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An ultrasound device that can precisely stimulate areas deep in the brain without surgery has been developed by researchers from UCL and the University of Oxford, opening up new possibilities for neurological research and treatment of disorders such as Parkinson’s disease.

Scientists have long been looking for a way to modulate brain function, which could improve our understanding of how the brain works and help to treat neurological diseases, using non-invasive methods that don’t involve surgery.

One technology that could help is transcranial ultrasound stimulation (TUS), which was recently discovered to be able to modulate the activity of neurons (the brain’s key communication cells) by delivering gentle mechanical pulses that influence how these cells send signals.

But to date current systems have struggled to reach deeper areas of the brain with sufficient precision to target specific brain structures. Conventional TUS systems often affect broader regions than intended, limiting their utility for targeted neuromodulation.

The study, published in Nature Communications, introduces a new ultrasound device capable of influencing deep brain regions without surgery for the first time, targeting areas around 1,000 times smaller than conventional ultrasound devices can pinpoint and 30 times smaller than previous deep brain ultrasound devices.

The new technology features 256 elements configured within a special helmet to send focused beams of ultrasound to specific parts of the brain in order to turn neuronal activity up or down. It also includes a soft plastic face mask which helps to target the ultrasound waves more precisely by keeping the head still.

The research team demonstrated the system’s capabilities on seven human volunteers by targeting a part of the thalamus, a small structure in the centre of the brain that helps to relay sensory and motor information, called the lateral geniculate nucleus (LGN). The LGN is involved in processing visual information.

In the first experiment, participants looked at a flashing checkerboard, which sent signals to the brain through the eyes. During stimulation with the ultrasound device, a functional magnetic resonance imaging (fMRI) scan showed significantly increased activity in the participants’ visual cortex, confirming precise targeting of the LGN.

A second experiment revealed sustained decreases in visual cortex activity for at least 40 minutes after ultrasound stimulation, highlighting the system’s potential for inducing lasting changes in brain function.

Though participants did not consciously perceive any changes in what they were seeing during the experiments, the brain scans revealed significant changes in neural activity. The ultimate goal is to harness these effects to produce clinically beneficial outcomes, such as stopping hand tremors.

This advance opens up opportunities for both neuroscience research and clinical treatment. For the first time, scientists can non-invasively study causal relationships in deep brain circuits that were previously only accessible through surgery.

Clinically, this new technology could transform treatment of neurological and psychiatric disorders like Parkinson’s disease, depression, and essential tremor, offering unprecedented precision in targeting specific brain circuits that play key roles in these conditions.

The ability to precisely modulate deep brain structures without surgery represents a paradigm shift in neuroscience, offering a safe, reversible, and repeatable method for both understanding brain function and developing targeted therapies.”

Professor Bradley Treeby, senior author of the study from UCL Medical Physics and Biomedical Engineering

In addition to its research applications, the system could pave the way for new clinical interventions. Deep brain stimulation (DBS), currently used to treat conditions like Parkinson’s disease, requires invasive surgery and carries associated risks. The new ultrasound system offers a non-invasive alternative with comparable precision, potentially allowing clinicians to test areas of the brain that could be used to treat disease before surgery or even replace surgical approaches altogether.

Recognising this clinical potential, several members of the research team have recently founded NeuroHarmonics, a UCL spinout company developing a portable, wearable version of the system. The company aims to make precise, non-invasive deep brain therapy accessible for both clinical treatment and broader therapeutic applications.

Dr Eleanor Martin, first author of the study from UCL Medical Physics and Biomedical Engineering, said: “We designed the system to be compatible with simultaneous fMRI, enabling us to monitor the effects of stimulation in real time. This opens up exciting possibilities for closed-loop neuromodulation and personalised therapies.”

The researchers emphasise that further studies are needed to fully understand the mechanisms underlying TUS-induced neuromodulation. However, the results mark a significant milestone in the development of safe, effective, and targeted brain stimulation technologies.

Dr Ioana Grigoras, a first author of the study from the Nuffield Department of Clinical Neurosciences, University of Oxford, said: “This novel brain stimulation device represents a breakthrough in our ability to precisely target deep brain structures that were previously impossible to reach non-invasively. We are particularly excited about its potential clinical applications for neurological disorders like Parkinson’s disease, where deep brain regions are especially affected.”

The study was supported by the Engineering and Physical Sciences Research Council (EPSRC), Wellcome, and the NIHR Oxford Health Biomedical Research Centre.

The revelation that over 100 million Pakistanis are overweight ought to ring alarm bells across every policymaking corridor in the country. This is not merely a matter of individual health choices; it is a national crisis unfolding in slow motion. The link between obesity and chronic diseases such as diabetes, cardiovascular illness, and hypertension is well-documented, and these conditions are already stretching our fragile healthcare system to its limits.

We must recognise that this is not an issue to be shrugged off as lifestyle indulgence. The economic consequences are stark: a population plagued with chronic illness cannot be productive, which directly hampers national growth. Rising healthcare costs will only add to the burden, particularly for vulnerable households already struggling to cope with inflation. If the young are unhealthy today, the workforce of tomorrow will be weaker, and less competitive on the global stage. That is not an abstract fear; it is a practical calculation we ignore at our peril.

