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Ultrasound brain stimulation may help counter delusions experienced by people with schizophrenia, a small trial suggests.
The trial involved transcranial ultrasound stimulation, in which a device placed on a patient’s head delivers ultrasound waves through the skull and into the brain. Its objective is to modify the activity of a targeted brain region.
Delusions are false beliefs that are very difficult to shake; for example, a person may believe that they are being stalked when they are not, or believe that a major disaster is about to occur without any evidence to suggest this. In the trial, researchers found that a 10-minute session of ultrasound treatment reduced the severity of delusions for at least a week in patients with schizophrenia or a related disorder.
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This targeted ultrasound treatment delivered directly to the brain could avoid some of the whole-body effects of antipsychotic medications, such as weight gain and high blood pressure. That said, the new results, published Tuesday October 20 in the journal npj acousticare a first step and will require further verification in larger trials.
“It is too early to know with certainty what the therapeutic benefits will be, but it is very exciting”, co-author of the study Dr. Donald Goffprofessor of psychiatry at New York University’s Grossman School of Medicine, told Live Science.
Target deep brain structures
The pilot study included 10 patients with schizophrenia or schizoaffective disorder. In both cases, patients experience psychotic symptoms, including delusions and hallucinations. Schizoaffective disorder also includes mood symptoms, such as mania.
The researchers interviewed each participant to characterize the content of their delusions and also documented their cognitive state and their experiences of auditory hallucinations – perceptions of sounds that are not actually occurring. Participants then received both ultrasound treatment and placebo treatment, spaced one week apart.
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Other non-invasive therapies, such as transcranial magnetic stimulation, which uses magnetic fields, can also stimulate the brain. But the ultrasound technique differs from these therapies because ultrasound waves can penetrate deeper into the brain with greater specificity, study co-author Shy Shohamneural engineer at NYU Grossman, told Live Science. He compared the way a transducer directs ultrasound waves to a given region of the brain with the way a lens focuses light.
In this case, the researchers focused their lens on a brain network called cortico-striatal-pallido-thalamic circuitwhich includes the structures located beneath the outer cortex of the brain. The relationship between this circuit and symptoms of schizophrenia is still somewhat unclear, in part because its deeper components are difficult to study with adequate resolution with MRI, the co-author said. Dr. Wei Qiclinical assistant professor of psychiatry at NYU Grossman. However, some previous studies suggest that this network plays a role in schizophrenia.
The ultrasound treatment targeted a brain structure called the internal globus pallidus (orange).
(Image credit: SEBASTIAN KAULITZKI/SCIENTIFIC PHOTO LIBRARY via Getty Images)
Much of what scientists know about the network comes from research on movement disorders, such as Parkinson’s diseasein which there is an imbalance between excitation and inhibition in the neurons that control movement. A similar dynamic could help explain the symptoms of schizophrenia, scientists believe.
“Our hypothesis is that in schizophrenia there is an imbalance between excitation and inhibition regarding what is actually important in the environment,” Qi told Live Science. “The inability to inhibit irrelevant cues may underlie psychosis.”
“Quite optimistic”
The researchers surveyed study participants after each treatment, asking how much each person believed their delusions and how much stress they caused. Compared to placebo treatment, ultrasound stimulation was associated with less severe delirium over the following week. There were, however, no significant changes in the patients’ auditory hallucinations or overall cognition.
Ultrasound therapy has caused mild side effects, such as fatigue and headaches. Some patients experienced a transient increase in delusions, which Qi attributed to normal fluctuations in symptoms expected in schizophrenia. These findings were just as common after the placebo treatment, so they may not be specifically related to ultrasound.
The stimulation specifically targeted the right side of a brain structure called the globus pallidus internus (GPI). In a previous studythe authors found that greater connectivity between this region and another structure – the dorsal anterior cingulate gyrus – was linked to more severe psychotic symptoms in schizophrenia. So they made the GPI their target.
So far, “there haven’t been many successful therapeutic attempts to target some of these deeper structures,” said Dr Deepak Sarpalassociate professor of psychiatry at the University of Pittsburgh School of Medicine, who was not involved in the study. Ultrasound waves reach brain regions below the cortex less invasively than deep brain stimulationin which a surgeon implants an electrode into a patient’s brain, Sarpal noted.
Researchers are not the only group using transcranial ultrasound to influence the cortico-striatal-pallido-thalamic circuit. Earlier this year, another group stimulated parts of the striatumwhich is located directly below the cortex, in patients with schizophrenia. They assessed hallucinations rather than delusions, finding that the treatment reduced symptoms for at least a week after the procedure.
In this line of research, the targeted nature of transcranial ultrasound presents advantages as a research tool as well as a therapeutic approach.
“If we find that a specific circuit or a node in a circuit seems to be closely related to the symptoms that we’re trying to treat, then it’s going to be a matter of understanding what stimulation pattern can allow us to correct that,” Goff said. Qi, Goff and their colleagues now plan to continue testing their technique on more patients and experiment with different doses of ultrasound.
“There’s still a lot of work to do,” Goff said, “but we’re really optimistic about his promises.”
This article is for informational purposes only and is not intended to offer medical advice.
Qi, W., Gilad, A., Santacatterina, M., Brinker, S., Capichioni, G., Ando, F., Shoham, S., and Goff, DC (2026). Transcranial ultrasound stimulation of the right internal globus pallidus in schizophrenia: a randomized, sham-controlled pilot study. npj acoustic2:39. https://doi.org/10.1038/s44384-026-00076-3
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