{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:03:48Z","timestamp":1791518628620,"version":"4.3.4"},"reference-count":111,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2026,6,9]]},"abstract":"<jats:p>Focused ultrasound (FUS) is an emerging technology that uses ultrasound waves to ablate or modulate tissue. While it has been explored in several different clinical fields for over two decades, it has only recently begun to receive attention in neurosurgery. The neurosurgical field seems primed to benefit from a non-invasive precision technology such as FUS, which could minimise the adverse effects of invasive surgery if it delivers comparable efficacy in treatment. Through thermoablation, the high-intensity form of focused ultrasound (HIFU) can ablate nuclei in the basal ganglia to treat movement disorders and also ablate tumours and other targets. The low-intensity form of focused ultrasound (LIFU), typically delivered in a pulsed mode, can be used in conjunction with microbubbles to transiently open the blood-brain barrier (BBB) to increase the bioavailability of therapeutics into brain tissue in a highly targeted manner. While ultrasound is non-invasive (in terms of access to the point of treatment), relatively cheap and with a well-understood safety envelope, it is challenging to accurately focus ultrasound through the skull. Uncertainties remain about the adverse intracranial effects of HIFU, including overheating and brain swelling. Transient BBB opening with LIFU could be a viable solution to an unmet need in therapy delivery; it has the potential to be part of a broader treatment envelope for patients who require both neurosurgical and chemotherapy treatment. We highlight the potential applications of FUS in neurosurgery, its promises and the challenges it still faces.<\/jats:p>","DOI":"10.1136\/jnnp-2026-339017","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:20:34Z","timestamp":1783531234000},"page":"jnnp-2026-339017","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the role of focused ultrasound in neurosurgery and neuro-oncology"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3906-5317","authenticated-orcid":false,"given":"Vratko","family":"Himic","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed R","family":"Benchouia","sequence":"additional","affiliation":[{"name":"UT Health San Antonio Long School of Medicine, San Antonio, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A","family":"Abikenari","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R","family":"Jagid","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joacir","family":"Graciolli Cordeiro","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo J","family":"Komotar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish H","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E","family":"Ivan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4391-713X","authenticated-orcid":false,"given":"Martin J","family":"Gillies","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8432-5771","authenticated-orcid":false,"given":"Paul","family":"Lyon","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander L","family":"Green","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026070810202598000_jnnp-2026-339017v1.1","doi-asserted-by":"publisher","DOI":"10.1038\/S41582-020-00418-Z"},{"key":"2026070810202598000_jnnp-2026-339017v1.2","doi-asserted-by":"crossref","DOI":"10.3171\/2017.11.FOCUS17610","article-title":"High-intensity focused ultrasound: past, present, and future in neurosurgery","volume":"44","author":"Quadri","year":"2018","journal-title":"Neurosurg Focus"},{"key":"2026070810202598000_jnnp-2026-339017v1.3","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000336766.18197.8E"},{"key":"2026070810202598000_jnnp-2026-339017v1.4","doi-asserted-by":"publisher","DOI":"10.3390\/tomography9030090"},{"key":"2026070810202598000_jnnp-2026-339017v1.5","unstructured":"U.S. Food and Drug Administration (FDA) . FDA Roundup: October 13, 2023. 2024. Available: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-roundup-october-13-2023"},{"key":"2026070810202598000_jnnp-2026-339017v1.6","doi-asserted-by":"crossref","unstructured":"Yoh N , Los Santos GD , Tazhibi M , et al . Focused Ultrasound for Ablation in Neurosurgery \u2014 Present Use and Future Directions. AR 2023;14\u20139. doi:10.37549\/AR2915","DOI":"10.37549\/AR2915"},{"key":"2026070810202598000_jnnp-2026-339017v1.