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Studying the effects of Low Intensity Focused Ultrasound (LIFU) to the dorsal posterior insula (dPI) and dorsal anterior cingulate cortex (dACC) on autonomic control using a test to probe the autonomic system. A cold pressor task will be performed pre and post LIFU application. Physiologic recordings will be recorded throughout.
Characterize the effect of LIFU to the bilateral dorsal posterior insula (dPI) and dorsal anterior cingulate cortex (dACC)) on autonomic control. The dPI is a critical brain area involved in autonomic function, being a core recipient of ascending pain and autonomic function. Similarly, the dACC has been strongly implicated in autonomic control and works with the insula for autonomic processing. Inconveniently, these brain regions lie deep to the cortex, prohibiting access using conventional noninvasive methods like transcranial magnetic stimulation (TMS). LIFU can be focused at depth to reach the insula and ACC with high spatial precision. However, the effect of LIFU to the human dPI and dACC on autonomic control is unknown. To address this, the investigators will target the right dPI and the dACC to assess how LIFU to each of these areas affects autonomic responses and subjective report to the cold pressor task, a safe, reproducible autonomic challenge.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| dPI | Experimental | LIFU to the dPI |
|
| ACC | Experimental | LIFU to the ACC |
|
| Sham | Sham Comparator | Sham LIFU application |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low-intensity focused ultrasound neuromodulation | Device | ultrasound transducer applying low intensity waveforms to targeted brain regions for neuromodulation. |
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| Measure | Description | Time Frame |
|---|---|---|
| Sympathetic tone response - Heart Rate Variability (HRV) | Changes in HRV | through study completion, an average of 1 month |
| Sympathetic tone response - Heart Rate (HR) | Changes in HR | through study completion, an average of 1 month |
| Sympathetic tone response - Blood Pressure (BP) | Changes in BP (systolic and diastolic pressure) | through study completion, an average of 1 month |
| Sympathetic tone response - Electrodermal Response (EDR) | Changes in EDR | through study completion, an average of 1 month |
| Sympathetic tone response - Electroencephalography (EEG) | Changes in low and high frequency power | through study completion, an average of 1 month |
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Inclusion Criteria:
Exclusion Criteria:
The exclusion criteria below are regularly implemented in MRI, CT, and EEG experiments for the safety of the subjects and for data quality assurance.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fralin Biomedical Research Institute at VTC | Roanoke | Virginia | 24016 | United States |
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| ID | Term |
|---|---|
| D054969 | Primary Dysautonomias |
| ID | Term |
|---|---|
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
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three arm model, participants receive each intervention/sham (dPI, ACC, or Sham) one per study visit in a randomized order.
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Sham application during a single randomized session (1 of 3 sessions).
| Sham Low-intensity focused ultrasound | Device | sham application of ultrasound using blocking of the ultrasound waves of the transducer. |
|