Focused Ultrasound Therapy
Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with symptoms secondary to Parkinson’s disease. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
Please note that for work being done on dementia, including that which is associated with Parkinson’s disease, please see the Disease and Conditions listing for Dementia.
How it Works
Where the beams converge, focused ultrasound produces a variety of therapeutic effects enabling Parkinson’s disease to be treated without surgery. For movement disorders, the mechanism of action is ablation (thermal disruption of the tissue) that can be aimed at several different treatment targets. For the preclinical work that one day may treat the underlying causes for Parkinson’s, the mechanisms can be temporarily disrupting the blood-brain barrier (BBB), which will allow desired therapeutics the ability to enter the brain. Opening the BBB also can enable undesired materials to more easily depart from the brain.
Advantages
Currently, there is no cure for Parkinson’s and the major options for treatment of motor symptoms include drug therapy and invasive surgery (e.g. deep brain stimulation, radiofrequency lesioning).
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost. In the long term, focused ultrasound has the potential to treat the underlying disease pathology and prevent progression and/or restore function.
Relief of Motor Symptoms
The FDA has approved the use of focused ultrasound for treatment of tremor-dominated Parkinson’s disease and Parkinson’s dyskinesia, which is a broad definition that includes a wide variety of motor complications, including motor fluctuations, involuntary extremity movement, rigidity, slow initiation of movement and other similar diseases.
Focused ultrasound has the potential to achieve symptomatic relief by making thermal lesions deep in the brain to interrupt circuits involved with tremor and dyskinesia. Symptoms and targets being assessed for treatment using focused ultrasound include:
- Parkinsonian tremor – target in the thalamus (thalamotomy)
- Parkinsonian dyskinesia – target in the globus pallidus (pallidotomy) or subthalamic nucleus
- Parkinsonian tremor, akinesia or dyskinesia – target in the pallidothalamic tract
At this time, focused ultrasound is only being assessed to treat one side of the brain, so it will affect tremor or dyskinesia unilaterally. Studies are being organized to assess the possibility of treating patients bilaterally, and one is included below.
- Focused ultrasound is non-invasive – no incisions, holes in the skull, electrodes in the brain – and therefore has reduced risk for infection and blood clots.
- Precise targeting minimizes damage to non-targeted healthy brain.
- Compared to deep brain stimulation, focused ultrasound is a single procedure, and does not require subsequent procedures/visits to replace batteries, repair broken wires, or adjust simulator settings. It also does not involve the collateral damage to healthy tissue or the risk of infections associated with implanting a foreign body.
Treating Underlying Pathology
Preclinical studies suggest focused ultrasound’s potential to restore function in Parkinson’s models. Focused ultrasound can temporarily open the blood-brain barrier (BBB) to improve the delivery of:
- Genes, growth factors, stem cells, other neuroprotective and/or neurorestorative drugs
- Anti-alpha synuclein antibodies
In October 2018, the Foundation had a multi-disciplinary workshop that aimed at using BBB opening in conjunction with potentially curative agents, to decide what research approaches have the most potential. Read the workshop summary >
Clinical Trials
There are several recent trials that assess the feasibility, safety, and preliminary efficacy of focused ultrasound to treat different symptoms of Parkinson’s.
Parkinson’s disease tremor (neuromodulation)
A clinical trial in Los Angeles is using transcranial ultrasound neuromodulation to treat patients with essential tremor.
A clinical trial in Los Angeles is using Low Intensity Focused Ultrasound Pulsation (LIFUP) to treat patients with Parkinson’s disease movement disorders.
Early-stage Parkinson’s Disease
There is a clinical trial in Spain for patients with early-stage Parkinson’s disease, and the treatment will be randomized and include either unilateral subthalamotomy or best medical treatment.
Parkinson’s disease patients with glucocerebrosidase deficiency
This trial is recruiting patients for treatment with recombinant glucocerebrosidase to offset this deficiency. This study is only open to those who are Canadian Citizens.
Peripheral electrical stimulation with focused ultrasound on motor symptoms
This clinical trial in Canada is using non-thermal mechanisms targeting superficial and deep targets to help treat patients with movement disorders symptoms from Parkinson’s disease.
The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here, it will take you to the latest information available from https://www.clinicaltrials.gov/.
See a list of treatment sites >
See here for a list of clinical trials sites >
See here for a list of laboratory research sites >
Regulatory Approval & Reimbursement
The Exablate system manufactured by Insightec is approved in Europe and in the US for treating tremor-dominant Parkinson’s disease. In November 2021, it also earned approval in the US for treating additional movement disorders associated with Parkinson’s disease, including mobility, rigidity and dyskinesia. We recommend that patients talk with the treatment site for questions about insurance coverage under Medicare, as some treatment sites are now being reimbursed by Medicare.
Preclinical Laboratory Studies
Preclinical studies suggest focused ultrasound’s potential to restore function in Parkinson’s models. Active studies are assessing focused ultrasound-induced BBB opening to improve the delivery of:
- Genes, growth factors, stem cells, other neuroprotective and/or neurorestorative drugs (University of Virginia/Johns Hopkins University; University of Maryland; Columbia University; Chang Gung University in Taiwan; University of Toronto)
- Anti-alpha synuclein antibodies (Columbia University; HM Puerta del Sur in Madrid/Institut Langevin in Paris)
Additional Resources
The Michael J. Fox Foundation for Parkinson’s Research
Exablate Neuro by Insightec LTD
Suggested Reading
Focused Ultrasound: Transforming treatment of Neurodegenerative Diseases August 2022
Parkinson’s Disease: Latest Treatments and Research. September 2020.
Focused Ultrasound for Parkinson’s Disease. April 2020.
