Focused Ultrasound & Other Lesion Therapies

Focused ultrasound (FUS) is a procedure used to treat movement symptoms in Parkinson’s disease (PD). Like deep brain stimulation (DBS), it targets specific brain areas involved in movement. It is a type of lesion therapy that uses sound waves to heat a very small, targeted area of brain tissue. This creates a permanent area of tissue damage (called a lesion) in that specific location. The lesion interrupts abnormal brain signals and can improve movement symptoms such as tremor.

Focused ultrasound is one of several advanced Parkinson’s treatments. Others include DBS and pump medications. It may be considered when medications no longer manage symptoms well or cause significant side effects. It treats movement symptoms but is not a cure for Parkinson’s.

The U.S. Food and Drug Administration (FDA) approved focused ultrasound in:

• 2016 to treat essential tremor (not Parkinson’s disease).
• 2018 to treat tremor-dominant Parkinson’s tremor.
• 2021 to treat other PD movement symptoms.
• 2025 to allow treatment on both sides of the brain, with procedures spaced at least six months apart to reduce the risk of side effects.

What to Expect

Focused ultrasound is performed using MRI and specialized equipment to precisely direct the ultrasound waves to the target area. This procedure is offered at medical centers with experience using this technology.

Other Types of Lesion Therapy

Other lesion therapies also focus on parts of the brain to help with movement symptoms in Parkinson’s. These include:

Radiofrequency Surgery
A probe heats and destroys brain tissue through a small opening in the skull. To lower the risk of side effects, treatment is usually done on one side of the brain. Symptoms on the untreated side usually remain.

Gamma Knife Radiosurgery
Uses focused radiation to create lesions without making cuts. It is rarely used because there are limits to how much radiation can be given safely.

Areas of the Brain Treated with Lesion Therapy

Lesion therapies treat specific areas of the brain related to movement. The areas treated depend on a person’s symptoms and treatment goals.

Possible Risks & Side Effects

Lesion procedures involve several risks and side effects. This is not a complete list — talk with your care team about possible risks based on your situation.

During or Soon After the Procedure

• Headache or dizziness
• Nausea
• Balance or walking problems (usually temporary but can be permanent in some cases)

Side Effects That May Last Longer

• Numbness or tingling (often in the face, hand or arm)
• Weakness on one side of the body
• Speech or swallowing problems

Less Common but Serious Risks

• Stroke
• Seizure

The procedure may help some symptoms, but the benefit can be different for each person.

Important Considerations

Lesions are permanent and cannot be adjusted if side effects occur. There is a higher risk of side effects when both sides of the brain are treated. Rare long-term effects are possible, even with treatment on one side.

Focused Ultrasound (FUS) vs. Deep Brain Stimulation (DBS)

Page reviewed by Arjun Tarakad, MD, Associate Professor of Neurology and Director of Deep Brain Stimulation Program, Baylor College of MedicinePage