Background: Transcranial ultrasound stimulation (TUS) is a non-invasive technique that focuses mechanical energy deep in the brain to modulate neural activity.However, targeting errors due to neuronavigation tracking imperfections can hinder TUS effectiveness, especially with deep brain targets.We report our multi-focus TUS strategy to target thalamus for tremor reduction in patients with essential (ET) and Parkinson tremor (PD).Methods: Three patients (2 ET, 1 PD) underwent TUS, targeting the thalamic ventrointermedius nucleus (Vim), using a 128-element phased array operating at 250 kHz.TUS was first delivered at 7 locations arranged in a circular disc pattern with inhibitory parameters (100 Hz pulse repetition frequency, 10% duty cycle, intensity at situ of 5 W/cm 2 , 30 s sonication durations).BabelBrain software (10.1109/TUFFC.2023.3274046)was used for planning the TUS delivery using subject MR tractography and CT imaging.Tremor was measured using accelerometry at baseline, immediately (0 min) and 5 min post-sonications.The 7 locations were split into two groups (G1 and G2, Fig 1-A), and the group showing the most tremor reduction was further explored with individual location targeting using 2 min sonication durations (e.g.G1-S1 is group 1, sonication 1).Results: All subjects showed significant tremor reduction.Fig 1-B shows the overlay of the normalized predicted acoustic field and Fig 1-C shows a rendering of the transducer relative to one subject.Examples of baseline acceleration compared to the lowest amplitude tremor achieved during testing is shown in Fig 1-D.Area under the curve (AUC) of the power spectral density (PSD) from 4 to 7 Hz of the tremor amplitude for all time points drops over multiple sonications (Fig 1-E).Conclusions: Multi-focus TUS improved targeting by identifying optimal stimulation locations, enhancing tremor reduction compared to baseline and over time.Because tremor seemed to remain suppressed after initial sonications, TUS may have cumulative effects.

Methods: Data were analyzed from 153 patients with LLD from the FOUR-D study (ClinicalTrials.govidentifier: NCT02998580) who received bilateral rTMS targeting the dorsolateral prefrontal cortex.Cognitive function was assessed pre-and post-treatment using measures of executive function, information processing speed, and learning and memory.Reliable change indices (RCIs), adjusted for practice effects and test-retest reliability, were employed to evaluate individual-level cognitive changes.Chisquare tests examined if proportions of cognitive improvers differed from expected proportions.Results: Cognitive performance from baseline to end of treatment remained stable for most patients.Reliable improved performance was observed in 0% to 20% of patients across cognitive measures, while worsened performance ranged from 0% to 2.7%.A small but significant proportion of patients (20%) showed improvement in verbal learning.Conclusions: Bilateral rTMS in LLD yielded no substantial cognitive enhancing effects, although a modest proportion showed improved verbal learning after rTMS treatment.Importantly, rTMS exhibited cognitive safety with relatively stable performance across time.Future research is needed to explore approaches to enhance the cognitive benefits of rTMS in patients with LLD.

19.791.64 vs 19.911.83 (control vs treatment, meanSE, p0.962); posttreatment 14.231.81 vs 12.521.66; p0.508; p0.352; p0.076)].There was significant improvement in the Traditional Chinese Medicine Likert scale for depression [baseline 6.690.58vs 6.960.54(p0.740);post-treatment 60.47 vs 4.430.51(p0.045);one-month 6.50.71vs 4.260.58(p0.035); and three-month 7.00.82vs 3.820.74(p0.033)].Better EQ-5D utility scores were observed in the treatment group, though this trend was not observed for cognitive functions assessed by MoCA and depressive symptoms assessed by MADRS.Conclusion: There is a trend of delayed antidepressant effectiveness of scalp acupuncture treatment in reducing phlegm and regulating "Qi" flow for a calm mind in patients with a primary diagnosis of depression.However, data interpretation is limited by the relatively small sample size.

Visual field recovery is often underemphasised in stroke rehabilitation; however, it has a substantial impact on daily functioning and quality of life [1]. Although vision training is employed, it typically requires prolonged intervention. We report a case demonstrating the potential for rapid improvement in post-stroke homonymous hemianopia using combined eye-tracking-adjusted vision training and transcranial direct current stimulation (tDCS). A patient with subacute-to-chronic homonymous hemianopia showed marked improvement following four days of intensive training.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique used as a therapeutic and experimental tool. It is FDA-approved for treating major depressive disorder in adults and has an excellent safety profile. rTMS is less well characterised in children but was recently approved as an augmentative treatment in adolescents (15-21 years). However, the adolescent brain is still undergoing structural and functional changes and the effect of rTMS on neurodevelopment is not understood. In the present study we used a mouse model to assess the impact of low intensity (perifocal) rTMS (LI-rTMS) in the developing brain on visual system organisation and associated behavioural outcomes. We used miniature coils to deliver LI-rTMS to the primary visual cortex (V1) in mice aged 28 days (∼12 human years), every day for two weeks (biomimetic high frequency stimulation, 10min). We measured anatomical organisation of the corticocollicular and geniculocortical visual pathways, visuomotor behaviour, as well as V1 expression of markers of inhibition, excitation and inflammation (astrocytes and microglia) in LI-rTMS and sham treated groups. LI-rTMS did not alter the organisation of visual pathways, excitatory/inhibitory balance or cause overt inflammation in the brain but did result in a mild deficit in visuomotor behaviour. Our results suggest that LI-rTMS delivered during development may have network-wide effects impacting sensorimotor integration. While we cannot rule out that changes in functional connectivity might be transient and/or beneficial in a disease context, our findings highlight that more clinical and preclinical studies are needed to validate the safety and mechanism of action of rTMS for children and adolescents.