuring Dr. Fouragnan 

• What is Transcranial Ultrasound Stimulation (TUS)? (< 3 minutes) 
• Low Intensity Focused Ultrasound (2 minutes) 

Related Stories 

Brain Implant that Could Boost Mood by Using Ultrasound to Go Under NHS Trial January 2025 

Targeted Ultrasound Can Change Brain Functions for Up to An Hour After Intervention September 2023 

2019 Groundbreaking Preclinical Research on Neuromodulation November 2019 

Focused Ultrasound Used to Identify Behavior-Specific Regions of the Brain April 2019