Program

Executive Summary：
oshikazu Ugawa, MD, a Director and Professor, Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan. He enjoyed the disaster of the earthquake 2011, Japan and still lives in Fukushima. He studied physiology of movement disorders under Professor Marsden and Professor Rothwell in Queen Square, London in 1987-1990. He received PhD from the University of Tokyo in 1992. He was a Director and Professor of Department of Neurology, Fukushima Medical University from 2007 to 2018. He has been a director of Department of Human Neurophysiology from 2019. He was the secretary general of the International Federation of Clinical Neurophysiology (IFCN) from 2014 to 2017, he has been a chair of brain stimulation SIG of IFCN since 2017 and an associate editor of Clinical Neurophysiology since 2006, and he is now the president of AO chapter of IFCN.

His main interest is a non-invasive brain stimulation, such as TMS and newly developed transcranial ultrasound stimulation (TUS). His clinical interest is movement disorders and has published around 490 papers in international journals, his H-index is 71.

Lecture Abstract：
Transcranial ultrasound stimulation (TUS) is a newly developed non-invasive brain stimulation method which enables us to perform a localized deep brain structure activation. Several stimulation parameters have been reported to induce long-lasting enhancement or reduction of the neural structures below the stimulation point. We have no standard stimulation protocols for specific clinical goals at present. Then, in this talk, I will introduce a new intervention method (decapulse stimulation (DPS)) and several clinical applications of TUS.

Decapluse stimulation (DPS): We developed a novel patterned TUS protocol capable of inducing bidirectional plasticity in M1. Two protocols, with a stimulation pattern comprising 10 pulses of ultrasound (decapulse stimulation, DPS), used the same intensity of ultrasound, fundamental frequency (0.5 MHz), net and total sonication duration (8 and 400 s), overall duty cycle (2%), but differed in pulse train duration (1 vs. 400 s), pulse repetition frequency (200 vs. 10 Hz). (DPS5 and DPS100). DPS5 induced enhancement of cortical MEP, whereas DPS100 induced reduction of cortical MEP, lasting 60 to 90 minutes after sonication. Neither threshold, short interval intracortical inhibition (SICI), intracortical facilitation (ICF), nor short interval intracortical facilitation (SICF) was affected by DPSs. The findings suggested a novel mechanism of plasticity induction applicable for clinical use, in which TUS patterns induce bidirectional effects without affecting intracortical synaptic functions probably mediated by different intracellular calcium influx patterns.

Clinical applications of TUS: For around 10 years after TUS invention, it has been used for functional studies in normal subjects, pathophysiological studies in patients, and treatment trials because of its capability to induce functional changes in the deep brain structures. The hippocampal stimulation or amyloid clearance by blood brain barrier opening in Alzheimer's disease, localized stimulation of epileptic foci, and other applications have been reported. I will show a few examples of the above applications.