Seol Kyung, Hong Brian, Kelhofer Nicolas, Pappu Suguna, Oelze Michael
Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
Department of Neurosurgery, Carle Foundation Hospital, Urbana, IL, United States.
Front Pain Res (Lausanne). 2025 Jun 17;6:1606672. doi: 10.3389/fpain.2025.1606672. eCollection 2025.
Low-Intensity Focused Ultrasound Stimulation (LIFU) is a noninvasive and nondestructive neuromodulatory method with growing evidence for the safe and effective treatment of chronic pain. However, the effect of LIFU applied to the spine region, including the spinal cord and dorsal root ganglia, is not well understood. In this work, we review current advances in LIFU of the spine region for the treatment of chronic neuropathic pain and movement disorders to explore potential clinical applications and indicate a direction for future study. To assess the current state of LIFU application to pain modulation over the spinal cord region, a systematic search was performed according to PRISMA guidelines using PubMed, Web of Science, Scopus, and citation matching through December 17, 2024. Inclusion criteria were English language, non-tissue-damaging ultrasound neuromodulation, intervention over the spinal cord region, and relation to neuropathic pain. Exclusion criteria were existing review papers, extracorporeal shockwave therapy, tissue-destructive ultrasound treatments, non-focused ultrasound, and experiments. Preliminarily, title and abstract screening identified 15 studies, all using animal models. While results varied with different target sites and ultrasound parameters, LIFU was found to reduce allodynic response and suppress movement disorders such as spasticity and tremor. There are limited animal studies and no completed human clinical trials that analyze the effect of LIFU on spinal neural tissue. Further, there has not been a study that aims to optimize ultrasound parameters in the spine region or a thorough investigation correlating targets in the spinal regions to the desired outcome. We reviewed the current understanding of LIFU of the spine region for treating chronic pain, spasticity, and tremors to identify current advances and gaps in the literature. Our review highlights the need for further study in the efficacy and safety of LIFU applied to the spinal region of animals and humans, given the wide variation in sonication parameters, inconsistent treatment effects, and unexplored mechanisms of action.
低强度聚焦超声刺激（LIFU）是一种非侵入性且无损的神经调节方法，越来越多的证据表明其在慢性疼痛的安全有效治疗方面具有潜力。然而，LIFU应用于脊柱区域（包括脊髓和背根神经节）的效果尚未得到充分了解。在这项工作中，我们回顾了脊柱区域LIFU在治疗慢性神经性疼痛和运动障碍方面的当前进展，以探索潜在的临床应用，并为未来的研究指明方向。为了评估LIFU应用于脊髓区域疼痛调制的当前状态，我们根据PRISMA指南，使用PubMed、科学网、Scopus以及截至2024年12月17日的引文匹配进行了系统检索。纳入标准为英文文献、非组织损伤性超声神经调节、针对脊髓区域的干预以及与神经性疼痛的关联。排除标准为现有综述论文、体外冲击波疗法、组织破坏性超声治疗、非聚焦超声以及实验研究。初步的标题和摘要筛选确定了15项研究，均使用动物模型。虽然结果因不同的靶点部位和超声参数而异，但发现LIFU可减轻异常性疼痛反应并抑制痉挛和震颤等运动障碍。目前关于LIFU对脊髓神经组织影响的动物研究有限，且尚无完整的人类临床试验。此外，尚未有研究旨在优化脊柱区域的超声参数，也没有对脊髓区域靶点与预期结果之间的关联进行全面研究。我们回顾了目前对脊柱区域LIFU治疗慢性疼痛、痉挛和震颤的理解，以确定文献中的当前进展和差距。我们的综述强调，鉴于超声处理参数差异很大、治疗效果不一致以及作用机制尚未探索，需要对LIFU应用于动物和人类脊柱区域的疗效和安全性进行进一步研究。
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