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600159"},{"key":"2026070810202598000_jnnp-2026-339017v1.8","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27401"},{"key":"2026070810202598000_jnnp-2026-339017v1.9","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.3171\/2022.6.JNS212483","article-title":"Magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor: 5-year follow-up results","volume":"138","author":"Cosgrove","year":"2023","journal-title":"J Neurosurg"},{"key":"2026070810202598000_jnnp-2026-339017v1.10","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27637"},{"key":"2026070810202598000_jnnp-2026-339017v1.11","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323216"},{"key":"2026070810202598000_jnnp-2026-339017v1.12","unstructured":"National Government Services Medical Policy Unit . Proposed LCD \u2013 Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor (DL37421), 2024. Available: https:\/\/www.cms.gov\/medicare-coverage-database\/view\/lcd.aspx?lcdid=39903&ver=8"},{"key":"2026070810202598000_jnnp-2026-339017v1.13","doi-asserted-by":"crossref","DOI":"10.1093\/braincomms\/fcaf168","article-title":"Safety and efficacy of bilateral staged focused ultrasound thalamotomy in refractory essential tremor","volume":"7","author":"Campins-Romeu","year":"2025","journal-title":"Brain Commun"},{"key":"2026070810202598000_jnnp-2026-339017v1.14","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.1002\/mds.28716","article-title":"Bilateral Focused Ultrasound Thalamotomy for Essential Tremor (best\u2010fus Phase 2 Trial)","volume":"36","author":"Iorio\u2010Morin","year":"2021","journal-title":"Movement Disorders"},{"key":"2026070810202598000_jnnp-2026-339017v1.15","doi-asserted-by":"crossref","unstructured":"Agrawal M , Garg K , Samala R , et al . Outcome and Complications of MR Guided Focused Ultrasound for Essential Tremor: A Systematic Review and Meta-Analysis. Front Neurol 2021;12. doi:10.3389\/fneur.2021.654711","DOI":"10.3389\/fneur.2021.654711"},{"key":"2026070810202598000_jnnp-2026-339017v1.16","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1002\/mdc3.70095","article-title":"Cognitive Outcomes Following Second-Sided Focused Ultrasound Thalamotomy for Tremor","volume":"12","author":"Boshmaf","year":"2025","journal-title":"Mov Disord Clin Pract"},{"key":"2026070810202598000_jnnp-2026-339017v1.17","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.3171\/2019.6.JNS19612","article-title":"Tractography-based targeting of the ventral intermediate nucleus: accuracy and clinical utility in MRgFUS thalamotomy","volume":"133","author":"Ranjan","year":"2019","journal-title":"J Neurosurg"},{"key":"2026070810202598000_jnnp-2026-339017v1.18","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.parkreldis.2021.09.013","article-title":"Lesions of the cerebello-thalamic tract rather than the ventral intermediate nucleus determine the outcome of focused ultrasound therapy in essential tremor: A 3T and 7T MRI-study","volume":"91","author":"Purrer","year":"2021","journal-title":"Parkinsonism Relat Disord"},{"key":"2026070810202598000_jnnp-2026-339017v1.19","doi-asserted-by":"crossref","DOI":"10.1007\/s00415-025-12915-6","article-title":"Invasive therapies for Parkinson\u2019s disease: an adapted excerpt from the guidelines of the German Society of Neurology","volume":"272","author":"Reese","year":"2025","journal-title":"J Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.20","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1001\/jamaneurol.2017.3098","article-title":"Safety and Efficacy of Focused Ultrasound Thalamotomy for Patients With Medication-Refractory, Tremor-Dominant Parkinson Disease: A Randomized Clinical Trial","volume":"74","author":"Bond","year":"2017","journal-title":"JAMA Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.21","unstructured":"InSightec . InSightec. A Feasibility Study to Evaluate Safety and Initial Effectiveness of ExAblate Transcranial MR Guided Focused Ultrasound for Unilateral Thalamotomy in the Treatment of Medication-Refractory Tremor Dominant Idiopathic Parkinson\u2019s Disease (Clinical trial registration NCT01772693). Available: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01772693"},{"key":"2026070810202598000_jnnp-2026-339017v1.22","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s10143-019-01216-y","article-title":"Safety and efficacy of magnetic resonance imaging-guided focused ultrasound neurosurgery for Parkinson\u2019s disease: a systematic review","volume":"44","author":"Xu","year":"2021","journal-title":"Neurosurg