Focused Ultrasound (FUS) / MR-Guided Focused Ultrasound (MRgFUS)

Overview

What It Is Focused Ultrasound (FUS), often delivered as MR-guided focused ultrasound (MRgFUS), is a non-invasive procedure that uses precisely targeted sound waves to heat and ablate small areas of tissue deep in the body—most commonly in the brain—without surgical incisions. Real-time MRI guides targeting and temperature monitoring. It is also used outside the brain (e.g., for certain pain and tumor applications) with different guidance systems.

How It Works High-intensity focused ultrasound creates a thermal lesion at a chosen target (for example, a thalamic nucleus involved in tremor). Destroying that small node can interrupt abnormal circuits that drive tremor or other symptoms. Because there is no implant and no open surgery, recovery is typically faster than with traditional neurosurgery. The treatment relies on immediate circuit disruption rather than gradual neuroplastic training, though the brain may reorganize around the new functional state over time.

Conditions - FDA-approved / established uses: medication-refractory essential tremor (including staged bilateral treatment in eligible patients); tremor-dominant Parkinson’s disease; certain motor complications of Parkinson’s disease (e.g., unilateral pallidotomy / related targets; staged bilateral options expanding); pain palliation for metastatic bone cancer when radiation is not suitable or has failed. - Also studied / used off-label or investigationally: neuropathic pain, obsessive-compulsive disorder, depression, epilepsy, dystonia, Alzheimer’s-related research (including blood–brain barrier opening), and other neurological applications. Availability and regulatory status vary by country and center. - Example facilities (U.S. and international) with established programs: Brigham and Women’s Hospital (Boston), Mayo Clinic, Cleveland Clinic, Stanford Health Care, UCLA Health, University of Maryland Medical Center, University of Virginia Health System, Sunnybrook Health Sciences Centre (Toronto), and other Focused Ultrasound Foundation Centers of Excellence.

How it is administered

Outpatient or short-stay hospital procedure. The head is stabilized in a frame; MRI guides focused ultrasound beams to the target while the patient is awake so tremor and side effects can be monitored in real time. No incision is made. Patients are often discharged the same day or after overnight observation.

Conditions connected in the NPA database

The NPA Treatment Database lists this treatment in connection with 3 condition records. A database relationship does not establish effectiveness, safety, or suitability for an individual.

• Parkinson's Disease (PD)
• Persistent Pain
• Epilepsy

Related questions

These controlled question pages reference this treatment through stored condition relationships.

• What treatments are listed for Epilepsy in the NPA database?
• What treatments are listed for Parkinson's Disease (PD) in the NPA database?
• What treatments are listed for Persistent Pain in the NPA database?

Symptoms connected in the NPA database

The current record associates this treatment with the following symptom information. This is not a claim that the treatment will improve these symptoms.

Practical information

Results and outcomes described in the source record

Tremor improvement is often noticeable during or immediately after the procedure; longer-term stability is assessed over weeks to months.

Side effects and risks

Possible temporary or lasting sensory changes (numbness/tingling), imbalance or gait difficulty, headache, or speech changes. Serious complications are uncommon but can include weakness or other neurological deficits. MRI and frame-related discomfort apply. Not appropriate for everyone (e.g., certain skull densities, MRI contraindications, or medical instability).

Research context in the NPA database

Research summary

Evidence Level: Strong (for essential tremor); Moderate to Strong (for selected Parkinson’s tremor/motor indications) What the research shows: Randomized and long-term studies support meaningful tremor reduction in medication-refractory essential tremor. Parkinson’s indications have supportive trial data and expanding FDA labels. Other neurological uses remain investigational. Key takeaway: An incisionless option for selected tremor and Parkinson’s patients; results are often immediate; patient selection and experienced centers matter.

Research detail

Overview MR-guided focused ultrasound delivers precise thermal ablation to brain (or other) targets without opening the skull. It is an established treatment for medication-refractory essential tremor and selected Parkinson’s disease indications, with a growing research pipeline in pain and other neurological conditions.

Evidence Base and Published Work • Essential tremor: pivotal and long-term studies support substantial reductions in hand tremor and improved quality of life after unilateral (and, where approved, staged bilateral) thalamotomy. • Parkinson’s disease: FDA-cleared uses include tremor-dominant disease and certain motor complications; staged bilateral approaches are expanding based on recent trial and regulatory updates. • Pain: FDA clearance includes palliation of metastatic bone pain in selected patients; neuropathic pain applications are more advanced in some countries than in the U.S. • Investigational areas include psychiatric indications, epilepsy, dystonia, and blood–brain barrier opening for drug delivery (e.g., Alzheimer’s research). • Leading clinical programs operate at centers such as Brigham and Women’s Hospital, Mayo Clinic, Cleveland Clinic, Stanford, UCLA, University of Maryland, University of Virginia, and Sunnybrook (Toronto).

Outcomes Outcomes most frequently described for approved tremor indications include immediate and sustained reduction in treated-side tremor, with variable risk of sensory or gait side effects. Parkinson’s motor outcomes depend on target and patient selection. Evidence is strongest for essential tremor; other uses range from moderate to emerging.

Questions to ask a provider

1. Am I a candidate for MRgFUS for my essential tremor or Parkinson’s symptoms, and is the indication FDA-approved for my situation? 2. Which brain target would be used, and would treatment be unilateral or staged bilateral? 3. What improvement in tremor or motor symptoms is realistic, and what side effects (numbness, imbalance, speech) should I expect? 4. How does this compare with deep brain stimulation for someone with my profile? 5. Which experienced centers perform this procedure, what is the total cost, and will my insurance cover it for this indication?