offline 5 Hz repetitive transcranial ultrasound stimulation

Stages

1. 1.
   Protocol setup with reproducibility enhancements(decision_gate)

   The abstract explicitly states that the replication benefited from added features intended to improve study rigor and reproducibility.

   Selection: Use a pre-registered, double-blind design with neuronavigation and individualized acoustic simulations to improve reproducibility relative to the original protocol.

2. 2.
   Sham-controlled physiological outcome measurement(confirmatory_validation)

   This stage tests whether the reported excitability effect replicates under the improved study design.

   Selection: Measure rMT, MEP amplitude, SICI, and ICF in response to 5 Hz-rTUS versus sham.

3. 3.
   Post-hoc acoustic target-exposure analysis(secondary_characterization)

   The post-hoc simulations were used to interpret the null physiological findings in light of targeting variability.

   Selection: Assess where the acoustic focus fell relative to the anatomical M1-hand area.

Steps

1. 1.
   Pre-register and double-blind the replication protocol

   Reduce bias and improve reproducibility in the replication attempt.

   These design features define the study before outcome collection.

2. 2.
   Determine transducer location using the TMS-hotspot for the right FDI motor representation

   Place the transducer according to the original work's targeting approach.

   Target location must be set before stimulation and outcome testing.

3. 3.
   Measure rMT, MEP amplitude, SICI, and ICF after 5 Hz-rTUS versus shamstimulation protocol and measurement-positioning method

   Test whether active 5 Hz-rTUS changes corticospinal excitability-related outcomes relative to sham.

   This is the primary confirmatory test of the reported neuromodulatory effect after protocol setup and targeting.

4. 4.
   Run post-hoc individualized 3D acoustic simulations to assess M1 target exposuretarget-exposure assessment method

   Interpret the physiological results by estimating whether the acoustic focus reached the anatomical M1-hand area.

   The abstract explicitly describes these simulations as post-hoc, indicating they were used after outcome measurement to explain variability and null effects.