Rev"},{"key":"2026070810202598000_jnnp-2026-339017v1.23","doi-asserted-by":"publisher","DOI":"10.3171\/2020.6.JNS192773"},{"key":"2026070810202598000_jnnp-2026-339017v1.24","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.3171\/2020.2.JNS192590","article-title":"Predicting final lesion characteristics during MR-guided focused ultrasound pallidotomy for treatment of Parkinson\u2019s disease","volume":"134","author":"Miller","year":"2021","journal-title":"J Neurosurg"},{"key":"2026070810202598000_jnnp-2026-339017v1.25","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2016311"},{"key":"2026070810202598000_jnnp-2026-339017v1.26","doi-asserted-by":"crossref","first-page":"e1395","DOI":"10.1212\/WNL.0000000000206771","article-title":"Prospective Long-term Follow-up of Focused Ultrasound Unilateral Subthalamotomy for Parkinson Disease","volume":"100","author":"Mart\u00ednez-Fern\u00e1ndez","year":"2023","journal-title":"Neurology"},{"key":"2026070810202598000_jnnp-2026-339017v1.27","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1001\/jamaneurol.2024.1220","article-title":"Staged Bilateral MRI-Guided Focused Ultrasound Subthalamotomy for Parkinson Disease","volume":"81","author":"Mart\u00ednez-Fern\u00e1ndez","year":"2024","journal-title":"JAMA Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.28","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.601153","article-title":"Bilateral MR-Guided Focused Ultrasound Pallidothalamic Tractotomy for Parkinson\u2019s Disease With 1-Year Follow-Up","volume":"12","author":"Gallay","year":"2021","journal-title":"Front Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.29","unstructured":"INSIGHTEC . Insightec Announces FDA Approval of Staged Bilateral Focused Ultrasound Treatment for Parkinson\u2019s Disease, 2025. Available: https:\/\/www.prnewswire.com\/news-releases\/insightec-announces-fda-approval-of-staged-bilateral-focused-ultrasound-treatment-for-parkinsons-disease-302499479.html"},{"key":"2026070810202598000_jnnp-2026-339017v1.30","doi-asserted-by":"crossref","unstructured":"Liang M , Hou L , Liang J , et al . Ameliorating motor performance and quality of life in Parkinson\u2019s disease: a comparison of deep brain stimulation and focused ultrasound surgery. Front Neurol 2025;16. doi:10.3389\/fneur.2025.1449973","DOI":"10.3389\/fneur.2025.1449973"},{"key":"2026070810202598000_jnnp-2026-339017v1.31","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1007\/s00701-020-04468-6","article-title":"Magnetic resonance-guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery: a case report","volume":"162","author":"Yamaguchi","year":"2020","journal-title":"Acta Neurochir (Wien)"},{"key":"2026070810202598000_jnnp-2026-339017v1.32","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-020-01744-x","article-title":"Magnetic resonance-guided focused ultrasound for mesial temporal lobe epilepsy: a case report","volume":"20","author":"Abe","year":"2020","journal-title":"BMC Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.33","unstructured":"NaviFUS Corporation . NaviFUS Corporation. A Pilot, Open-label, Two-arm, Parallel-group Randomized Trial Study to Evaluate the Efficacy and Safety of NaviFUSTM System Neuromodulating Treatment for Patients With Drug Resistant Epilepsy (Clinical trial registration NCT06492720). Available: https:\/\/clinicaltrials.gov\/study\/NCT06492720"},{"key":"2026070810202598000_jnnp-2026-339017v1.34","unstructured":"NaviFUS Corporation . NaviFUS Corporation. A Pilot, Single Blind, Randomized Crossover Study to Evaluate the Safety and Efficacy of NaviFUSTM System Neuromodulating Treatment for Patients With Drug Resistant Epilepsy (Clinical trial registration NCT04999046). 2023. Available: https:\/\/clinicaltrials.gov\/study\/NCT04999046"},{"key":"2026070810202598000_jnnp-2026-339017v1.35","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2022.886584","article-title":"Recent Advances in the Use of Focused Ultrasound as a Treatment for Epilepsy","volume":"16","author":"Lescrauwaet","year":"2022","journal-title":"Front Neurosci"},{"key":"2026070810202598000_jnnp-2026-339017v1.36","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1007\/s10072-024-07946-2","article-title":"MRgFUS disconnection surgery for hypothalamic hamartoma-related epilepsy: case report and literature review","volume":"46","author":"Ricciardi","year":"2025","journal-title":"Neurol Sci"},{"key":"2026070810202598000_jnnp-2026-339017v1.37","unstructured":"InSightec . A Feasibility Study to