(See an archived version from March 2019.)
Notable Papers
Wu Y, Xu W. Addressing Methodological Variability and Enhancing Efficacy Assessment in Focused Ultrasound Thalamotomy for Parkinson’s Tremor. Mov Disord. 2025 Feb 4. doi: 10.1002/mds.30136. PMID: 39902592
Aharonson V, Lazebnik T, Sinai A, Nassar M, Senderova I, Constantinescu M, Tov LL, Schlesinger I. Novel Objective Tool to Assess Tremor Reveals Unilateral Focused Ultrasound Improves Tremor Bilaterally. Neurol Ther. 2025 Jan 22. doi: 10.1007/s40120-024-00705-7. PMID: 39843652
Saeki C, Kajiyama Y, Kakuda K, Baba K, Hattori N, He X, Tani N, Hosomi K, Oshino S, Kanemoto M, Kishima H, Mochizuki H. Focused Ultrasound Lesioning of the Subthalamic Nucleus for Asymmetric Parkinson’s Disease in Japan. Mov Disord Clin Pract. 2025 Jan 9. doi: 10.1002/mdc3.14331. PMID: 39786311
Wu SK, Tsai CL, Mir A, Hynynen K. MRI-guided focused ultrasound for treating Parkinson’s disease with human mesenchymal stem cells. Sci Rep. 2025 Jan 15;15(1):2029. doi: 10.1038/s41598-025-85811-8. PMID: 39815002
Braccia A, Golfrè Andreasi N, Ghielmetti F, Aquino D, Savoldi AP, Cilia R, Telese R, Colucci F, Gaudiano G, Romito LM, Elia AE, Leta V, Levi V, Castelli N, Devigili G, Rinaldo S, Stanziano M, Caldiera V, Grisoli M, Ciceri EFM, Eleopra R. Magnetic Resonance-Guided Focused Ultrasound Thalamotomy in a Prospective Cohort of 52 Patients with Parkinson’s Disease: A Possible Critical Role of Age and Lesion Volume for Predicting Tremor Relapse. Mov Disord. 2025 Jan 18. doi: 10.1002/mds.30093. PMID: 39825750
Armengou-Garcia L, Sanchez-Catasus CA, Aviles-Olmos I, Jiménez-Huete A, Montoya-Murillo G, Gorospe A, Martin-Bastida A, Gonzalez-Quarante LH, Guridi J, Rodriguez-Oroz MC. Unilateral Magnetic Resonance-Guided Focused Ultrasound Lesion of the Subthalamic Nucleus in Parkinson’s Disease: A Prospective Study. Mov Disord. 2024 Dec;39(12):2230-2241. doi: 10.1002/mds.30020. Epub 2024 Sep 18. PMID: 39295191
Campins-Romeu M, Conde-Sardón R, Sastre-Bataller I, Morata-Martínez C, Losada-López M, León-Guijarro JL, Raga-Rodríguez L, Pérez-García J, Gutiérrez-Martín A, Lozano AM, Baviera-Muñoz R, Martínez-Torres I. MRgFUS subthalamotomy in Parkinson’s disease: an approach aimed at minimizing Lesion Volume. NPJ Parkinsons Dis. 2024 Dec 2;10(1):230. doi: 10.1038/s41531-024-00843-7. PMID: 39622797
Rodriguez-Oroz MC, Martínez-Fernández R, Lipsman N, Horisawa S, Moro E. Bilateral Lesions in Parkinson’s Disease: Gaps and Controversies. Mov Disord. 2024 Dec 27. doi: 10.1002/mds.30090. PMID: 39726415
Ponomarchuk E, Tsysar S, Kadrev A, Kvashennikova A, Chupova D, Pestova P, Papikyan L, Karzova M, Danilova N, Malkov P, Chernyaev A, Buravkov S, Sapozhnikov O, Khokhlova V. Boiling Histotripsy in Ex Vivo Human Brain: Proof-of-concept. Ultrasound Med Biol. 2025 Feb;51(2):312-320. doi: 10.1016/j.ultrasmedbio.2024.10.006. Epub 2024 Oct 30. PMID: 39482208
Aubignat M, Roussel M, Aarabi A, Tir M, Lefranc M, Godefroy O. Cognitive impacts of unilateral MR-guided focused ultrasound thalamotomy: a meta-analysis and a call for systematic neuropsychological assessment. J Neurosurg. 2024 Dec 27:1-9. doi: 10.3171/2024.7.JNS24906. PMID: 39729615
Oshima S, Kim A, Sun XR, Rifi Z, Cross KA, Fu KA, Salamon N, Ellingson BM, Bari AA, Yao J. Predicting Post-Operative Side Effects in VIM MRgFUS Based on THalamus Optimized Multi Atlas Segmentation (THOMAS) on White-Matter-Nulled MRI: A Retrospective Study. AJNR Am J Neuroradiol. 2024 Dec 27. doi: 10.3174/ajnr.A8448. PMID: 39730158
Jha R, Wadhwa A, Chua MMJ, Cosgrove GR, Rolston JD. Tremor Severity and Operative Parameters Predict Imbalance in Patients Undergoing Focused Ultrasound Thalamotomy. Mov Disord Clin Pract. 2024 Dec;11(12):1542-1549. doi: 10.1002/mdc3.14237. Epub 2024 Oct 25. PMID: 39450579
Silva N, Green M, Roque D, Krishna V. The Use of Focused Ultrasound Ablation for Movement Disorders. Magn Reson Imaging Clin N Am. 2024 Nov;32(4):651-659. doi: 10.1016/j.mric.2024.04.003. Epub 2024 Jul 29. PMID: 39322354
Click here for additional references on PubMed.
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