Focused ultrasound (FUS), also known as high-intensity focused ultrasound (HIFU), is a minimally invasive treatment option for patients with disabling tremor — a neurological condition characterized by uncontrollable tremors during movement. In addition, it has been recently approved for use in select patients with Parkinson’s disease experiencing stiffness, slowness and medication-induced dyskinesias affecting predominantly one side of the body. This groundbreaking treatment option is guided by an MRI and does not require incisions or invasive probes. During treatment, ultrasound waves pass safely through a patient’s skull to precisely heat and create a highly precise and accurate lesion that are involved in generating a tremor. As such, a disabling tremor is immediately improved, and the patient is sent home the same day.

What Are the Benefits of Focused Ultrasound?

Benefits of focused ultrasound treatment may include:

Immediate resolution of symptoms for many patients
No incisions or implanted hardware
There is minimal risk of infection or bleeding
Outpatient procedure — Patients typically go home on the day of the procedure
Quick recovery time — Patients may return to daily activities within a day of the procedure
FDA approved — Safe and effective with minimal side effects

Overall, focused ultrasound treatment has been shown to be safe for treating disabling tremors and select patients with Parkinson’s disease with minimal risk. However, as with any medical procedure, there are possible risks, which may include speech issues or ataxia — a group of disorders that affect coordination, balance and speech. Speech-language pathologists and physical therapists provide care to patients for symptoms related to the procedure or the disease process.

Focused Ultrasound Details

Preparation

To qualify for focused ultrasound treatment, many implants may be MRI‑compatible, and blood thinners may need to be temporarily paused for the procedure. In preparation for the procedure, the patient must have a cleanly shaven head to ensure there is no obstruction of the sound waves. A local numbing medication is applied and a standard, helmet-like frame is secured to the patient’s head to minimize head movement during the treatment.

Treatment

During a focused ultrasound treatment, the patient remains awake and lies inside an MRI scanner with their head in the focused ultrasound helmet-like device. The treating neurosurgeon identifies the target area based on high-resolution MRI scans, and a total of 1,024 individual ultrasound transducers are then precisely focused on the targeted area. At first, low-energy ultrasound is applied to the targeted area, allowing the patient to provide feedback on tremor improvement as well as any potential side effects. This feedback allows the treating neurosurgeon to adjust the treatment before high-energy ultrasound is applied.

The treating neurosurgeon then proceeds to apply one or more treatments of high-intensity ultrasound to make the final ablation. After each one, the patient will perform tasks, such as touching their nose, allowing the physician to evaluate improvement until the targeted area is completely ablated. Each individual ultrasound beam is harmless, and it is only where they meet at the targeted area that tissues are heated to the point of ablation. The overall procedure typically takes two-and-a-half hours. Many patients show immediate improvement in their tremor, and the improvement is long-lasting.

Focused ultrasound is designed to be an outpatient procedure, meaning the patient can go home on the same day.

Recovery

Following the procedure, the patient will move to the recovery room where the focused ultrasound helmet device is removed. The physician will let the patient know when they can go home and when they will need to return for a follow-up visit.

Follow-up appointments generally occur two weeks after the procedure and continue at three months, and nine months to one year after the procedure. Patients will also follow up with their movement disorders neurologist during that time.

Still Have Questions?

Still have questions? Watch our informational webinar featuring Orlando Health Neuroscience Institute neurosurgeon Jan Hachmann, MD, and neurologist Vikram Shivkumar, MD. Learn more about treatment options for essential tremor and tremor-dominant Parkinson’s disease, and hear directly from our specialists.

To schedule an appointment or if you have any questions, call (321) 841-7550.

Patient Testimonial

Michael lived with essential tremors for most of his life. Thanks to the Orlando Health Neuroscience Institute, he regained functionality in his hand through an incisionless treatment designed for patients with essential tremor and certain forms of Parkinson’s disease. Watch to learn more.

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