Evaluate Safety and Initial Effectiveness of MR-Guided Focused Ultrasound Ablation Therapy in the Treatment of Focal Epilepsy (Clinical trial registration NCT02804230). Available: https:\/\/clinicaltrials.gov\/study\/NCT02804230"},{"key":"2026070810202598000_jnnp-2026-339017v1.38","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/epi.17535","article-title":"A phase 1 open\u2010label trial evaluating focused ultrasound unilateral anterior thalamotomy for focal onset epilepsy","volume":"64","author":"Krishna","year":"2023","journal-title":"Epilepsia"},{"key":"2026070810202598000_jnnp-2026-339017v1.39","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17105"},{"key":"2026070810202598000_jnnp-2026-339017v1.40","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.brs.2023.11.013","article-title":"Transcranial ultrasound neuromodulation for epilepsy: A pilot safety trial","volume":"17","author":"Bubrick","year":"2024","journal-title":"Brain Stimul"},{"key":"2026070810202598000_jnnp-2026-339017v1.41","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/2050-5736-2-17","article-title":"First noninvasive thermal ablation of a brain tumor with MR-guided focusedultrasound","volume":"2","author":"Coluccia","year":"2014","journal-title":"J Ther Ultrasound"},{"key":"2026070810202598000_jnnp-2026-339017v1.42","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.ultrasmedbio.2018.10.016","article-title":"Sonodynamic Therapy for Malignant Glioma Using 220-kHz Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound and 5-Aminolevulinic acid","volume":"45","author":"Yoshida","year":"2019","journal-title":"Ultrasound Med Biol"},{"key":"2026070810202598000_jnnp-2026-339017v1.43","unstructured":"Moosa S . Pilot Study of Sonodynamic Therapy With 5-ALA for the Treatment of Recurrent Glioblastoma Using Neuronavigation-Guided Low-Intensity Focused Ultrasound (Clinical trial registration NCT06039709). Available: https:\/\/clinicaltrials.gov\/study\/NCT06039709"},{"key":"2026070810202598000_jnnp-2026-339017v1.44","unstructured":"Sanai N . A Phase 0, First in Human, Open-label Study of Intravenous Aminolevulinic Acid HCl (ALA) and MR-Guided Focused Ultrasound Device (MRgFUS) in Participants with Recurrent High Grade Glioma (HGG) (Clinical trial registration NCT04559685). Available: https:\/\/clinicaltrials.gov\/study\/NCT04559685"},{"key":"2026070810202598000_jnnp-2026-339017v1.45","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-025-04957-7"},{"key":"2026070810202598000_jnnp-2026-339017v1.46","doi-asserted-by":"crossref","first-page":"712","DOI":"10.3340\/jkns.2018.0226","article-title":"Factors Related to Successful Energy Transmission of Focused Ultrasound through a Skull : A Study in Human Cadavers and Its Comparison with Clinical Experiences","volume":"62","author":"Jung","year":"2019","journal-title":"J Korean Neurosurg Soc"},{"key":"2026070810202598000_jnnp-2026-339017v1.47","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.3171\/2020.9.JNS201109","article-title":"Correction of the skull density ratio for transcranial MRI-guided focused ultrasound thalamotomy: clinical significance of predicting therapeutic temperature","volume":"135","author":"Hori","year":"2021","journal-title":"J Neurosurg"},{"key":"2026070810202598000_jnnp-2026-339017v1.48","unstructured":"Kadowaki M , Sugiyama K , Nozaki T , et al . The potential role of the regional skull conditions in predicting the efficacy of transcranial magnetic resonance-guided focused ultrasound in patient with low skull density ratio. medRxiv [Preprint] 2025. doi:10.1101\/2025.03.12.25323386 Available: https:\/\/www.medrxiv.org\/content\/10.1101\/2025.03.12.25323386v2"},{"key":"2026070810202598000_jnnp-2026-339017v1.49","doi-asserted-by":"crossref","DOI":"10.1121\/1.4976339","article-title":"Accurate simulation of transcranial ultrasound propagation for ultrasonic neuromodulation and stimulation","volume":"141","author":"Robertson","year":"2017","journal-title":"J Acoust Soc Am"},{"key":"2026070810202598000_jnnp-2026-339017v1.50","doi-asserted-by":"crossref","first-page":"L9","DOI":"10.1088\/1361-6560\/aa7cd5","article-title":"Design of patient-specific focused ultrasound arrays for non-invasive brain therapy with increased trans-skull transmission and steering range","volume":"62","author":"Hughes","year":"2017","journal-title":"Phys Med Biol"},{"key":"2026070810202598000_jnnp-2026-339017v1.51","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1001\/jamaneurol.2024.2295","article-title":"Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor: