A case report of focused ultrasound neuromodulation of the bilateral nucleus accumbens for methamphetamine use disorder

Abstract

Nearly 2 million people had a diagnosis of methamphetamine use disorder (MUD) in 2023 and overdose deaths involving psychostimulants are increasing. Given that there are no currently approved U.S. Food and Drug Administration medications for MUD, novel treatments are needed to complement standard of care behavioral treatments. Neuromodulation using transcranial focused ultrasound (FUS) has the capacity to noninvasively and precisely target subcortical structures, such as the nucleus accumbens, a structure integral to the reward neurocircuitry. Previous findings in individuals with opioid use disorder have demonstrated the potential of FUS in reducing substance craving and use; however, to date, no study has examined the effects of FUS for primary MUD. The objective of the current case study was to evaluate the safety and impact of nucleus accumbens FUS on methamphetamine craving (via a cue-induced craving paradigm) and use (via urine toxicology and self-report) in a man in his mid-20s with primary MUD. The participant received a 20-min session of low-intensity FUS (220 kHz) neuromodulation and completed follow-up visits 1-, 7-, 30-, 60-, and 90-days postprocedure. Results demonstrated that the FUS procedure was safe and well-tolerated. Cue induced craving acutely reduced during the procedure with sustained complete suppression throughout the 90-day follow-up (baseline craving rating was nine out of 10 [where 10 represents maximum craving]; craving at follow-up visits were consistently zero out of 10). Methamphetamine negative urine toxicology was observed during all follow-up visits, contrasting his pre-FUS use patterns of multiple episodes of use per week. While promising, larger, sham-controlled, randomized studies are warranted to determine the potential of FUS for MUD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).