SONATA LIFU for OCD

Safety and Feasibility Study of ATTN201 Repeated Subthalamic Nucleus Focused Ultrasound Stimulation for the Treatment of Obsessive Compulsive Disorder

The study tests ATTN201, an investigational non-invasive headband that delivers low-intensity focused ultrasound (LIFU) to the subthalamic nucleus (STN) as a treatment for obsessive-compulsive disorder (OCD). It's a randomized, double-blind, 1:1 (active: sham) study with 40 total participants spanning 12-16 weeks and 14 in-person and remote visits.

Study Overview

• Status: Recruiting
• Conditions: Obsessive Compulsive Disorder
• Intervention / Treatment: Device: Low Intensity Focused Ultrasound; Device: Sham (No Treatment)

Detailed Description

This is a randomized, double-blind, sham-controlled study evaluating the safety and feasibility of ATTN201, an investigational, non-invasive, wearable ultrasound headband, in adults with obsessive-compulsive disorder (OCD). ATTN201 uses low-intensity focused ultrasound (LIFU), guided by magnetic resonance imaging (MRI), to deliver stimulation to the subthalamic nucleus (STN), a brain region implicated in OCD symptom circuits. This is the fifth study in which ATTN201 has been used in humans, and the device is not currently approved by the U.S. Food and Drug Administration (FDA) for clinical use outside of research.

Approximately 40 participants will be enrolled in this study, ages 18-80, will be enrolled at a single site in San Francisco. Participants will be randomly assigned in a 1:1 ratio to receive either active focused ultrasound stimulation (20 participants) or sham (inactive) stimulation (20 participants). Sham stimulation sounds the same as active stimulation but does not deliver a therapeutic ultrasound effect to the brain. Neither participants nor the study staff administering treatment will know which group a participant has been assigned to during the treatment period.

Participation lasts approximately 12 to 16 weeks and includes 14 in-person and remote visits.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Giovanna Rocchio; Phone Number: 6177657150; Email: giovanna.rocchio@pennmedicine.upenn.edu

Study Locations

• United States
  • California
    • San Francisco, California, United States, 94107
      • Recruiting
      • Attune Neurosciences
      • Principal Investigator: Katherine Scangos, MD, PhD
      • Contact: Lena Kozyr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Have a principal diagnosis of OCD according to the DSM-5 with duration of > 1 year
2. Have a Y-BOCS of > 16
3. Participants currently on OCD medication must be at the same stable dose(s) for at least 3 weeks prior to screening and throughout the course of the study, and must continue to be under the care of their treating psychiatrist through the duration of the study.
4. Be between 22 to 80 years of age (inclusive) on the day of signing informed consent.
5. Be able and willing to undergo a cranial MRI
6. Be able and willing to wear an Attune device throughout the experimental sessions.
7. Sign the informed consent form, in accordance with local requirements, after the scope and nature of the investigation have been explained to the subject, and before screening assessments.
8. Be able to speak, read, and understand the language of the trial staff and the informed consent form.
9. Possess the ability to respond verbally to questions, follow instructions, and complete study assessments.
10. Be able to adhere to the stimulation protocol and visit schedules.
11. Be determined by the investigator to be medically stable at baseline/randomization as assessed by medical history and non-significant clinical results of a vital signs examination.
12. Male participants must ensure a condom is used for all sexual intercourse and follow acceptable methods of contraception for their female partner for the entire duration of the study. Male participants should not father a child or donate sperm for this same period.

13. Female participants who are sexually active agree to use two methods of contraception for the duration of the study or not be of childbearing potential as indicated by one of the following:

    1. Has reached natural menopause, defined as 45 years of age with ≥6 months of spontaneous amenorrhea
    2. Has had a hysterectomy;
    3. Has had bilateral tubal ligation; or
    4. Has had a bilateral oophorectomy (with or without a hysterectomy) and greater than 6 weeks have passed since the surgery

Exclusion Criteria:

1. Has a current or prior history of bipolar I or II disorder, schizophrenia or other psychotic disorder, borderline personality disorder, Tourette's disorder
2. Has acute suicidality or suicide attempt or self-injurious behavior in the last 6 months
3. Has a history of deep brain stimulation or ablative surgery
4. Has a history of substance abuse including alcohol use disorder in the past 6 months (except for caffeine and nicotine)
5. Has a history of traumatic brain injury with loss of consciousness, seizures,or other neurological disorders.

6. Has any contraindications for completing a brain MRI scan.

   a. The subject's head must fit within the head coil (32 or 64 channel), while wearing the MR-compatible device.

7. Has had a ketamine or TMS treatment within the last month prior to recruitment.
8. Has had any medical or psychiatric symptoms or conditions that could interfere with study activities or confound interpretation of study results.

9. Has a recent or ongoing, uncontrolled, clinically significant medical condition where participation in the trial would pose a significant medical risk to the subject or would confound study results within 3 months of Screening, such as:

   1. Conditions including but not limited to diabetes, hypertension, Human Immunodeficiency Virus (HIV) or other relevant infections, thyroid or endocrine disease, Chronic Obstructive Pulmonary Disease (COPD), delirium, congestive heart failure, angina, cardiac or gastrointestinal disease, or renal disease requiring dialysis, or unstable malignancies.
   2. Major surgery including not limited to abdominal, thoracic, cardiac, or orthopedic surgery, or any procedure requiring general anesthesia.
   3. Subjects with recently controlled or treated medical conditions may be considered for re-screening on a case-by-case basis after consultation with the Sponsor.
   4. Has a history of hepatitis or liver disease that, in the opinion of the investigator, has been active within the 6 months prior to Visit 1.
10. Is pregnant, is attempting to become pregnant, or is nursing children.
11. Is or has an immediate family member (e.g., spouse, parent/legal guardian, sibling, or child) who is an investigational site or sponsor staff directly involved with this trial.
12. Has a Body Mass Index (BMI) >34 kg/m2. BMI is calculated by taking the subject's weight in kg and dividing by the subject's height in meters, squared