An Open-Label Clinical Trial","volume":"81","author":"Kaplitt","year":"2024","journal-title":"JAMA Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.52","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1093\/neuros\/nyaa485","article-title":"Bilateral Deep Brain Stimulation is the Procedure to Beat for Advanced Parkinson Disease: A Meta-Analytic, Cost-Effective Threshold Analysis for Focused Ultrasound","volume":"88","author":"Mahajan","year":"2021","journal-title":"Neurosurgery"},{"key":"2026070810202598000_jnnp-2026-339017v1.53","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1002\/mds.27587","article-title":"Cost\u2010Effectiveness of Magnetic Resonance\u2010Guided Focused Ultrasound for Essential Tremor","volume":"34","author":"Li","year":"2019","journal-title":"Movement Disorders"},{"key":"2026070810202598000_jnnp-2026-339017v1.54","article-title":"Overcoming the Blood-Brain Barrier: Focused Ultrasound in Glioblastoma Treatment","volume":"17","author":"Jurgaitis","year":"2025","journal-title":"Cureus"},{"key":"2026070810202598000_jnnp-2026-339017v1.55","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2020.00675","article-title":"Focused Ultrasound for Noninvasive, Focal Pharmacologic Neurointervention","volume":"14","author":"Wang","year":"2020","journal-title":"Front Neurosci"},{"key":"2026070810202598000_jnnp-2026-339017v1.56","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043330"},{"key":"2026070810202598000_jnnp-2026-339017v1.57","doi-asserted-by":"crossref","DOI":"10.3390\/cancers17030513","article-title":"Clinical Trials of Focused Ultrasound for Brain Tumors","volume":"17","author":"Lu","year":"2025","journal-title":"Cancers (Basel)"},{"key":"2026070810202598000_jnnp-2026-339017v1.58","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-024-04795-z"},{"key":"2026070810202598000_jnnp-2026-339017v1.59","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines14030674","article-title":"Reconsidering Carotid Artery Stenting for Asymptomatic Carotid Stenosis in the Era of Endovascular Evolution","volume":"14","author":"DeYoung","year":"2026","journal-title":"Biomedicines"},{"key":"2026070810202598000_jnnp-2026-339017v1.60","doi-asserted-by":"crossref","DOI":"10.3171\/2017.11.FOCUS17631","article-title":"A minimally invasive catheter-based ultrasound technology for therapeutic interventions in brain: initial preclinical studies","volume":"44","author":"Ghoshal","year":"2018","journal-title":"Neurosurg Focus"},{"key":"2026070810202598000_jnnp-2026-339017v1.61","doi-asserted-by":"publisher","DOI":"10.7150\/thno.35892"},{"key":"2026070810202598000_jnnp-2026-339017v1.62","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2147\/IJN.S286221","article-title":"Gene Therapy for Drug-Resistant Glioblastoma via Lipid-Polymer Hybrid Nanoparticles Combined with Focused Ultrasound","volume":"16","author":"Yang","year":"2021","journal-title":"Int J Nanomedicine"},{"key":"2026070810202598000_jnnp-2026-339017v1.63","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2024-011198","article-title":"Novel fusion superkine, IL-24S\/IL-15, enhances immunotherapy of brain cancer","volume":"13","author":"Kumar","year":"2025","journal-title":"J Immunother Cancer"},{"key":"2026070810202598000_jnnp-2026-339017v1.64","doi-asserted-by":"crossref","DOI":"10.1038\/s41467-024-48326-w","article-title":"Ultrasound-mediated delivery of doxorubicin to the brain results in immune modulation and improved responses to PD-1 blockade in gliomas","volume":"15","author":"Arrieta","year":"2024","journal-title":"Nat Commun"},{"key":"2026070810202598000_jnnp-2026-339017v1.65","unstructured":"Sonabend AM . Phase 1 &amp; 2 Trial of Blood-brain Barrier Opening With an Implantable Ultrasound Device SonoCloud-9 and Treatment With Albumin-bound Paclitaxel and Carboplatin in Patients With Recurrent Glioblastoma (Clinical trial registration NCT04528680). 