The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies

Abstract Background Low-intensity transcranial ultrasound stimulation (LITUS) is an emerging non-invasive neuromodulation technique for pain treatment, with the unique ability to modulate deep brain nuclei associated with pain. The aim of this study is to systematically review and summarize the evid...

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Main Authors: Hao-Ran Xu, Yiu-Liang Yi, Chuan Xue, Zi-Qi Guo, Li Ding, Jie Jia
Format: Article
Language:English
Published: BMC 2025-07-01
Series:The Journal of Headache and Pain
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Online Access:https://doi.org/10.1186/s10194-025-02096-y
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author Hao-Ran Xu
Yiu-Liang Yi
Chuan Xue
Zi-Qi Guo
Li Ding
Jie Jia
author_facet Hao-Ran Xu
Yiu-Liang Yi
Chuan Xue
Zi-Qi Guo
Li Ding
Jie Jia
author_sort Hao-Ran Xu
collection DOAJ
description Abstract Background Low-intensity transcranial ultrasound stimulation (LITUS) is an emerging non-invasive neuromodulation technique for pain treatment, with the unique ability to modulate deep brain nuclei associated with pain. The aim of this study is to systematically review and summarize the evidence for the efficacy of LITUS in pain management and to elucidate the potential mechanisms underlying its analgesic effects. Methods A systematic search was conducted across five databases up to Mar 31st, 2025. Controlled studies in both human and animal subjects were included. Two independent reviewers completed the screening and risk of bias assessment process following predefined inclusion and exclusion criteria. Results A total of thirteen studies were included in the review. These studies demonstrated LITUS’s potential in managing various types of pain among different populations and animal models, particularly targeting the anterior cingulate cortex, thalamus, insular cortex, primary sensorimotor cortex, and periaqueductal gray. Most included studies showed positive effects and verified the safety of LITUS on pain, reporting few adverse effects. Conclusions LITUS is an effective and non-invasive tool for pain regulation in animals and humans, enabling precise modulation of deep brain circuits. Analgesic effects may be affected by pain-related risk factors, insufficient dosage, suboptimal protocols, and target selection. Initial evidence has highlighted the direct link between LITUS parameters, brain region responses, and pain behavior. Modulation of brain excitatory, nociceptive circuit, electrophysiological response, autonomic response, biochemistry, neuroinflammation, and psychology are proposed as the potential mechanisms underlying the efficacy of LITUS. More high-quality research is urgently needed to advance clinical LITUS use and reveal its mechanisms.
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spelling doaj-art-a852aae51eb344b6bb5d3b57333fdf1f2025-08-20T03:46:25ZengBMCThe Journal of Headache and Pain1129-23772025-07-0126112310.1186/s10194-025-02096-yThe efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studiesHao-Ran Xu0Yiu-Liang Yi1Chuan Xue2Zi-Qi Guo3Li Ding4Jie Jia5Department of Rehabilitation Medicine, Huashan Hospital, Fudan UniversityDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan UniversityDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan UniversityDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan UniversityDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan UniversityDepartment of Rehabilitation Medicine, Huashan Hospital, Fudan UniversityAbstract Background Low-intensity transcranial ultrasound stimulation (LITUS) is an emerging non-invasive neuromodulation technique for pain treatment, with the unique ability to modulate deep brain nuclei associated with pain. The aim of this study is to systematically review and summarize the evidence for the efficacy of LITUS in pain management and to elucidate the potential mechanisms underlying its analgesic effects. Methods A systematic search was conducted across five databases up to Mar 31st, 2025. Controlled studies in both human and animal subjects were included. Two independent reviewers completed the screening and risk of bias assessment process following predefined inclusion and exclusion criteria. Results A total of thirteen studies were included in the review. These studies demonstrated LITUS’s potential in managing various types of pain among different populations and animal models, particularly targeting the anterior cingulate cortex, thalamus, insular cortex, primary sensorimotor cortex, and periaqueductal gray. Most included studies showed positive effects and verified the safety of LITUS on pain, reporting few adverse effects. Conclusions LITUS is an effective and non-invasive tool for pain regulation in animals and humans, enabling precise modulation of deep brain circuits. Analgesic effects may be affected by pain-related risk factors, insufficient dosage, suboptimal protocols, and target selection. Initial evidence has highlighted the direct link between LITUS parameters, brain region responses, and pain behavior. Modulation of brain excitatory, nociceptive circuit, electrophysiological response, autonomic response, biochemistry, neuroinflammation, and psychology are proposed as the potential mechanisms underlying the efficacy of LITUS. More high-quality research is urgently needed to advance clinical LITUS use and reveal its mechanisms.https://doi.org/10.1186/s10194-025-02096-yTranscranial ultrasoundLow-intensity transcranial ultrasoundPainNeuromodulationEffectiveness
spellingShingle Hao-Ran Xu
Yiu-Liang Yi
Chuan Xue
Zi-Qi Guo
Li Ding
Jie Jia
The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies
The Journal of Headache and Pain
Transcranial ultrasound
Low-intensity transcranial ultrasound
Pain
Neuromodulation
Effectiveness
title The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies
title_full The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies
title_fullStr The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies
title_full_unstemmed The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies
title_short The efficacy and mechanisms of low-intensity transcranial ultrasound stimulation on pain: a systematic review of human and animal studies
title_sort efficacy and mechanisms of low intensity transcranial ultrasound stimulation on pain a systematic review of human and animal studies
topic Transcranial ultrasound
Low-intensity transcranial ultrasound
Pain
Neuromodulation
Effectiveness
url https://doi.org/10.1186/s10194-025-02096-y
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