## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Treatment](/living-with-parkinsons/treatment) ## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Treatment](/living-with-parkinsons/treatment) # Focused Ultrasound & Other Lesion Therapies ## 💡 Quick Summary - Less common Parkinson’s surgeries like focused ultrasound, thalamotomy, pallidotomy and subthalamotomy may reduce tremor or motor fluctuations when [medications](/living-with-parkinsons/treatment/prescription-medications "Prescription Medications") and standard treatments are no longer effective. - Focused ultrasound is non-invasive and FDA-approved for medication-resistant tremor. - These treatments are rarely performed, as deep brain stimulation (DBS) or [Duopa](/living-with-parkinsons/treatment/surgical-treatment-options/duopa "Duopa") are more common for people with Parkinson’s. ![Surgeons checking monitor](/sites/default/files/styles/no_sizing/public/images/othersurgicaloptions.jpg?itok=Dn7Gf6OA) Focused ultrasound (FUS) is a procedure used to treat movement symptoms in Parkinson’s disease (PD). Like **[deep brain stimulation (DBS)](/living-with-parkinsons/treatment/surgical-treatment-options/deep-brain-stimulation "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](/living-with-parkinsons/treatment/prescription-medications "Prescription 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. ### Download your guide to Advanced Treatment Options Learn more about advanced treatments, including why they are used and the benefits, risks and possible side effects to consider. [DOWNLOAD NOW](https://www.parkinson.org/library/books/advanced-treatment-options) 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](/understanding-parkinsons/movement-symptoms/tremor "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. - ### During the procedure - The head is shaved, and a helmet is positioned to direct the ultrasound waves to the target area. - Chilled water flows through the helmet to keep the head cool. - MRI scans guide the treatment in real time. - No incisions or general anesthesia are needed, and you remain awake during the procedure. This makes it less invasive than traditional surgery. ## 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. - ### Pallidotomy - Treats the globus pallidus internus - Can help with **[slow movement](/understanding-parkinsons/movement-symptoms/bradykinesia "Bradykinesia (Slowness of Movement)")**, **[stiffness](/understanding-parkinsons/movement-symptoms/rigidity "Rigidity")** and **[dystonia](/understanding-parkinsons/movement-symptoms/dystonia "Dystonia")** - May also reduce tremor, “off” time and dyskinesia (extra, involuntary movements) - ### Thalamotomy - Treats the thalamus - May help reduce tremor - ### Subthalamotomy - Treats the subthalamic nucleus - May help with slowness and stiffness but has a higher risk of causing dyskinesia (extra, involuntary movements) - Is experimental for both focused ultrasound and radiofrequency surgery and is not FDA approved ## 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) ![Focused Ultrasound versus DBS](/sites/default/files/styles/no_sizing/public/images/Focused-Ultrasound-vs-DBS-Table.png?itok=_Phxpbt7) *Page reviewed by Arjun Tarakad, MD, Associate Professor of Neurology and Director of Deep Brain Stimulation Program, Baylor College of MedicinePage* ## Related Materials Books ### [ Advanced Treatment Options: A Guide to Deep Brain Stimulation, Pump Medications & Focused Ultrasound ](/library/books/advanced-treatment-options) [Read Now](/library/books/advanced-treatment-options) Videos & Webinars ### [ Neuro Talk: Surgical Options for Parkinson’s Disease ](/library/videos/surgical-options) [Watch Now](/library/videos/surgical-options) Podcasts ### [ Episode 106: Tremors: Coping & Treatment Options ](/library/podcast/106) [Listen Now](/library/podcast/106) ## Related Blog Posts ![neurotalk-blog-jim](/sites/default/files/styles/500x360/public/images/neurotalk-blog-jim.jpg?h=8e7b635d&itok=ppJc-Tvr) Advancing Research ### [ Neuro Talk: Surgical Options ](/blog/research/neuro-talk-surgeries) READ NOW ![stethoscope](/sites/default/files/styles/500x360/public/images/toledotrial-bloghero.png?h=ed9ce7df&itok=pbjM1za4) Advancing Research ### [ What’s Hot in PD? Choosing Between Subcutaneous Apomorphine Infusions, Intestinal Pumps (Duopa) and Deep Brain Stimulation: Implications of the TOLEDO Trial ](/blog/research/intestinal-pumps) READ NOW ![patient with doctor](/sites/default/files/styles/500x360/public/images/treatmentpd-blogprev.png?h=ed9ce7df&itok=Kpoudn4n) Science News ### [ Possible New Key to Parkinson's Treatment ](/blog/science-news/new-treatment) READ NOW ### Order a Parkinson’s Hospital Safety Guide The Hospital Safety Guide is a resource for people with Parkinson's and their care partners filled with useful tools and information to prepare for and navigate a hospital stay. [ORDER NOW](/resources-support/pd-library/order-publications) [LEARN MORE](/resources-support/hospital-safety-guide) - Share on Facebook - Share on X - Share on LinkedIn