Transcranial ultrasound stimulation could help reduce delusions in people with schizophrenia, according to a small randomized, sham-controlled trial.
The experimental approach uses a device placed on the head to send ultrasound waves through the skull to specific brain regions, with the aim of modulating neural activity. In this study, a single 10-minute session of the treatment was associated with reduced delusion severity lasting at least one week in patients with schizophrenia or schizoaffective disorder. Delusions are persistent false beliefs, such as unfounded fears of being followed or imminent catastrophe.
The targeted nature of this technique may limit whole-body side effects seen with some antipsychotic medications, including weight gain and elevated blood pressure. The findings, published Oct. 20 in npj Acoustics, are preliminary and require confirmation in larger studies. “It’s too early to know for certain what the therapeutic benefits will be,” said study co-author Dr. Donald Goff of the New York University Grossman School of Medicine, but he called the results encouraging.
Targeting deep brain structures with transcranial ultrasound stimulation
The pilot study enrolled 10 adults diagnosed with schizophrenia or schizoaffective disorder, conditions marked by psychosis that can include delusions and hallucinations, with mood symptoms also present in schizoaffective disorder. Researchers interviewed participants to document the content of their delusions, assessed cognition, and recorded experiences of auditory hallucinations. Each participant received both an active ultrasound session and a sham session one week apart.
Other noninvasive neuromodulation methods, such as transcranial magnetic stimulation, can influence brain activity. However, investigators noted that ultrasound can reach deeper brain structures with greater spatial precision. The team likened the focusing of ultrasound waves by a transducer to how a lens concentrates light on a specific point.
In this trial, stimulation targeted a network called the cortico-striatal-pallido-thalamic circuit, which includes regions beneath the cerebral cortex. Co-authors said links between this circuit and schizophrenia symptoms are still being clarified, in part because deeper structures are difficult to study at high resolution with MRI. Prior research in movement disorders such as Parkinson’s disease has shown that imbalances between excitatory and inhibitory signaling can drive symptoms, a phenomenon the team suggested could also relate to psychosis.
One hypothesis proposed by the researchers is that schizophrenia involves a breakdown in filtering irrelevant information from the environment, reflecting an imbalance between excitation and inhibition. This failure to suppress noise could contribute to delusional thinking.
‘Quite optimistic’ about next steps
After each session, participants reported how strongly they believed their delusions and how distressing those beliefs felt. Compared with the sham condition, the active transcranial ultrasound stimulation was linked to less severe delusions over the following week. The study detected no significant changes in auditory hallucinations or overall cognitive performance.
Reported side effects were mild, including fatigue and headache. Some participants experienced brief increases in delusions, which the team attributed to typical symptom fluctuations seen in schizophrenia. These events occurred with similar frequency after sham sessions, suggesting they were not specific to the ultrasound.
The protocol focused stimulation on the right globus pallidus internus. The authors previously reported that stronger connectivity between this region and the dorsal anterior cingulate gyrus correlated with more severe psychotic symptoms, which informed their choice of target.
Experts noted that few therapies have successfully targeted deep brain structures for schizophrenia. Ultrasound can access subcortical regions without surgery, unlike deep brain stimulation that requires implanted electrodes. Earlier this year, another group used transcranial ultrasound to stimulate parts of the striatum in patients with schizophrenia and reported at least a week of reduced hallucinations, though that study assessed different symptoms.
Researchers said the precision of transcranial ultrasound offers value as both a probe of brain circuitry and a potential therapy. If specific nodes are closely tied to symptoms, future work could refine stimulation patterns to correct circuit dysfunction. The team plans to expand testing to larger cohorts and explore different dosing strategies. “A lot more work needs to be done,” Goff said, adding that they are “quite optimistic” about the approach’s promise.
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This report is for informational purposes only and does not constitute medical advice.