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Active Stimulation; ATTN201 focused ultrasound stimulation delivered to the subthalamic nucleus (STN)	Device: Low Intensity Focused Ultrasound; ATTN201 is an investigational, non-invasive, wearable headband containing two ultrasound transducers positioned over the temporal region of the skull. Guided by a pre-treatment MRI, the device delivers focused low-intensity ultrasound (LIFU) to the subthalamic nucleus (STN).; Other Names: LIFU
Sham Comparator: Sham Stimulation; ATTN201 sham/unfocused stimulation - device is fitted and produces the same audible sound as active stimulation but delivers no substantive focused ultrasound effect to the brain.	Device: Sham (No Treatment); Participants are fitted with the same ATTN201 headband used in the active arm, and the device is operated using the same procedures and audible output as active stimulation. However, the ultrasound is unfocused and does not deliver a therapeutic effect to the brain. This sham condition is designed to be indistinguishable from active stimulation to preserve blinding of participants and study staff.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in OCD symptom severity	Measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS)	up to 3 months
Incidence and severity of adverse events	Device-related and procedure-related side effects	up to 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Anxiety Symptoms	Beck Anxiety Inventory	up to 3 months
Change in depressive symptoms	Beck Depression Inventory - II (BDI-II)	up to 3 months
Change in global impression	Clinical global impression severity and clinical global impression improvement	up to 3 months
Change in functional disability	Sheehan Disability Scale	up to 3 months
session-level symptom change	Visual Analog Scale ratings collected at each study intervention session	up to 3 months
Change in resting-state and task based functional connectivity	fMRI	up to 3 months

Collaborators and Investigators

• Sponsor: University of Pennsylvania
• Collaborators: Attune Neurosciences Inc

Publications and helpful links

General Publications

• Stern JM, Spivak NM, Becerra SA, Kuhn TP, Korb AS, Kronemyer D, Khanlou N, Reyes SD, Monti MM, Schnakers C, Walshaw P, Keselman I, Cohen MS, Yong W, Fried I, Jordan SE, Schafer ME, Engel J Jr, Bystritsky A. Safety of focused ultrasound neuromodulation in humans with temporal lobe epilepsy. Brain Stimul. 2021 Jul-Aug;14(4):1022-1031. doi: 10.1016/j.brs.2021.06.003. Epub 2021 Jun 23.
• Blackmore J, Shrivastava S, Sallet J, Butler CR, Cleveland RO. Ultrasound Neuromodulation: A Review of Results, Mechanisms and Safety. Ultrasound Med Biol. 2019 Jul;45(7):1509-1536. doi: 10.1016/j.ultrasmedbio.2018.12.015. Epub 2019 May 18.
• Aubry JF, Attali D, Schafer ME, Fouragnan E, Caskey CF, Chen R, Darmani G, Bubrick EJ, Sallet J, Butler CR, Stagg CJ, Klein-Flugge MC, Yoo SS, Holland CK, Treeby B, Martin E, Verhagen L, Butts Pauly K. ITRUSST consensus on biophysical safety for transcranial ultrasound stimulation. Brain Stimul. 2025 Nov-Dec;18(6):1896-1905. doi: 10.1016/j.brs.2025.10.007. Epub 2025 Oct 8.
• Munoz F, Meaney A, Gross A, Liu K, Pouliopoulos AN, Liu D, Konofagou EE, Ferrera VP. Long term study of motivational and cognitive effects of low-intensity focused ultrasound neuromodulation in the dorsal striatum of nonhuman primates. Brain Stimul. 2022 Mar-Apr;15(2):360-372. doi: 10.1016/j.brs.2022.01.014. Epub 2022 Jan 29.
• Gaur P, Casey KM, Kubanek J, Li N, Mohammadjavadi M, Saenz Y, Glover GH, Bouley DM, Pauly KB. Histologic safety of transcranial focused ultrasound neuromodulation and magnetic resonance acoustic radiation force imaging in rhesus macaques and sheep. Brain Stimul. 2020 May-Jun;13(3):804-814. doi: 10.1016/j.brs.2020.02.017. Epub 2020 Feb 21.
• Darmani G, Bergmann TO, Butts Pauly K, Caskey CF, de Lecea L, Fomenko A, Fouragnan E, Legon W, Murphy KR, Nandi T, Phipps MA, Pinton G, Ramezanpour H, Sallet J, Yaakub SN, Yoo SS, Chen R. Non-invasive transcranial ultrasound stimulation for neuromodulation. Clin Neurophysiol. 2022 Mar;135:51-73. doi: 10.1016/j.clinph.2021.12.010. Epub 2021 Dec 31.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2026
• Primary Completion (Estimated): July 31, 2028
• Study Completion (Estimated): October 31, 2028

Study Registration Dates

• First Submitted: July 14, 2026
• First Submitted That Met QC Criteria: July 22, 2026
• First Posted (Actual): July 27, 2026

Study Record Updates

• Last Update Posted (Actual): July 27, 2026
• Last Update Submitted That Met QC Criteria: July 22, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: OCD; LIFU
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders; Obsessive-Compulsive Disorder
• Other Study ID Numbers: 25-0483

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: No