康复学报 (Jan 2025)
Expert Consensus on Neuromodulation Application of Transcranial Focused Ultrasound in Pain Management
Abstract
Transcranial focused ultrasound (tFUS) is an emerging non-invasive neuromodulation technology that utilizes highly focused acoustic waves to achieve precise, reversible, and non-invasive regulation of specific brain regions. With its high spatial resolution, deep penetration capability, and adjustability, tFUS demonstrates significant potential in pain management. This consensus statement comprehensively addresses the technical principles and clinical advantages of tFUS, its neuromodulatory effects in sensory processing, translational applications in pathological pain conditions, safety considerations and adverse event management, standardized operational procedures, and future directions, aiming to provide guidance for future research and clinical applications of tFUS. The primary aspects covered include: (1) Technical principles and clinical advantages of tFUS, encompassing its basic working principles, key parameters, biophysical effects, and clinical benefits. (2) Neuromodulatory effects of tFUS in sensory processing, focusing on precise regulation of key brain regions, multi-level neural regulatory mechanisms, impacts on sensory function, and implications for sensory processing research. (3) Translational applications in pathological pain conditions, including chronic neuropathic pain, acute pain, experimental pain models, and migraine. (4) Safety and adverse event management, covering overall safety assessment, common adverse reactions and their management strategies, serious adverse event response, long-term safety considerations, and safety in special populations. (5) Standardized operational procedures for tFUS treatment, including assessment of indications/contraindications, pre-treatment evaluation, parameter selection and optimization, monitoring during treatment, and follow-up management. (6) Future directions, encompassing treatment protocol optimization, clinical accessibility improvement, expansion of indications, and long-term efficacy and safety assessment. Currently, clinical research on tFUS in pain management is relatively limited. This consensus is based on existing literature and expert experience to provide reference for applications and future research directions. Despite challenges, tFUS shows promise as an important complementary approach in chronic pain management, offering new treatment options for patients with refractory pain. However, there remains a considerable gap between current preliminary research findings and widespread clinical application. Only through rigorous scientific research and clinical validation can tFUS truly play a significant role in future precision pain medicine.