2025. Available: https:\/\/clinicaltrials.gov\/study\/NCT04528680"},{"key":"2026070810202598000_jnnp-2026-339017v1.66","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1080\/14737175.2025.2534615","article-title":"An overview of focused ultrasound as a treatment option for gliomas","volume":"25","author":"Hey","year":"2025","journal-title":"Expert Rev Neurother"},{"key":"2026070810202598000_jnnp-2026-339017v1.67","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.abj4011","article-title":"MR-guided focused ultrasound enhances delivery of trastuzumab to Her2-positive brain metastases","volume":"13","author":"Meng","year":"2021","journal-title":"Sci Transl Med"},{"key":"2026070810202598000_jnnp-2026-339017v1.68","doi-asserted-by":"crossref","first-page":"34504017","DOI":"10.1073\/pnas.2103280118","article-title":"Localized blood-brain barrier opening in infiltrating gliomas with MRI-guided acoustic emissions-controlled focused ultrasound","volume":"118","author":"Anastasiadis","year":"2021","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2026070810202598000_jnnp-2026-339017v1.69","doi-asserted-by":"crossref","DOI":"10.3390\/pharmaceutics13071084","article-title":"Focused Ultrasound Combined with Microbubbles in Central Nervous System Applications","volume":"13","author":"Chen","year":"2021","journal-title":"Pharmaceutics"},{"key":"2026070810202598000_jnnp-2026-339017v1.70","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.903059","article-title":"Low-Intensity Focused Ultrasound Technique in Glioblastoma Multiforme Treatment","volume":"12","author":"Mungur","year":"2022","journal-title":"Front Oncol"},{"key":"2026070810202598000_jnnp-2026-339017v1.71","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00112-2"},{"key":"2026070810202598000_jnnp-2026-339017v1.72","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.adq6645","article-title":"Blood-brain barrier opening with neuronavigation-guided focused ultrasound in pediatric patients with diffuse midline glioma","volume":"17","author":"Wu","year":"2025","journal-title":"Sci Transl Med"},{"key":"2026070810202598000_jnnp-2026-339017v1.73","unstructured":"CarThera . A Study to Evaluate the Safety and the Efficacy of Transient Opening of the Blood-brain Barrier (BBB) by Low Intensity Pulsed Ultrasound With the SonoCloud-9 Implantable Device in Recurrent Glioblastoma Patients Eligible for Surgery and for Carboplatin Chemotherapy (Clinical trial registration NCT03744026). 2022. Available: https:\/\/clinicaltrials.gov\/study\/NCT03744026"},{"key":"2026070810202598000_jnnp-2026-339017v1.74","doi-asserted-by":"crossref","unstructured":"Carpentier A , Stupp R , Sonabend AM , et al . Repeated blood\u2013brain barrier opening with a nine-emitter implantable ultrasound device in combination with carboplatin in recurrent glioblastoma: a phase I\/II clinical trial. Nat Commun 2024;15. doi:10.1038\/s41467-024-45818-7","DOI":"10.1038\/s41467-024-45818-7"},{"key":"2026070810202598000_jnnp-2026-339017v1.75","unstructured":"Spencer D . Drug Discovery World (DDW).Regulatory update for malignant glioma drug. 2024. Available: https:\/\/www.ddw-online.com\/us-and-eu-regulatory-update-for-carboplatin-in-malignant-glioma-29753-202405\/"},{"key":"2026070810202598000_jnnp-2026-339017v1.76","doi-asserted-by":"publisher","DOI":"10.7150\/thno.21630"},{"key":"2026070810202598000_jnnp-2026-339017v1.77","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1016\/j.brs.2021.09.015","article-title":"Histological examination of focused ultrasound effects on human brain tissue","volume":"14","author":"Spivak","year":"2021","journal-title":"Brain Stimul"},{"key":"2026070810202598000_jnnp-2026-339017v1.78","doi-asserted-by":"crossref","DOI":"10.1200\/JCO.2024.42.16_suppl.TPS2098","article-title":"A prospective, multicenter trial of low-intensity focused ultrasound (LIFU) for blood-brain barrier disruption for liquid biopsy in glioblastoma (LIBERATE)","volume":"42","author":"Ahluwalia","year":"2024","journal-title":"JCO"},{"key":"2026070810202598000_jnnp-2026-339017v1.79","doi-asserted-by":"publisher","DOI":"10.3171\/2016.3.JNS151635"},{"key":"2026070810202598000_jnnp-2026-339017v1.80","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0125911","article-title":"Long-Term Safety of Repeated Blood-Brain Barrier Opening via Focused Ultrasound with Microbubbles in Non-Human Primates Performing a Cognitive Task","volume":"10","author":"Downs","year":"2015","journal-title":"PLoS ONE"},{"key":"2026070810202598000_jnnp-2026-339017v1.81","doi-asserted-by":"publisher","DOI":"10.3171\/2022.9.JNS221565"},{"key":"2026070810202598000_jnnp-2026-339017v1.82","doi-asserted-by":"crossref","DOI":"10.1093\/noajnl\/vdaa071","article-title":"Therapeutic enhancement of blood\u2013brain and blood\u2013tumor barriers permeability by laser interstitial thermal therapy","volume":"2","author":"Salehi","year":"2020","journal-title":"Neuro-Oncology Advances"},{"key":"2026070810202598000_jnnp-2026-339017v1.83","doi-asserted-by":"crossref","DOI":"10.1007\/s11060-025-05305-5","article-title":"Modulating