Program

Executive Summary：
Lennart Verhagen, PhD
Assistant Professor of Cognitive Neuromodulation
Director Radboud FUS Center
Chair ITRUSST
Scientist at Nudge

Lennart Verhagen is a Professor of Cognitive Neuromodulation at the Donders Institute for Brain, Cognition, and Behaviour at the Radboud University, Nijmegen, the Netherlands. He is the Chair of the International consortium for Transcranial Ultrasonic Stimulation Safety and Standards (ITRUSST), the Director of the Radboud Focused Ultrasound Center, and a resident scientist at Nudge. Previously, he was a fellow at Oxford University, where he pioneered ultrasonic neuromodulation with seminal studies in non-human primates. Recently, he has joined Nudge as a scientist and advisor.

Verhagen builds the next-generation neurotechnology for humans, using ultrasound for non-invasive, focal, deep neuromodulation. His lab has standardized protocols and safety, debunked pseudo-studies, mitigated confounds, and developed novel effective protocols. He has shown how tailored ultrasound protocols can lead to immediate effects or hour-long modulation, opening new horizons for research and the clinic.

Translating insights from animal studies to human application, his lab has shown how ultrasound can bias actions and decisions, with controlled stimulation of cortical regions and thalamic nuclei. Using combined stimulation and neuroimaging approaches, he has investigated the neurophysiological mechanisms of ultrasonic neuromodulation, showing particular involvement of inhibitory GABA-ergic circuits. In recent work, he has targeted the human amygdala, leading to the suppression of fear learning and acceleration of fear extinction, a long-sought-after intervention for anxiety and stress disorders.

The Verhagen lab aims to make ultrasound so safe and effective that everybody can benefit from this technology.

Lecture Abstract：
In this lecture, I will give an overview of the principles, effects, and safety of transcranial ultrasound stimulation in humans. This emerging neurotechnology uses focused ultrasound waves to non-invasively target deep in the brain. I will showcase the practical approach, main challenges, and principal opportunities of this technique in the context of motor neurophysiology, sensorimotor control, fear learning, and reward-based learning. I will discuss both immediate effects on neural acticity, and prolonged effects on gating neural plasticity.

Executive Summary：
Yoshikazu Ugawa, MD, Director and Professor, Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan. He survived the disaster of the earthquake 2011, Japan and still lives in Fukushima. He studied clinical neurophysiology 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 in 2017 to 2023and an associate editor of Clinical Neurophysiology in 2006 to 2022, and he is now the president of AO chapter of IFCN. He is also the vice-president of Asian Oceanican Region of World Federation of Neurology (WFN) from 2023.

His main interest is non-invasive brain stimulation, such as TMS and newly developed transcranial ultrasound stimulation (TUS). His clinical interest is movement disorders and has published around 500 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. 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.
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.

Executive Summary：
Dr. Juicheng Chen is a doctor of neurology from the University of London and has studied "focused ultrasound" for Parkinson's disease at Stanford University. Dr. Chen is committed to innovative treatments for movement disorders. His current main topics include botulinum toxin treatment of dystonia, transcranial magnetic stimulation treatment of stroke, stem cell therapy, and Parkinson's treatment with the Shenbo Knife. Dr. Chen is a director of the Society of Clinical Neurophysiology and has been engaged in education on transcranial magnetic stimulation and electrical stimulation for many years. Hope that research can make medicine more advanced and benefit patients

Executive Summary：
Byung-Jo Kim, MD, PhD, is a Professor of Neurology at Korea University College of Medicine and a neurologist at Korea University Anam Hospital. He specializes in neuroimmunology, neuromuscular disorders, and clinical electrophysiology. His research focuses on the electrophysiologic and imaging-based analysis of peripheral nerves, muscles, and the central nervous system, with particular emphasis on neuromuscular diseases, autoimmune disorders of the nervous system, and neuropathic pain.

Dr. Kim has authored more than 250 peer-reviewed publications and has actively collaborated with biomedical engineers to develop innovative medical devices for recording electrophysiologic signals. He currently serves as Editor-in-Chief of the Journal of Clinical Neurology and is the Korean delegate to the International Federation of Clinical Neurophysiology (IFCN). He also holds key leadership roles in several Korean medical societies, including serving as President of the Korean Society of Clinical Neurophysiology, and has previously served as Vice President for Medical Research at Korea University.

