Focused Ultrasound Trial Targets Schizophrenia Hallucinations at UCSF
Researchers test a noninvasive wearable device aimed at deep brain circuits to silence persistent auditory symptoms
Psychiatrists at the University of California San Francisco have started a first-in-human trial using low-intensity focused ultrasound to suppress auditory hallucinations in patients with schizophrenia. The study tests whether acoustic pulses delivered through the skull can alter deep brain activity without surgery. More than 70 percent of people with schizophrenia hear voices, and about 40 percent do not find relief through antipsychotic drugs.
Targeting the caudate with acoustic pulses
Hearing voices that others cannot hear remains one of the most disabling symptoms of schizophrenia. To address cases where medication fails, a clinical team led by Karuna Subramaniam, a professor of psychiatry at UCSF, launched a Phase I clinical trial using low-intensity focused ultrasound, known as LIFU. As reported by MedicalXpress, the noninvasive therapeutic innovation delivers concentrated acoustic energy directly to the caudate, a structure inside the striatum deep within the brain.
The intervention relies on a wearable medical device engineered by Attune Neurosciences. Unlike standard surgical neuromodulation, which requires drilling through bone to implant electrodes, this hardware rests outside the head. It focuses low-power sound waves through the cranium, aiming specifically at the neural circuits thought to generate phantom voices.
“For many people with schizophrenia, hearing voices remains a persistent and distressing problem despite medication.”
— Karuna Subramaniam, professor of psychiatry at UCSF
Testing active pulses against a sham control
The clinical protocol enrolls up to 12 participants to determine whether repeated sessions provide lasting relief. Each subject receives five daily sessions of active acoustic stimulation directed at the caudate and five daily sessions of an unfocused control condition, separated by a washout period, according to MedicalXpress.
The control condition provides identical total acoustic energy across the skull to replicate the physical sensation of the treatment without focusing on the anatomical target. Comparing both phases allows the team to isolate the real physiological effect of the ultrasound from any placebo response. The invention also includes assessments before and after the trial using resting-state functional magnetic resonance imaging to document changes in connectivity between the caudate and the rest of the brain.
Early patient responses and parallel research
The current trial builds on single-session findings by Subramaniam and colleagues published in the journal Brain Stimulation, which showed brief reductions in auditory symptoms. Early reports from participants in the ongoing repeated-session protocol describe quiet intervals and diminished voice intensity, as detailed by MedicalXpress.
Other academic groups are investigating related strategies. Investigators at NYU Langone Health published data in npj Acoustics evaluating a different focused ultrasound device that targeted the globus pallidus in patients with schizophrenia or schizoaffective disorder, recording modest drops in delusions. As recruitment at UCSF continues, the researchers plan to monitor treatment durability and evaluate whether repeated sonication creates lasting neuroplastic modifications.
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