{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:52:26Z","timestamp":1786121546968,"version":"build-2736575974"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy of transcranial ultrasound stimulation (TUS) in improving neurological deficits, motor, cognitive, swallowing function, and activities of daily living (ADL) in stroke patients<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang Database were searched for randomized controlled trials (RCTs) on TUS for stroke patients from inception to December 1, 2025. Two reviewers independently conducted literature screening, data extraction, risk of bias assessment using the Cochrane tool, and methodological quality evaluation using the PEDro scale. Meta-analysis was performed with RevMan 5.3, and publication bias was assessed using Egger\u2019s test in Stata 18.0<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-one RCTs involving 1,748 patients were included. TUS combined with conventional rehabilitation significantly improved neurological deficits (NIHSS: MD = \u22121.98, 95% CI: \u22123.61 to \u22120.34,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), upper-limb motor function (FMA-UE: MD = 7.96, 95% CI: 7.16\u20138.76,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), lower-limb motor function (FMA-LE: MD = 3.98, 95% CI: 2.70\u20135.26,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), cognitive function (MMSE: MD = 1.22, 95% CI: 0.74\u20131.71,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), ADL (BI: MD = 9.08, 95% CI: 5.72\u201312.44,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and swallowing (Fujishima-Ichiro: MD = 1.72, 95% CI: 1.30\u20132.13,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) Subgroup analyses suggested that cognitive benefits were more pronounced in non-acute patients, while ADL improvements were greater in those with moderate-to-severe dependence. Regarding TUS parameters, 800 kHz provided stable motor recovery, and unilateral temporal window stimulation was sufficient for meaningful functional gains. Methodological quality was acceptable (3 good, 18 fair trials), and no publication bias was detected for BI score (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05)\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence supports that TUS combined with rehabilitation effectively promotes recovery of neurological, motor, cognitive, swallowing, and daily living functions in stroke patients, with particular value for those with moderate-to-severe dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD420261296388.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2026.1828888","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:28:36Z","timestamp":1786080516000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcranial ultrasound stimulation for post-stroke dysfunction: a meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"20","author":[{"given":"Huiping","family":"Li","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Hunan Normal University Hunan Provincial People\u2019s Hospital","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingming","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Hunan Normal University Hunan Provincial People\u2019s Hospital","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Hunan Normal University Hunan Provincial People\u2019s Hospital","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Hunan Normal University Hunan Provincial People\u2019s Hospital","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The First Affiliated Hospital of Shaoyang University","place":["Shaoyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.3870\/zgkf.2016.01.019","article-title":"Clinical efficacy of ultrasound combined with rehabilitation in acute cerebral infarction.","volume":"31","author":"Cao","year":"2016","journal-title":"Chin. J. Rehabil."},{"key":"B2","doi-asserted-by":"publisher","first-page":"5568","DOI":"10.1038\/s41598-018-23929-8","article-title":"Preventive effect of low intensity pulsed ultrasound against experimental cerebral ischemia\/reperfusion injury via apoptosis reduction and brain-derived neurotrophic factor induction.","volume":"8","author":"Chen","year":"2018","journal-title":"Sci. Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3969\/j.issn.1002-2376.2022.08.073","article-title":"Application effect of transcranial ultrasound therapeutic instrument combined with detailed nursing in patients with progressive cerebral infarction.","volume":"35","author":"Chen","year":"2022","journal-title":"Med. Equip."