{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:52:35Z","timestamp":1773010355980,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Republic of Korea (NRF)","award":["2020R1A2C1004355"],"award-info":[{"award-number":["2020R1A2C1004355"]}]},{"name":"National Research Foundation of Republic of Korea (NRF)","award":["2022R1F1A1062766"],"award-info":[{"award-number":["2022R1F1A1062766"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>It is important to improve cerebrovascular health before the occurrence of cerebrovascular disease, as it has various aftereffects and a high recurrence rate, even with appropriate treatment. Various medical recommendations for preventing cerebrovascular diseases have been introduced, including smoking cessation, exercise, and diet. However, the effectiveness of these methods varies greatly from person to person, and their effects cannot be confirmed unless they are practiced over a long period. Therefore, there is a growing need to develop more quantitative methods that are applicable to the public to promote cerebrovascular health. Thus, in this study, we aimed to develop noninvasive and quantitative thermal stimulation techniques using ultrasound to improve cerebrovascular health and prevent cerebrovascular diseases. This study included 27 healthy adults in their 20s (14 males, 13 females). Thermal stimulation using therapeutic ultrasound at a frequency of 3 MHz was applied to the right sternocleidomastoid muscle in the supine posture for 2 min at four intensities (2.4, 5.1, 7.2, and 10.2 W\/cm2). Diagnostic ultrasound was used to measure the peak systolic velocity (PSV), heart rate (HR), and pulse wave velocity (PWV) in the right common carotid artery (CCA), and the physiological changes were compared between intervention intensities. Compared to pre-intervention (preI), the PSV showed a significant increase during intervention (durI) at intensities of 7.2 W\/cm2 and 10.2 W\/cm2 (p = 0.010 and p = 0.021, respectively). Additionally, PWV showed a significant decrease for post-intervention (postI) at 7.2 W\/cm2 and 10.2 W\/cm2 (p = 0.036 and p = 0.035, respectively). However, the HR showed no significant differences at any of the intensities. The results demonstrate that an intervention at 3 MHz with an intensity of 7.2 W\/cm2 or more can substantially increase cerebral blood flow and reduce arterial stiffness. Therefore, the use of therapeutic ultrasound of appropriate intensity is expected to improve the cerebral blood flow and reduce vascular stiffness to maintain cerebral blood flow at a certain level, which is closely related to the prevention and treatment of cerebrovascular diseases, thereby improving cerebrovascular health.<\/jats:p>","DOI":"10.3390\/s23208487","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T08:32:57Z","timestamp":1697445177000},"page":"8487","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Quantitative Thermal Stimulation Using Therapeutic Ultrasound to Improve Cerebral Blood Flow and Reduce Vascular Stiffness"],"prefix":"10.3390","volume":"23","author":[{"given":"Kyung-Kwon","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Radiological Science, College of Health Science, Gachon University, Incheon 21936, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1873-5561","authenticated-orcid":false,"given":"Chansol","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Health Science, Gachon University Graduate School, Incheon 21936, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwon","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5952-1423","authenticated-orcid":false,"given":"Yeong-Bae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea"},{"name":"Neuroscience Research Institute, Gachon University, Incheon 21565, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9573-8432","authenticated-orcid":false,"given":"Chang-Ki","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiological Science, College of Health Science, Gachon University, Incheon 21936, Republic of Korea"},{"name":"Department of Health Science, Gachon University Graduate School, Incheon 21936, Republic of Korea"},{"name":"Neuroscience Research Institute, Gachon University, Incheon 21565, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S140","DOI":"10.5005\/jp-journals-10071-23192","article-title":"Acute ischemic stroke: Management approach","volume":"23","author":"Chugh","year":"2019","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.4070\/kcj.2016.46.4.507","article-title":"Thirty-year trends in mortality from cerebrovascular diseases in Korea","volume":"46","author":"Lee","year":"2016","journal-title":"Korean Circ. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1161\/01.STR.0000116183.50167.D9","article-title":"Ten-year risk of first recurrent stroke and disability after first-ever stroke in the Perth community stroke study","volume":"35","author":"Hardie","year":"2004","journal-title":"Stroke"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1212\/WNL.0b013e3181fb44b3","article-title":"Auckland stroke outcomes study. Part 2: Cognition and functional outcomes 5 years poststroke","volume":"75","author":"Feigin","year":"2010","journal-title":"Neurology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1161\/STROKEAHA.117.016815","article-title":"One-year incidence, time trends, and predictors of recurrent ischemic stroke in Sweden from 1998 to 2010: An observational study","volume":"48","author":"Irewall","year":"2017","journal-title":"Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1055\/s-0038-1649503","article-title":"Global burden of stroke","volume":"38","author":"Katan","year":"2018","journal-title":"Semin. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1161\/STR.0000000000000116","article-title":"Prevention of stroke in patients with silent cerebrovascular disease: A scientific statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"48","author":"Smith","year":"2017","journal-title":"Stroke"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/ner.12177","article-title":"Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage","volume":"17","author":"Stewart","year":"2014","journal-title":"Neuromodulation J. Int. Neuromodulation Soc."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ando, S., Takagi, Y., Watanabe, H., Mochizuki, K., Sudo, M., Fujibayashi, M., Tsurugano, S., and Sato, K. (2021). Effects of electrical muscle stimulation on cerebral blood flow. BMC Neurosci., 22.","DOI":"10.1186\/s12868-021-00670-z"},{"key":"ref_10","unstructured":"Teoli, D., and An, J. (2023). StatPearls, StatPearls Publishing."