# Focused Ultrasound in the Rehabilitation Setting:
## 3 Focused Ultrasound Applications in Disabling Conditions
### Psychiatric/Neurological Disorders  
FUS has been applied in psychiatric and neurological disorders. [PERSON] et al. (2011) reported symptom improvement in ten patients with OCD/MDD without cognitive impairment following MRgFUS anterior capsulotomy. [PERSON] et al. (2022) demonstrated a reduction  
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Application** & **Condition/Target** & **FUS Technique** & **Mechanism** & **Key Outcomes** & **Adverse Effects** \\ \hline
**Epilepsy** & \begin{tabular}{c} Refractory seizures \\ \end{tabular} & Anterior thalamic ablation & \begin{tabular}{c} Disruption of seizure \\ \end{tabular} & Reduced seizure frequency & Transient verbal fluency deficits \\  & & & \
\begin{tabular}{c} Enhanced \\ neuroplasticity \\ \end{tabular} &
\begin{tabular}{c} \(\geq\)20\% motor \\ learning \\ improvement \\ \end{tabular} & None significant reported \\
**Rehabilitation** & \begin{tabular}{c} Chronic motor deficits \\ \end{tabular} & \begin{tabular}{c} LIFUS to \\ ipsilesional \\ motor cortex \\ \end{tabular} & \
\begin{tabular}{c} Non-thermal \\ neuromodulation \\ \end{tabular} &
\begin{tabular}{c} Non-thermal \\ rate \\ \end{tabular} & Not specified \\ \hline
**Phantom Limb** & \begin{tabular}{c} Amputation- \\ related \\ sensations \\ \end{tabular} & \begin{tabular}{c} High-intensity \\ FUS (71.5 W/cm\({}^{2}\)) \\ \end{tabular} & \
\begin{tabular}{c} Peripheral nerve \\ reactivation \\ \end{tabular} &
\begin{tabular}{c} Restored \\ sensation; pain \\ modulation \\ \end{tabular} & Not specified \\ \hline
**Musculoskeletal** & \begin{tabular}{c} Knee \\ osteoarthritis, \\ facet joint \\ \end{tabular} & \begin{tabular}{c} MRgFUS \\ thermal ablation \\ \end{tabular} & \begin{tabular}{c} Targeted \\ denervation of \\ nociceptive \\ fibers \\ \end{tabular} & \
\begin{tabular}{c} 73.7\% with \(\geq\)50\% \\ pain reduction; \\ functional \\ improvement \\ \end{tabular} &
\begin{tabular}{c} Mild \\ post-procedural \\ discomfort \\ \end{tabular} \\ \hline
**Cognitive** & \begin{tabular}{c} Executive \\ Modulation \\ \end{tabular} & \begin{tabular}{c} Transcranial FUS \\ function \\ \end{tabular} & \begin{tabular}{c} Cortical network \\ cortex \\ \end{tabular} & \begin{tabular}{c} Improved \\ modulation \\ \end{tabular} & \
\begin{tabular}{c} Transient \\ headaches \\ performance \\ \end{tabular} &
\begin{tabular}{c} Transient \\ headaches \\ (64 participants) \\ \end{tabular} \\ \hline
**Neurodegenerative** & Alzheimer’s disease & \
\begin{tabular}{c} MRgFUS- \\ mediated BBB \\ opening \\ \end{tabular} &
\begin{tabular}{c} Enhanced drug \\ delivery via \\ blood-brain \\ barrier \\ disruption \\ \end{tabular} & Increased CSF & No cognitive \\  & & & & \\ \hline \hline \end{tabular}
\end{table}
Table 1: _Cont._in seizure frequency in two epilepsy patients after anterior thalamic ablation, although one patient experienced transient verbal fluency deficits. [PERSON] et al. conducted a phase I trial demonstrating the safety and feasibility of low-intensity focused ultrasound (LIFUS) applied to the ipsilesional motor cortex in 18 chronic stroke patients during motor rehabilitation. In their dose-escalation study (0-8 W/cm\({}^{2}\) spatial-peak pulse-average intensity), 67% of the high-intensity group participants (4-8 W/cm\({}^{2}\)) showed \(\geq\)20% motor sequence learning improvements compared to controls, alongside modulated corticospinal excitability patterns [23]. In a separate study, [PERSON] et al. [24] investigated MRgFUS-mediated BBB opening in nine patients with Alzheimer's disease. While no cognitive improvements were observed, they noted an increase in cerebrospinal fluid neurofilament light chain levels.