Lecture Abstract：
Application of high-resolution ultrasonography (US) in the clinical practice of neuromuscular disorders has been rapidly expanding. Traditionally, evaluation of patients begins with history, neurological examination, and electrodiagnostic testing (EDx), which remains the gold standard for functional assessment of the peripheral neuromuscular system. However, increasing evidence now demonstrates that ultrasonography provides essential morphological and pathophysiological information that EDx alone cannot capture. This has accelerated the integration of US into routine practice and is creating a growing gap between ultrasound-enhanced and standard clinical neurophysiology.
Quantitative parameters such as nerve cross-sectional area (CSA), muscle echo intensity (EI), and dynamic US findings are increasingly validated as reliable biomarkers. Nerve CSA correlates with demyelinating changes in disorders such as CIDP, while muscle EI and pattern analysis allow differentiation of neuropathic from myopathic processes. Dynamic US enhances diagnostic certainty through fasciculation detection in ALS. Together, these findings not only support diagnosis but also provide prognostic information and guide treatment strategies.
In this lecture, I will discuss the scope of US applications in neuromuscular disorders, with illustrative cases and results from recent research. Accumulating evidence suggests that NMUS should no longer be regarded as optional, but rather as a complementary — and in some cases indispensable — tool in modern clinical neurophysiology. With ongoing technological advances in probes and post image processing, ultrasonography becomes an integral, patient-friendly modality alongside EDx for nearly all patients with neuromuscular disorders.

Executive Summary：
Dr. Ting-Yu Jill Chang is an Associate Professor of Neurology at Chang Gung Memorial Hospital in Taiwan, where she also serves as Ward Director of the Stroke Unit. She is also actively involved in the Taiwan Stroke Society as Deputy Secretary-General.

Dr. Chang is a stroke neurologist with special expertise in neuroimaging and big-data research on cerebrovascular diseases. She trained as a visiting scholar at the Stanford Stroke Center from 2018 to 2020. In clinical practice, Dr. Chang has over 10 years of experience with botulinum toxin treatment for neurological conditions. She is particularly recognized for her work in post-stroke spasticity and chronic migraine, with extensive expertise in ultrasound-guided injection techniques. She is also the author of the academic book Post-Stroke Spasticity: Ultrasound-Guided Botulinum Toxin Injection and co-author of the 2021 national guidelines on spasticity treatment in Taiwan.

With her combined clinical and research background, Dr. Chang is dedicated to advancing stroke care and improving outcomes for patients with post-stroke complications.

Lecture Abstract：
Post-stroke spasticity is a common complication that not only impairs mobility and function but also affects quality of life for patients and caregivers. Effective management requires careful assessment and targeted therapy. Botulinum toxin A injection has become a cornerstone treatment, but its success depends greatly on accurate muscle selection and precise injection techniques.

This lecture will begin with a brief overview of the pathogenesis and clinical evaluation of post-stroke spasticity, emphasizing the importance of individualized assessment. The main focus will be on practical strategies for muscle selection, tailored to different clinical scenarios and patient presentations.

A key part of the session will highlight the hierarchy of guidance techniques used in botulinum toxin injection—from anatomical landmarks and palpation to the integration of electrical stimulation and, most importantly, ultrasound guidance. Sonography provides real-time visualization of muscles, surrounding structures, and toxin spread, significantly improving injection accuracy and safety.

By combining evidence-based principles with practical demonstrations, this talk aims to provide clinicians with an accessible framework for applying ultrasound guidance in daily practice, ultimately enhancing treatment outcomes for patients with post-stroke limb spasticity.

Executive Summary：
Chih-Peng Lin, MD, PhD, FIPP, CIPS

Dr. Lin is the section chief of the division of pain medicine, department of anesthesiology at the National Taiwan University Hospital (NTUH), with a joint appointment as attending physician in the department of oncology. He is also Professor, College of Medicine, National Taiwan University. His major research interests are mechanisms and possible therapeutic approaches for neuropathic pain and opioid tolerance/hyperalgesia, new interventional technique development, pain psychology and pain medicine related outcome research. He is passionate about education and interventional management for chronic pain, especially refractory cancer pain, with additional expertise in multimodality guided pain intervention. He is the course organizer of the ultrasound tract of 1st, 2nd, 3rd, 4th and 5th WIP Taipei annual symposium and interventional pain workshop.

Lecture Abstract：
Ultrasound has become an indispensable imaging modality in interventional pain medicine over the past two decades. Ultrasound can provide real-time visualization of soft tissues, nerves, vessels, and musculoskeletal structures and has transformed many pain interventions from blind or fluoroscopy-based approaches into precise, radiation-free procedures.

This talk will provide an updated overview of what is new in ultrasound-guided techniques for chronic pain management which begins with a timeline review of the evolution of ultrasound in pain medicine from early adoption in regional anesthesia to current use in advanced pain interventions.

Well established applications—including peripheral nerve blocks, myofascial injections, and
spinal procedures—will be summarized, followed by exploration of innovative techniques. These include ultrasound-guided genicular nerve radiofrequency ablation for knee osteoarthritis, erector spinae plane blocks in neuropathic pain, and targeting of small superficial nerves such as ilioinguinal and lateral femoral cutaneous nerves.
Integration of ultrasound guidance into radiofrequency ablation, regenerative therapies, and peripheral neuromodulation will also be briefly introduced.

In summary, ultrasound-guided techniques are no longer adjunctive but are becoming central in chronic pain management, offering greater safety, precision, and patient-centered care. The field continues to evolve rapidly, and clinicians should stay updated to adopt these innovations into daily practice.