High-Frequency Focused Ultrasound targeting the midbrain in the Guinea Pig Induces Activation and Plasticity of the Efferent System, and Protection Against Noise-Induced Hearing Loss

Focused ultrasound (FUS) is a promising noninvasive neuromodulation approach, but whether it can directly activate central auditory neurons in vivo remains unresolved. We applied high-frequency FUS (20 MHz) to the central nucleus of the inferior colliculus (CNIC) in anesthetized guinea pigs while recording electrophysiological responses from the auditory pathway and cochlea. FUS evoked cortical activity through indirect cochlear activation, possibly via skull-mediated mechanical coupling, rather than direct inferior colliculus activation, with ultrasound-evoked compound action potentials predominating in the ipsilateral cochlea. More interestingly, FUS stimulation of the CNIC induced activation of neurons and glial cells in the CNIC and auditory cortex as demonstrated by c-Fos expression, suggesting that FUS stimulation activated the afferent pathway. We also show that FUS engaged the auditory efferent system, likely via medial olivocochlear neurons, producing reduced compound action potential amplitudes, enhanced cochlear microphonics, and persistent effects lasting at least two hours, consistent with long-lasting efferent plasticity. Strikingly, FUS administered before acoustic trauma almost completely prevented noise-induced hearing loss, limiting auditory brainstem response threshold shifts to <10 dB versus ~60 dB in controls. Gentamicin abolished these physiological and protective effects, implicating medial olivocochlear activation. These findings identify FUS as a potent noninvasive strategy for engaging auditory efferent circuits and protecting against acoustic injury.