the glioma microenvironment with laser interstitial thermal therapy: mechanisms and therapeutic implications","volume":"176","author":"Vargas","year":"2025","journal-title":"J Neurooncol"},{"key":"2026070810202598000_jnnp-2026-339017v1.84","doi-asserted-by":"publisher","DOI":"10.1021\/acs.nanolett.6b03517"},{"key":"2026070810202598000_jnnp-2026-339017v1.85","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30332-2"},{"key":"2026070810202598000_jnnp-2026-339017v1.86","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-021-03837-0"},{"key":"2026070810202598000_jnnp-2026-339017v1.87","unstructured":"InSightec . A Pivotal Study to Evaluate the Safety and Effectiveness of Exablate Model 4000 Using Microbubble Resonators to Temporarily Mediate Blood-Brain Barrier Disruption (BBBD) for Liquid Biopsy in Subjects With GlioBlastoma Brain Tumors (Clinical trial registration NCT05383872). 2025. Available: https:\/\/clinicaltrials.gov\/study\/NCT05383872"},{"key":"2026070810202598000_jnnp-2026-339017v1.88","doi-asserted-by":"crossref","DOI":"10.3171\/2024.6.FOCUS24278","article-title":"A systematic review of focused ultrasound for psychiatric disorders: current applications, opportunities, and challenges","volume":"57","author":"Henn","year":"2024","journal-title":"Neurosurg Focus"},{"key":"2026070810202598000_jnnp-2026-339017v1.89","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1038\/s41380-020-0737-1","article-title":"Magnetic resonance-guided focused ultrasound capsulotomy for refractory obsessive compulsive disorder and major depressive disorder: clinical and imaging results from two phase I trials","volume":"25","author":"Davidson","year":"2020","journal-title":"Mol Psychiatry"},{"key":"2026070810202598000_jnnp-2026-339017v1.90","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2308719"},{"key":"2026070810202598000_jnnp-2026-339017v1.91","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2023.1211566","article-title":"Low-intensity focused ultrasound targeting the nucleus accumbens as a potential treatment for substance use disorder: safety and feasibility clinical trial","volume":"14","author":"Mahoney","year":"2023","journal-title":"Front Psychiatry"},{"key":"2026070810202598000_jnnp-2026-339017v1.92","unstructured":"InSightec . Insightec Secures FDA Approval and CE Marking for Exablate\u00ae Prime on Philips MR Systems. 2024. Available: https:\/\/insightec.com\/news\/insightec-secures-fda-approval-and-ce-marking-for-exablate-prime-on-philips-mr-systems\/"},{"key":"2026070810202598000_jnnp-2026-339017v1.93","unstructured":"PR Newswire . INSIGHTEC announces Exablate Prime \u2013 The next generation of MR-guided focused ultrasound. 2024 Available: https:\/\/www.prnewswire.com\/il\/news-releases\/insightec-announces-exablate-prime-the-next-generation-of-mr-guided-focused-ultrasound-302046880.html"},{"key":"2026070810202598000_jnnp-2026-339017v1.94","unstructured":"Bell J . Carthera receives FDA Breakthrough Device designation for Sonocloud-9 system. NeuroNews International; 2022. Available: https:\/\/neuronewsinternational.com\/carthera-receives-fda-breakthrough-device-designation-for-sonocloud-9-system\/"},{"key":"2026070810202598000_jnnp-2026-339017v1.95","unstructured":"MedPath . Carthera\u2019s SonoCloud System Receives EMA Orphan Medical Device Endorsement for Brain Tumor Treatment. 2025. Available: https:\/\/trial.medpath.com\/news\/4df9f2bde733e2b4\/carthera-s-sonocloud-system-receives-ema-orphan-medical-device-endorsement-for-brain-tumor-treatment"},{"key":"2026070810202598000_jnnp-2026-339017v1.96","unstructured":"NaviFUS Corporation . An Open Label, Prospective, Pilot Study to Evaluate the Safety and Preliminary Efficacy of the Combination of Focused Ultrasound With Re-irradiation for the Treatment Patients With Recurrent Glioblastoma Multiforme Using NaviFUS System (Clinical trial registration NCT04988750). 2023. Available: https:\/\/clinicaltrials.gov\/study\/NCT04988750"},{"key":"2026070810202598000_jnnp-2026-339017v1.97","unstructured":"NaviFUS Corporation . A Prospective, Open-Label, Single-Arm Pilot Study to Evaluate the Safety and Efficacy of Bevacizumab in Combination With NaviFUS System for the Treatment of Recurrent Glioblastoma Multiforme (rGBM) (Clinical trial registration NCT06329570). Available: https:\/\/clinicaltrials.gov\/study\/NCT06329570"},{"key":"2026070810202598000_jnnp-2026-339017v1.98","unstructured":"NaviFUS Corporation . A FIH Feasibility Study to Evaluate the Safety of Transient Disruption of Blood-brain Barrier in Recurrent Glioblastoma Multiforme (GBM) Patients Using NaviFUS System [Clinical trial registration] [Internet]. clinicaltrials.gov; 2019 Jun [cited 2025 Sep 7]. Available: https:\/\/clinicaltrials.gov\/study\/NCT03626896"},{"key":"2026070810202598000_jnnp-2026-339017v1.99","unstructured":"NaviFUS Corporation . A Phase I, Two-stage, and Open Label Study to Evaluate the Safety and Tolerability of Using NaviFUS System in Patients With Drug Resistant Epilepsy (Clinical trial registration NCT03860298). 