A Wearable Dual-Mode Probe for Image-Guided Closed-Loop Ultrasound Neuromodulation.

Low-intensity focused ultrasound (FUS) is an emerging non-invasive and spatially/temporally precise method for modulating the firing rates and patterns of peripheral nerves. This paper describes an image-guided platform for chronic and patient-specific FUS neuromodulation. The system uses custom wearable probes containing separate ultrasound imaging and modulation transducer arrays realized using piezoelectric transducers assembled on a flexible printed circuit board (PCB). Dual-mode probes operating around 4 MHz (imaging) and 1.3 MHz (modulation) were fabricated and tested on tissue phantoms. The resulting B-mode images were analyzed using a template-matching algorithm to estimate the location of the target nerve and then direct the modulation beam toward the target. The ultrasound transmit voltage used to excite the modulation array was optimized in real-time by automatically regulating functional feedback signals (the average rates of emulated muscle twitches detected by an on-board motion sensor) through a proportional and integral (PI) controller, thus providing robustness to inter-subject variability and probe positioning errors. The proposed closed-loop neuromodulation paradigm was experimentally demonstrated in vitro using an active tissue phantom that integrates models of the posterior tibial nerve and nearby blood vessels together with embedded sensors and actuators.