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Cho, Y.J., Jung, D.E., Nam, K., Bae, J., Lee, S., and Jeon, Y. (2022). Effects of transcutaneous electrical nerve stimulation on myocardial protection in patients undergoing aortic valve replacement: A randomized clinical trial. BMC Anesthesiol., 22.","DOI":"10.1186\/s12871-022-01611-x"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1081458","DOI":"10.3389\/fneur.2023.1081458","article-title":"Electrical stimulation therapy for peripheral nerve injury","volume":"14","author":"Ni","year":"2023","journal-title":"Front. Neurol."},{"key":"ref_13","first-page":"623","article-title":"Overview of therapeutic ultrasound applications and safety considerations","volume":"31","author":"Miller","year":"2012","journal-title":"J. Ultrasound Med. Off. J. Am. Inst. Ultrasound Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.2147\/JPR.S314342","article-title":"Ultrasound is effective to treat temporomandibular joint disorder","volume":"14","author":"Ba","year":"2021","journal-title":"J. Pain Res."},{"key":"ref_15","unstructured":"Matthews, M.J., and Stretanski, M.F. (2023). StatPearls, StatPearls Publishing."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1113\/expphysiol.2011.057091","article-title":"Effect of passive heat stress on arterial stiffness","volume":"96","author":"Ganio","year":"2011","journal-title":"Exp. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1093\/rheumatology\/40.12.1331","article-title":"Therapeutic ultrasound in soft tissue lesions","volume":"40","author":"Speed","year":"2001","journal-title":"Rheumatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1298\/jjpta.Vol17_001","article-title":"Effects of therapeutic ultrasound on intramuscular blood circulation and oxygen dynamics","volume":"17","author":"Morishita","year":"2014","journal-title":"J. Jpn. Phys. Ther. Assoc."},{"key":"ref_19","unstructured":"Gupta, A.K., and Gelb, A.W. (2008). Essentials of Neuroanesthesia and Neurointensive Care, W. B. Saunders."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/0301-5629(85)90035-3","article-title":"Measurement of blood flow by ultrasound: Accuracy and sources of error","volume":"11","author":"Gill","year":"1985","journal-title":"Ultrasound Med. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3389\/fcvm.2019.00041","article-title":"Pulse wave velocity in atherosclerosis","volume":"6","author":"Kim","year":"2019","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.atherosclerosis.2012.09.024","article-title":"Pulse wave velocity is associated with early clinical outcome after ischemic stroke","volume":"225","author":"Rojek","year":"2012","journal-title":"Atherosclerosis"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.atherosclerosis.2011.09.013","article-title":"The association between cerebral atherosclerosis and arterial stiffness in acute ischemic stroke","volume":"219","author":"Kim","year":"2011","journal-title":"Atherosclerosis"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1161\/01.STR.0000065428.03209.64","article-title":"Aortic stiffness is an independent predictor of fatal stroke in essential hypertension","volume":"34","author":"Laurent","year":"2003","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1038\/hr.2017.24","article-title":"Reference values of one-point carotid stiffness parameters determined by carotid echo-tracking and brachial pulse pressure in a large population of healthy subjects","volume":"40","author":"Vriz","year":"2017","journal-title":"Hypertens. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2050312113507563","DOI":"10.1177\/2050312113507563","article-title":"Comparison of sequentially measured Aloka echo-tracking one-point pulse wave velocity with SphygmoCor carotid-femoral pulse wave velocity","volume":"1","author":"Vriz","year":"2013","journal-title":"SAGE Open Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"106064","DOI":"10.1016\/j.ultras.2020.106064","article-title":"Measurement of local pulse wave velocity for carotid artery by using an ultrasound-based method","volume":"102","author":"Tang","year":"2020","journal-title":"Ultrasonics"},{"key":"ref_28","first-page":"230","article-title":"Three-MHz ultrasound heats deeper into the tissues than originally theorized","volume":"39","author":"Hayes","year":"2004","journal-title":"J. Athl. Train."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1212\/WNL.0000000000002368","article-title":"Association of arterial stiffness with progression of subclinical brain and cognitive disease","volume":"86","author":"Tsao","year":"2016","journal-title":"Neurology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"294","DOI":"10.2519\/jospt.1996.24.5.294","article-title":"Acute effects of therapeutic ultrasound delivered at varying parameters on the blood flow velocity in a muscular distribution artery","volume":"24","author":"Fabrizio","year":"1996","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.ultrasmedbio.2005.01.010","article-title":"The effects of therapeutic ultrasound on heart rate variability: A placebo controlled trial","volume":"31","author":"Nacitarhan","year":"2005","journal-title":"Ultrasound Med. Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s00276-015-1551-3","article-title":"A morphometric analysis of the superior cervical ganglion and its surrounding structures","volume":"38","author":"Fazliogullari","year":"2016","journal-title":"Surg. Radiol. Anat."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1097\/AJP.0000000000000184","article-title":"Ultrasound features of middle cervical sympathetic ganglion","volume":"31","author":"Shin","year":"2015","journal-title":"Clin. J. Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40885-018-0102-8","article-title":"Arterial stiffness and hypertension","volume":"24","author":"Oh","year":"2018","journal-title":"Clin. Hypertens."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/20\/8487\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:07:29Z","timestamp":1760130449000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/20\/8487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,16]]},"references-count":34,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["s23208487"],"URL":"https:\/\/doi.org\/10.3390\/s23208487","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,16]]}}}