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/j.brs.2024.09.006","article-title":"Transcranial focused ultrasound stimulation enhances cerebrospinal fluid movement: Real-time in vivo two-photon and widefield imaging evidence.","volume":"17","author":"Choi","year":"2025","journal-title":"Brain Stimul."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e70318","DOI":"10.1002\/brb3.70318","article-title":"Effects of low intensity focused ultrasound stimulation combined with functional electrical stimulation on corticospinal excitability and upper extremity fine motor function.","volume":"15","author":"Desai","year":"2025","journal-title":"Brain Behav."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e2438232024","DOI":"10.1523\/JNEUROSCI.2438-23.2024","article-title":"Investigation of metaplasticity associated with transcranial focused ultrasound neuromodulation in humans.","volume":"44","author":"Ding","year":"2024","journal-title":"J. Neurosci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"88","DOI":"10.3969\/j.issn.2095-1752.2018.26.160","article-title":"Observation on the efficacy of transcranial ultrasound-neuromuscular electrical stimulation in patients with dysphagia after stroke.","volume":"8","author":"Fan","year":"2018","journal-title":"Yiyao Qianyan"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.19891\/j.issn1673-9388.(2025)01-0001-04","article-title":"Effects of transcranial ultrasound-neuromuscular stimulation therapy combined with resuvastatin on patients with acute cerebral infarction.","volume":"19","author":"Fan","year":"2025","journal-title":"J. Dis. Monitor Control."},{"key":"B9","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1177\/17474930241308142","article-title":"World stroke organization: Global stroke fact sheet 2025.","volume":"20","author":"Feigin","year":"2025","journal-title":"Int. J. Stroke"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1016\/j.brs.2018.08.013","article-title":"Low-intensity ultrasound neuromodulation: An overview of mechanisms and emerging human applications.","volume":"11","author":"Fomenko","year":"2018","journal-title":"Brain Stimul."},{"key":"B11","doi-asserted-by":"publisher","first-page":"964060","DOI":"10.3389\/fnins.2022.964060","article-title":"Transcranial ultrasound stimulation applied in ischemic stroke rehabilitation: A review.","volume":"16","author":"Guo","year":"2022","journal-title":"Front. Neurosci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2815","DOI":"10.1161\/STROKEAHA.124.048033","article-title":"Global, regional, and national burden of Stroke, 1990-2021: A systematic analysis for global burden of disease 2021.","volume":"55","author":"He","year":"2024","journal-title":"Stroke"},{"key":"B13","doi-asserted-by":"publisher","first-page":"4958","DOI":"10.1038\/s41598-021-84473-6","article-title":"Low-intensity pulsed ultrasound therapy promotes recovery from stroke by enhancing angio-neurogenesis in mice in vivo.","volume":"11","author":"Ichijo","year":"2021","journal-title":"Sci. Rep."},{"key":"B14","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.neuroimage.2018.01.009","article-title":"Mapping stimulus feature selectivity in macaque V1 by two-photon Ca2+ imaging: Encoding-model analysis of fluorescence responses to natural movies.","volume":"180","author":"Ikezoe","year":"2018","journal-title":"Neuroimage"},{"key":"B15","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ultrasmedbio.2025.09.003","article-title":"Low-intensity ultrasound and neural repair: Unlocking brain plasticity and functional recovery.","volume":"52","author":"Issa","year":"2026","journal-title":"Ultrasound Med. Biol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3969\/j.issn.1672-2779.2024.01.034","article-title":"Effects of transcranial ultrasonic nerve and muscle stimulators combined with Xingnao Kaiqiao needling method on lower-limb dysfunction in hemiplegia after cerebral infarction.","volume":"22","author":"Jin","year":"2024","journal-title":"Chin Med. Mod. Distance Educ. China"},{"key":"B17","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s10072-024-07704-4","article-title":"Transcranial ultrasound with electrical stimulation of the cerebello-parietal nucleus on cerebral blood flow and limb function in patients with stroke.","volume":"46","author":"Liu","year":"2025","journal-title":"Neurol. Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"3315","DOI":"10.19435\/j.1672-1721.2020.23.039","article-title":"Effect of electrical stimulation combined with ultrasound on functional recovery in stroke patients.","volume":"24","author":"Liu","year":"2020","journal-title":"Med. Forum."