Focused Ultrasound

What it is

Focused Ultrasound (FUS) is a new neurosurgical technology that enables brain modulation without the need for a surgical incision.  Specifically, the technology allows the creation of “lesions” or disconnections that disrupt pathological brain activity in order to reduce the signs or symptoms of certain neurological diseases.

Who can benefit

Currently, FUS is FDA-approved for patients with Essential Tremor and for those with Parkinson’s Disease for whom tremor is the major disabling feature.  FUS is most beneficial for those with tremor on only one side of the body, or who only want one side treated.  Those who wish to have tremor on both sides treated, or who have Parkinson’s Disease with other movement problems, may consider Deep Brain Stimulation as an alternative.

How it works

FUS uses carefully focused beams of ultrasound energy to target and heat specific circuits of the brain.  The FUS procedure is carried out under near-real-time MRI visualization.  A patient places his or her head into the FUS helmet and together the patient and helmet are positioned within the MRI scanner.  The MRI is programmed to read the temperature of the brain at the target location while hundreds of ultrasound transducers in the helmet deliver highly focused energy to that target.

Initially, low energy is delivered to the target to disrupt abnormal brain activity in that circuit.  If tremor is reduced or eliminated, then the temperature is increased so that the target can be ablated, disconnecting the circuit responsible for the tremor.

Because ultrasound energy does not travel well through air, patients must shave their heads for the procedure. In addition, because the skull is made up largely of air, if the skull is too thick, the energy cannot be focused accurately, and so some patients may not be eligible for this procedure.  A CT scan prior to the procedure will allow us to determine whether it is safe to proceed with MRI-guided FUS.