2020. Available: https:\/\/clinicaltrials.gov\/study\/NCT03860298"},{"key":"2026070810202598000_jnnp-2026-339017v1.100","unstructured":"NaviFUS Corporation . A Prospective, Open-label, Single-arm, Multi-center, Pilot Study to Evaluate the Safety, Tolerability, and Preliminary Efficacy of Low-intensity Focused Ultrasound Neuromodulation in Patients With Drug-resistant Unilateral or Bilateral Temporal Lobe Epilepsy [Clinical trial registration] [Internet]. clinicaltrials.gov; Clinical trial registration no.: NCT06388707 . 2025. Available: https:\/\/clinicaltrials.gov\/study\/NCT06388707"},{"key":"2026070810202598000_jnnp-2026-339017v1.101","unstructured":"NaviFUS . Exciting Partnership: NaviFUS and Bracco Join Forces to Revolutionize Brain Disease Treatment! 2024. Available: https:\/\/navifus.com\/2024\/09\/19\/exciting-partnership-navifus-and-bracco-join-forces-to-revolutionize-brain-disease-treatment\/"},{"key":"2026070810202598000_jnnp-2026-339017v1.102","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2019.09.010"},{"key":"2026070810202598000_jnnp-2026-339017v1.103","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1109\/TBCAS.2023.3299750","article-title":"A Review of Ultrasound Neuromodulation Technologies","volume":"17","author":"Javid","year":"2023","journal-title":"IEEE Trans Biomed Circuits Syst"},{"key":"2026070810202598000_jnnp-2026-339017v1.104","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1001\/jamaneurol.2017.3129","article-title":"A Review of the Current Therapies, Challenges, and Future Directions of Transcranial Focused Ultrasound Technology","volume":"75","author":"Krishna","year":"2018","journal-title":"JAMA Neurol"},{"key":"2026070810202598000_jnnp-2026-339017v1.105","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/neuros\/nyz407","article-title":"Ultrasound Ablation in Neurosurgery: Current Clinical Applications and Future Perspectives","volume":"87","author":"Franzini","year":"2020","journal-title":"Neurosurgery"},{"key":"2026070810202598000_jnnp-2026-339017v1.106","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1109\/TUFFC.2014.006882","article-title":"In Vivo application and localization of transcranial focused ultrasound using dual-mode ultrasound arrays","volume":"62","author":"Haritonova","year":"2015","journal-title":"IEEE Trans Ultrason Ferroelectr Freq Control"},{"key":"2026070810202598000_jnnp-2026-339017v1.107","doi-asserted-by":"crossref","first-page":"3482","DOI":"10.1109\/TBME.2021.3073951","article-title":"A Dual-Mode 2D Matrix Array for Ultrasound Image-Guided Noninvasive Therapy","volume":"68","author":"Zhang","year":"2021","journal-title":"IEEE Trans Biomed Eng"},{"key":"2026070810202598000_jnnp-2026-339017v1.108","doi-asserted-by":"publisher","DOI":"10.7150\/thno.76199"},{"key":"2026070810202598000_jnnp-2026-339017v1.109","doi-asserted-by":"crossref","first-page":"2751","DOI":"10.1109\/TBME.2013.2264484","article-title":"Real-time implementation of a dual-mode ultrasound array system: in vivo results","volume":"60","author":"Casper","year":"2013","journal-title":"IEEE Trans Biomed Eng"},{"key":"2026070810202598000_jnnp-2026-339017v1.110","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-018-00691-3"},{"key":"2026070810202598000_jnnp-2026-339017v1.111","doi-asserted-by":"crossref","first-page":"s41467","DOI":"10.1038\/s41467-026-70714-7","article-title":"Suppression of pathological oscillations with transcranial focused ultrasound in Parkinson\u2019s disease","volume":"17","author":"Eraifej","year":"2026","journal-title":"Nat Commun"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2026-339017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:20:44Z","timestamp":1783531244000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2026-339017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":111,"alternative-id":["10.1136\/jnnp-2026-339017"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2026-339017","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]}}}