},{"key":"B19","doi-asserted-by":"publisher","first-page":"591","DOI":"10.3760\/cma.j.issn.0254-1424.2019.08.008","article-title":"Effect of local low-frequency electrical stimulation combined with transcranial ultrasound on shoulder-hand syndrome after ischemic stroke.","volume":"41","author":"Lu","year":"2019","journal-title":"Chinese J. Phys. Med. Rehabil."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.19542\/j.cnki.1006-5180.2308-239","article-title":"Rehabilitation effect of transcranial ultrasound combined with neuromuscular electrical stimulation on cognitive dysfunction after stroke.","volume":"31","author":"Lu","year":"2024","journal-title":"Chinese J. Rural Med. Pharm."},{"key":"B21","doi-asserted-by":"publisher","first-page":"102829","DOI":"10.1016\/j.eclinm.2024.102829","article-title":"Temporal trends in cross-country inequalities of stroke and subtypes burden from 1990 to 2021: A secondary analysis of the global burden of disease study 2021.","volume":"76","author":"Luo","year":"2024","journal-title":"EClinicalMedicine"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7652\/jdyxb202602021","article-title":"Effects of transcranial ultrasound neuromuscular stimulation combined with lower limb rehabilitation robot on lower limb motor function in patients with ischemic stroke.","author":"Ma","year":"2025","journal-title":"J. Xi\u2019an Jiaotong Univer."},{"key":"B23","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3760\/cma.j.issn.0254-1424.2015.04.012","article-title":"Effect of transcranial ultrasound therapy on limb function recovery in patients with acute cerebral infarction.","volume":"37","author":"Niu","year":"2015","journal-title":"Chinese J. Phys. Med. Rehabil."},{"key":"B24","doi-asserted-by":"publisher","first-page":"719","DOI":"10.3969\/j.issn.1000-744X.2021.05.017","article-title":"Clinical observation of motor imagery combined with transcranial ultrasound neuromuscular stimulation on upper limb function and activities of daily living in stroke patients.","volume":"45","author":"Pu","year":"2021","journal-title":"Guizhou Med. J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1136\/svn-2023-002614","article-title":"Low-intensity focused ultrasound stimulation promotes stroke recovery via astrocytic HMGB1 and CAMK2N1 in mice.","volume":"9","author":"Qi","year":"2024","journal-title":"Stroke Vasc. Neurol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"861","DOI":"10.34133\/research.0861","article-title":"Synergistic therapeutic platform combining transcranial low-intensity ultrasound stimulation and curcumin load liposome ameliorates cerebral ischemia by modulating microglia polarization-mediated neuroinflammatory microenvironment.","volume":"8","author":"Qin","year":"2025","journal-title":"Research"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1161\/STROKEAHA.107.496117","article-title":"Effective and safe conditions of low-frequency transcranial ultrasonic thrombolysis for acute ischemic stroke: Neurologic and histologic evaluation in a rat middle cerebral artery stroke model.","volume":"39","author":"Saguchi","year":"2008","journal-title":"Stroke"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1039\/c7nr08636a","article-title":"Organelle-targeting surface-enhanced Raman scattering (SERS) nanosensors for subcellular pH sensing.","volume":"10","author":"Shen","year":"2018","journal-title":"Nanoscale"},{"key":"B29","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1161\/STROKEAHA.125.052307","article-title":"Harnessing the power of low-intensity focused ultrasound stimulation in Stroke: Modulating immune response.","volume":"57","author":"Shu","year":"2026","journal-title":"Stroke"},{"key":"B30","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1038\/s41583-021-00528-7","article-title":"The neural mechanisms of manual dexterity.","volume":"22","author":"Sobinov","year":"2021","journal-title":"Nat. Rev. Neurosci."},{"key":"B31","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3390\/clinpract15090163","article-title":"Neurogenic dysphagia: Peripheral and central neuromodulation.","volume":"15","author":"Stampanoni Bassi","year":"2025","journal-title":"Clin. Pract."},{"key":"B32","doi-asserted-by":"publisher","first-page":"88","DOI":"10.19368\/j.cnki.2096-1782.2024.06.088","article-title":"Effect of transcranial ultrasound and neuromuscular electrical stimulation on patients with dysphagia after stroke.","volume":"9","author":"Tian","year":"2024","journal-title":"Syst. Med."