40 Hz ultrasound is a drug-free brain-stimulation method sending sound waves too high to hear through the skull in bursts forty times a second to drive a fast brain rhythm that weakens in Alzheimer's disease. Evidence is almost entirely from animals; no published study has tested it in people. Benefits for healthy longevity are unproven, risks at careful settings look small but poorly measured, and it remains a research tool. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Brain MRI with SWI (microbleed count) | No established target; track new microbleeds against own baseline scan | Safety check: new microbleeds stop use |
| Plasma p-tau217 | No established target; track change from own baseline | Defines amyloid status; expected to change |
| Plasma Aβ42/40 ratio | No established target; track change from own baseline | Expected to change if amyloid clearance occurs |
| Resting EEG 40 Hz power | No established target; track change from own baseline | Measures the 40 Hz brain response |
| Montreal Cognitive Assessment (MoCA) | Not specified in the ER | Cognitive screen |
| Hearing check | Not specified in the ER | Documents whether the pulses are audible |
Cadence: Baseline before any research use; symptom questionnaire after every session; cognitive testing at 2, 6 and 10 weeks; plasma biomarkers at the end of each course, then every 6–12 months; repeat MRI after the first course or with any new neurological symptom