Neuromodulation Effect of Focused Ultrasound for Motor Recovery in Patients With Stroke

Inclusion Criteria:

• Patients with stroke (including hemorrhagic or ischemic stroke) diagnosed by aboard-certificated physician.

• Occurrence of stroke within three months.

• Upper limb muscle strength ≤ 4 points according to the Medical Research CouncilManual Muscle Testing scale.

• No previous history of stroke, epilepsy, dementia, Parkinson's disease, or otherneurodegenerative diseases.

• Patients could maintain sitting posture for more than 15 minutes on a chair.

• 18 years of age or older.

Exclusion Criteria:

• History of recurrent stroke, traumatic brain injuries, brain tumors, spinal cordinjury, Parkinson's disease or other musculoskeletal system diseases that may affectevaluation and treatment.

• Contraindications to focused ultrasound, including pregnancy, cardiac pacemaker orimplantable medical device, abnormal connective tissue diseases, coagulopathy (PLT<100,000/μL, PT>14 seconds, APTT>36 seconds, INR>1.3), implants near or in thebrain, or those deemed Unsuitable for this treatment by the physician.

• Unable to cooperate with treatment or functional assessment due to impairedconsciousness or aphasia; inability to informed consent.

• Patient with cranial bone factor causing the inability of tFUS penetration.

• Patient under anticoagulants with coagulopathy (PLT<100,000/μL, PT>14 seconds,APTT>36 seconds, INR>1.3)

• Patients who are not suitable for undergoing CT imaging examination;

• Major physical illnesses and neurological disorders (such as epilepsy, brainsurgery, etc.)

• Patients with metallic implants in their bodies;

• Patients taking tricyclic antidepressants, analgesics, or using antiepileptic drugs

• Individuals experiencing sleep disorders during tFUS treatment;

• Individuals with history of alcoholism

• Patients with severe or uncontrollable intracranial pressure;

• Patients requiring anticoagulants;

• Any intracranial space-occupying lesions;

• Significant calcification of intracranial vessels based on pre-treatment CT imaging;

• Subjects with lesions/wounds on the scalp in the target region.