What is MR-Guided Focused Ultrasound (MRgFUS)?
MR-guided focused ultrasound (MRgFUS), also referred to as high-intensity focused ultrasound, is a noninvasive, incisionless procedure. This therapy uses highly focused sound waves as a form of energy to treat essential tremor and symptoms associated with Parkinson's disease, including tremor, rigidity, and slowness of movement.
How Does Focused Ultrasound Therapy Work?
MR-guided focused ultrasound combines two imaging technologies to help treat movement disorders and associated symptoms. Magnetic resonance (MR) technology provides doctors with precise images to locate the affected area. Then highly focused sound waves destroy (ablate) a precise area of brain tissue. The MR technology also measures the precise temperature of brain tissue during the treatment, increasing the safety of the procedure.
MRgFUS can target an area in the thalamus, a region of the brain involved in many body functions, including control of movement. MRgFUS can also alleviate some Parkinson's disease symptoms when it is used to target the pallidum, another brain region involved in the control of movement.
Who is a Candidate for MR-Guided Focused Ultrasound?
If you have essential tremor or Parkinson's disease and your tremors are not controlled by medications, your doctor may ask you to consider focused ultrasound therapy.
MRgFUS therapy is not appropriate for everyone. It may not be an option for people who:
- Are pregnant, due to unknown effects of the contrast dye on a fetus
- Have claustrophobia or are unable to lie still for several hours in the MRI scanner
- Have certain heart conditions, magnetic metal implants, pacemakers, neurostimulators, or other unremovable devices that can't go inside of the MRI scanner
- Have thick scar tissue or a dense skull, which make it difficult for the sound waves to travel through to reach the brain
What to Expect During Focused Ultrasound Treatment
Focused ultrasound is an outpatient procedure that takes just a few hours. You remain awake, but your doctor can give you sedative medication to keep you calm and comfortable.
You lie on an MRI bed, so your doctor can slide you in and out of the MRI scanner during the procedure to test your response to treatment.
During focused ultrasound, your doctor:
- Performs an MRI to locate the area of the brain to be treated.
- Applies the ultrasound waves to the targeted brain area.
- Performs more MRI scans to monitor the treatment.
- You will be asked to move your arms and hands at several points during treatment so your doctor can monitor if the ultrasound is relieving your tremors.
Recovery After Focused Ultrasound
You may stay overnight in the hospital after MRgFUS or return home the same day. You will be able to return to work and perform normal activities within a few days.
Some people experience temporary side effects for days or weeks following focused ultrasound treatment. These include:
- Dizziness
- Headache
- Nausea or vomiting
- Numbness or tingling in the lips or fingers
- Problems with coordination and balance while walking
- Problems with speaking or swallowing
Benefits and Risks of Focused Ultrasound for Essential Tremor and Parkinson's Disease
Many people who have focused ultrasound for essential tremor find that their symptoms improve or disappear immediately. Because the goal of MRgFUS is to create a lesion on the brain, the effects should be long-lasting or permanent.
Focused ultrasound is an option for people who cannot have or prefer not to have surgery for essential tremor. Because the procedure does not require an incision, you have a faster recovery and lower risk of infection compared to traditional brain surgery. The precision of focused ultrasound protects brain tissue around the area being treated.
In rare cases, focused ultrasound treatment does not improve tremors, or tremors may return months or years after treatment. Research suggests that this may relate to the size of the lesion created on the brain during treatment—larger lesions are associated with lower chances of symptom recurrence but may have a slightly higher risk of side effects. Your doctor plans your treatment based on your brain anatomy to maximize improvement while minimizing the risk of side effects.
Is MR-Guided Focused Ultrasound Covered by Insurance?
Insurance coverage for focused ultrasound depends on your specific condition and health insurance plan. Contact your health insurance provider or talk with your doctor to review coverage for this procedure.
Why Choose Penn Medicine for MR-Guided Focused Ultrasound?
Penn Medicine is one of the first health systems in the world to offer MR-guided focused ultrasound as a noninvasive treatment for essential tremor. We are the only hospital in Pennsylvania and one of the few in the northeast that offers this innovative treatment.
People who choose us for MRgFUS find:
- Patient-centered care: Our Movement Disorders Center offers all leading treatment options for essential tremor. Our team works with each other and with you to understand your unique needs and preferences. We then make comprehensive treatment recommendations designed to control your symptoms and maximize your quality of life.
- Experienced team: Our neurosurgeons have decades of experience with implantable devices and surgeries for movement disorders. Their skill in these precise procedures means you get the best results possible—for fewer symptoms and a better quality of life.
- Pioneering treatments: As leaders in essential tremor and Parkinson's disease research, our neurologists and neurosurgeons are on the cutting edge of the newest, most effective treatments for movement disorders. We are uniquely positioned to offer more options, including MR-guided focused ultrasound. This groundbreaking treatment is not widely available, but MRgFUS has become a standard treatment at Penn Medicine.
- Care close to home: Penn neurosurgeons see patients at satellite locations across the region allowing convenient consultations, second opinions, and pre- and post-operative care in your community.
Make an Appointment
Please call 800-789-7366 or make an appointment.