MR-Guided Focused Ultrasound (MRgFUS) for Tremor Treatment

MR-Guided Focused Ultrasound (MRgFUS) is a medical treatment that uses sound waves to target and heat a small area of the brain. This helps stop the abnormal signals that cause tremors (shaking) in people with conditions like essential tremor or Parkinson’s disease.

Treatment happens inside of a magnetic resonance imaging (MRI) machine, which helps doctors see the brain in real time. Even though there are no cuts or incisions, MRgFUS is a type of surgery, because it makes permanent changes to brain tissue.

How Focused Ultrasound Works

MRgFUS sends many ultrasound beams into the brain, all focusing on one tiny spot. When the beams meet, they create enough heat to damage a small area (called a lesion). This stops brain signals that cause shaking. MRI scans help the doctor find the exact spot to treat. MRI also allows the doctor to check progress during the procedure. MRgFUS is non-invasive (no surgery or cutting), and it doesn't use radiation, which makes it safer than some older methods.

Background and Benefits of Focused Ultrasound

MRgFUS was approved by the FDA in 2016. It’s based on an older treatment called a thalamotomy, but the new method doesn’t require cutting into the skull. MRgFUS offers the potential for a significant drop in tremor symptoms. However, it can still have side effects, such as causing trouble speaking, weakness, numbness or balance issues.

Before and After MRgFUS

 Watch this powerful before-and-after video showing the life-changing impact of MRgFUS, the latest treatment option for essential tremor and Parkinson’s disease. Discover how this new treatment is helping Froedtert & MCW patients transform shaky hands into steady progress.

Who Can Benefit from MRgFUS

MRgFUS is FDA-approved for people with essential tremor and for some people with Parkinson’s-related tremors who don’t get enough relief from medication or can’t take the medication. To have the procedure, patients must be able to have an MRI safely. To have the procedure, patients must be able to have an MRI without needing sedation and without contraindications for MRI. For example, you may not be a good candidate if you have an unsafe implanted device or have required anesthesia for previous MRIs. This will be discussed with your doctor during your workup for MRgFUS.

What Happens During the Procedure

MRgFUS is done as an outpatient procedure. Patients have the procedure and go home the same day, after a short recovery period. First, the patient's head is shaved to let ultrasound waves pass through clearly. A special head frame is attached to the head to keep it still. Then the patient lies on a table inside the MRI machine with a device around their head that holds cold water to cool the scalp and help focus the ultrasound beams.

Doctors and MRI technologists take MRI pictures to find the exact spot in the brain to treat. They start with low-power ultrasound waves to make sure the treatment location is correct and to check for side effects. Once they are sure the location is correct, they use stronger waves to heat and treat the area. Doctors carefully watch for symptom relief and side effects during the procedure.

After the Procedure

Most people feel better the same day and go home soon after having MRgFUS. Tremors usually improve in the hand opposite the side of the brain treated. Results can last a long time, but MRgFUS is not a cure. Tremors might come back or get worse as the disease progresses. Some people have mild side effects — like numbness, balance problems or speech issues — but these often go away after a few weeks.

MRgFUS vs Deep Brain Stimulation: Key Differences

The main difference between MRgFUS and deep brain stimulation (DBS) is how they work. MRgFUS doesn’t require any devices to be placed in the brain or under the skin. It also creates a permanent change in the brain.

DBS is different because it requires surgery to put wires in the brain and a device like a pacemaker under the skin. With DBS, doctors can change settings over time to help control symptoms, which is not possible with MRgFUS.