},{"key":"B33","first-page":"1642","article-title":"Effects of motor imagery combined with transcranial ultrasound neuromuscular electrical stimulation on upper limb and daily living ability in patients with stroke.","volume":"36","author":"Wang","year":"2020","journal-title":"J. Modern Med. Health"},{"key":"B34","doi-asserted-by":"publisher","first-page":"676","DOI":"10.34133\/research.0676","article-title":"Low-intensity pulsed ultrasound promotes oligodendrocyte maturation and remyelination by down-regulating the Interleukin-17A\/Notch1 signaling pathway in mice with ischemic stroke.","volume":"8","author":"Wang","year":"2025","journal-title":"Research"},{"key":"B35","doi-asserted-by":"publisher","first-page":"50","DOI":"10.14336\/AD.2020.0623","article-title":"Transcranial focused ultrasound stimulation improves neurorehabilitation after middle cerebral artery occlusion in mice.","volume":"12","author":"Wang","year":"2021","journal-title":"Aging Dis."},{"key":"B36","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3969\/j.issn.2096-7950.2022.11.fshlfykfyx202211003","article-title":"Study on effects of electroacupuncture combined with rehabilitation training and transcranial ultrasound neuromuscular stimulation on motor function recovery in patients with acute ischemic stroke.","volume":"3","author":"Wang","year":"2022","journal-title":"Reflexol. Rehabil. Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"4315","DOI":"10.1007\/s10072-022-05906-2","article-title":"The effects and mechanisms of transcranial ultrasound stimulation combined with cognitive rehabilitation on post-stroke cognitive impairment.","volume":"43","author":"Wang","year":"2022","journal-title":"Neurol. Sci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"828","DOI":"10.7507\/1002-0179.202303069","article-title":"Effect of transcranial ultrasound stimulation on upper limb function recovery and cortical excitability in stroke patients.","volume":"38","author":"Xi","year":"2023","journal-title":"West China Med. J."},{"key":"B39","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1002\/ana.26294","article-title":"Induction of human motor cortex plasticity by theta burst transcranial ultrasound stimulation.","volume":"91","author":"Zeng","year":"2021","journal-title":"Ann. Neurol."},{"key":"B40","first-page":"98","article-title":"Observation of therapeutic effect of transcranial low frequency ultrasound on post-stroke cognitive impairment.","volume":"2","author":"Zhang","year":"2021","journal-title":"Reflexol. Rehabil. Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3969\/j.issn.2096-3718.2025.05.016","article-title":"Effect of transcranial ultrasound neuromuscular electrical stimulation combined with brain-computer interface training on upper limb function and quality of life in stroke patients with hemiplegia.","volume":"9","author":"Zhang","year":"2025","journal-title":"Modern Med. Health Res. Electronic J."},{"key":"B42","doi-asserted-by":"publisher","first-page":"926027","DOI":"10.3389\/fneur.2022.926027","article-title":"Low-intensity transcranial ultrasound stimulation facilitates hand motor function and cortical excitability: A crossover, randomized, double blind study.","volume":"13","author":"Zhang","year":"2022","journal-title":"Front. Neurol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3760\/cma.j.cn371468-20240703-00307","article-title":"The improvement effect of transcranial ultrasound stimulation combined with low-frequency neuromuscular electrical stimulation on cognitive and motor function in patients with stroke.","volume":"34","author":"Zhao","year":"2025","journal-title":"Chinese J. Behav. Med. Brain Sci."},{"key":"B44","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3969\/j.issn.1674-4985.2017.23.011","article-title":"Effects of transcranial ultrasonography and laser combined with neuromuscular electrical stimulation on quality of life and limb function of stroke patients.","volume":"14","author":"Zhu","year":"2017","journal-title":"Med. Innov. China"}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2026.1828888\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:28:58Z","timestamp":1786080538000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2026.1828888\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":44,"alternative-id":["10.3389\/fnins.2026.1828888"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2026.1828888","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1828888"}}