Focused Ultrasound Neuromodulation: Exploring a Novel Treatment for Severe Opioid Use Disorder

Area of Science:

• Neuroscience
• Neuromodulation
• Addiction Medicine

Background:

• Opioid use disorder presents significant challenges due to treatment limitations and high mortality rates.
• Current therapies for opioid use disorder have limited efficacy, leading to frequent relapse and fatalities.
• There is a critical need for innovative therapeutic strategies to manage severe opioid and co-occurring substance use disorders.

Purpose of the Study:

• To evaluate the safety and feasibility of focused ultrasound (FUS) neuromodulation in individuals with severe opioid use disorder.
• To assess the potential of FUS to reduce substance cravings and usage in patients with co-occurring substance use disorders.
• To investigate the impact of FUS targeting the nucleus accumbens (NAc) on craving and substance use.

Main Methods:

• A prospective, open-label, single-arm study involving 8 participants with severe opioid use disorder and co-occurring substance use.
• Participants underwent a single 20-minute session of low-intensity FUS (220 kHz) neuromodulation targeting the bilateral nucleus accumbens (NAc).
• Outcomes including safety, tolerability, craving, substance use (self-report, urine toxicology), mood, and neuroimaging (fMRI) were assessed over 90 days post-FUS.

Main Results:

• Focused ultrasound (FUS) neuromodulation was found to be safe, with no serious adverse events or imaging abnormalities reported.
• Participants experienced immediate and sustained significant reductions in cue-induced opioid craving (91% reduction at 90 days).
• Reductions in craving and substance use were observed for other illicit substances, confirmed by urine toxicology, with several participants achieving sustained abstinence.

Conclusions:

• Neuromodulation using focused ultrasound (FUS) targeting the nucleus accumbens (NAc) is a safe and potentially effective adjunctive treatment for severe opioid and co-occurring substance use disorders.
• FUS neuromodulation demonstrated significant reductions in drug cravings and substance use, indicating its therapeutic potential.
• Larger, randomized, sham-controlled studies are recommended to further validate the efficacy of NAc FUS neuromodulation.