Skin-attached bioadhesive patch enabling ultrasound deep brain stimulation and real-time electrophysiological monitoring for REM sleep enhancement

Wearable bioelectronic interfaces capable of simultaneous neural sensing and targeted deep brain modulation remain limited by the lack of non-invasive technologies with sufficient spatial precision and mechanical stability for continuous operation. Here we report NEUSLeeP, a flexible skin-attached bioadhesive patch integrating electrophysiological sensing with transcranial focused ultrasound neuromodulation. The system incorporates a tunable concentric-ring ultrasound array, conformal hydrogel electrophysiological electrodes, and compliant interconnects within a soft substrate optimized for stable overnight operation. This integrated architecture enables spatially selective modulation and concurrent electrophysiological monitoring of deep brain structures, specifically the subthalamic nucleus during natural sleep. In a 28-participant study, NEUSLeeP demonstrated robust monitoring of sleep performance with precise-targeted neuromodulation of STN resulting in an increase in REM duration by 4.6% and reducing REM latency by 24%. This work establishes an ultrasound bioelectronic platform for non-invasive, spatiotemporally precise modulation and monitoring of deep neural circuits for neuroscience and bioelectronic medicine. ClinicalTrials.gov identifier: NCT07190287.