It is high time the state treated this as a public health emergency. Tackling the crisis requires a two-fold approach: systemic measures and mass awareness. On one hand, we need urban planning that encourages physical activity, regulation of processed food industries, and stronger healthcare interventions for early prevention. On the other hand, awareness campaigns must confront cultural attitudes that normalise sedentary lifestyles and poor diets. Relying solely on individual willpower will achieve little when the environment is stacked against healthier choices.

The urgency of this matter needs to be acknowledged before the crisis deepens further. Pakistan cannot afford to carry the weight—literally—of neglect.

Today, the World Health Organization (WHO) has released updated editions of its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), adding new treatments for various types of cancer and for diabetes with associated comorbidities such as obesity. Medicines for cystic fibrosis, psoriasis, haemophilia and blood-related disorders are among the other additions.

WHO EML and EMLc include medicines for priority health needs of populations. They are adopted in over 150 countries, serving as a basis for public sector procurement, supply of medicines and health insurance, reimbursement schemes. The revisions mark the 24^th edition of WHO EML and 10^th edition of EMLc.

The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact.”

Dr. Yukiko Nakatani, Assistant Director-General for Health Systems, Access and Data

Launched in 1977 largely to promote better access to medicines in developing countries, the WHO Model Lists have become a trusted global policy tool for decisions related to the selection and universal coverage of medicines within all health systems.

The WHO Expert Committee on the Selection and Use of Essential Medicines reviewed 59 applications, including 31 proposals for the addition of new medicines or medicine classes. As a result, 20 new medicines were added to the EML and 15 to the EMLc, along with new use indications for seven already-listed products. The updated lists now include a total of 523 essential medicines for adults and 374 for children, reflecting the most pressing public health needs.

Cancer medicines

Cancer is the second leading cause of death globally, claiming nearly 10 million lives each year and responsible for almost one in three premature deaths from noncommunicable diseases. Cancer treatments have been a major focus of the WHO EML for the past decade. With cancer medicines accounting today for about half of all new drug approvals by regulatory agencies, the Expert Committee applies rigorous criteria to recommend only those therapies that offer the greatest clinical benefit. As a result, few approved cancer medicines are included – only those proven to prolong life by at least 4-6 months.

Seven applications encompassing 25 cancer medicines were evaluated. As part of broader efforts to reduce inequities in cancer care, the Committee recommended increasing access to PD-1/PD-L1 immune checkpoint inhibitors, a class of immunotherapy medicines that help the body’s immune system recognize and attack cancer cells more effectively. Pembrolizumab was added to the EML as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer. For the latter, atezolizumab and cemiplimab are included as therapeutic alternatives.

The Committee also considered several expert-recommended strategies – highlighted in the cancer experts report – aimed at improving access to and affordability of cancer treatments. It endorsed evidence-based clinical and health system strategies, including dose optimisation approaches, to improve access. The Committee emphasized that while health system reforms require time and government action, clinical strategies can be implemented immediately to deliver faster benefits, especially in resource-limited settings.

Medicines for diabetes and obesity

Diabetes and obesity are two of the most urgent health challenges facing the world today. Over 800 million people were living with diabetes in 2022, with half going untreated. At the same time, more than 1 billion people worldwide are affected by obesity, and rates are rising especially fast in low- and middle-income countries. These two conditions are closely linked and can lead to serious health problems, including heart disease and kidney failure.

The WHO Expert Committee reviewed strong scientific evidence showing that a group of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists can help people with type 2 diabetes – especially those who also have heart or kidney disease – by improving blood sugar control, reducing the risk of heart and kidney complications, supporting weight loss, and even lowering the risk of early death.

GLP-1 receptor agonists – semaglutide, dulaglutide and liraglutide – and the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist (tirzepatide) have been added to the EML. They are used as glucose lowering therapy for adults with type 2 diabetes mellitus with established cardiovascular disease or chronic kidney disease and obesity (defined as body mass index (BMI) ≥ 30kg/m²). This provides clear guidance to countries on which patients can benefit most from these therapies.

High prices of medicines like semaglutide and tirzepatide are limiting access to these medicines. Prioritizing those who would benefit most, encouraging generic competition to drive down prices and making these treatments available in primary care – especially in underserved areas – are key to expanding access and improving health outcomes. WHO will continue monitoring developments, support fair pricing strategies, and help countries improve access to these life-changing treatments.

“A large share of out-of-pocket spending on noncommunicable diseases goes toward medicines, including those classified as essential and that, in principle, should be financially accessible to everyone,” said Deusdedit Mubangizi, WHO Director of Policy and Standards for Medicines and Health Products. “Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centred programmes that leave no one behind.”

More details of the Expert Committee’s recommendations, describing the additions, changes and removal of medicines and formulations, and decisions not to recommend medicines are available in the Executive Summary here.