Abstract：
OBJECTIVE: 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.
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.
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.
摘要：
目的：腹侧囊/腹侧纹状体（VC/VS）的深部脑刺激（DBS）对治疗难治性强迫症（OCD）有效；然而，DBS与神经外科手术风险相关。经颅聚焦超声（tFUS）是一种较新的非侵入性形式（即，非手术)刺激，可以调节更深的区域，比如VC/VS。tFUS参数刚刚开始研究，通常未在同一参与者中进行比较。我们探索了三种VC/VStFUS方案和内嗅皮层（ErC）tFUS会话对健康个体VC/VS和皮质-纹状体-丘脑-皮层回路（CSTC）的影响，以便以后应用于强迫症患者。
方法：12个人参加了这个探索性多站点的tFUS总共48次会议，学科内参数研究。我们收集了静息状态，奖励任务,ErCtFUS和三个具有不同脉冲重复频率（PRF）的VC/VStFUS会话之前和之后的动脉自旋标记（ASL）磁共振成像扫描，脉冲宽度（PWs），和占空比（DC）。
结果：VC/VS协议A（PRF=10Hz，PW=5ms,5％DC）与奖励任务期间壳核活化增加有关（p=0.003），与前扣带回皮质（p=0.022）和眶额皮质（p=0.004）的VC/VS静息状态功能连接（rsFC）增加。VC/VS协议C(PRF=125Hz,PW=4ms,50%DC)与壳核VC/VSrsFC降低相关(p=0.017)，随着苍白球的增加，VC/VSrsFC增加（p=0.008）。VC/VS协议B(PRF=125Hz,PW=0.4ms,5％DC）与任务相关的CSTC激活或rsFC的变化无关。没有一个方案影响CSTCASL灌注。
结论：这项研究开始探索一种新兴形式的无创大脑刺激的多维参数空间，tFUS.我们在小样本中的初步发现表明，应继续研究VC/VStFUS以进行OCD的非侵入性治疗。
方法：12个人参加了这个探索性多站点的tFUS总共48次会议，学科内参数研究。我们收集了静息状态，奖励任务,ErCtFUS和三个具有不同脉冲重复频率（PRF）的VC/VStFUS会话之前和之后的动脉自旋标记（ASL）磁共振成像扫描，脉冲宽度（PWs），和占空比（DC）。
结果：VC/VS协议A（PRF=10Hz，PW=5ms,5％DC）与奖励任务期间壳核活化增加有关（p=0.003），与前扣带回皮质（p=0.022）和眶额皮质（p=0.004）的VC/VS静息状态功能连接（rsFC）增加。VC/VS协议C(PRF=125Hz,PW=4ms,50%DC)与壳核VC/VSrsFC降低相关(p=0.017)，随着苍白球的增加，VC/VSrsFC增加（p=0.008）。VC/VS协议B(PRF=125Hz,PW=0.4ms,5％DC）与任务相关的CSTC激活或rsFC的变化无关。没有一个方案影响CSTCASL灌注。
结论：这项研究开始探索一种新兴形式的无创大脑刺激的多维参数空间，tFUS.我们在小样本中的初步发现表明，应继续研究VC/VStFUS以进行OCD的非侵入性治疗。
