Focused Ultrasound Therapy
Focused ultrasound therapy (FUS) is an early-stage, single-procedure, non-invasive technology to manage tremor and dyskinesia. It is FDA-approved and is approved to treat tremor outside the U.S. as well. It treats Parkinson's symptoms through focused beams of ultrasonic energy that target specific areas deep in the brain, interrupting circuits involved with tremor and dyskinesia. Using a mechanism called ablation, the focused beams can disrupt targeted brain tissue to treat motor symptoms. Because focused ultrasound allows for precise targeting of areas of the brain, there is no damage to healthy tissue.
Other FUS mechanisms can temporarily disrupt the blood-brain barrier (BBB), allowing desired therapeutics access into the brain. This disruption of the BBB is also beneficial because it enables undesirable substances to leave the brain more easily.
Because FUS involves no incisions, holes in the skull, or electrodes in the brain, it can provide a powerful alternative to DBS with less risk of complications, as well as a lower cost. It does not require subsequent procedures, office visits for battery replacement, broken wire repair, or appointments to adjust simulator settings.
Researchers are currently exploring whether focused ultrasound can treat Parkinson's underlying pathology and prevent progression and restore function. Pre clinical studies suggest that FUS may restore function given its ability to temporarily open the BBB to improve the delivery of therapies such as anti-alpha synuclein antibodies, neuroprotective and neurorestorative drugs and other therapies.
Transcranial magnetic stimulation (TMS), stem cell therapy, and gene therapy are additional procedures you may hear about. The jury is still out on their safety and efficacy. As more information is available, we will make you aware. Currently, there are no hospital systems in the state of Alabama offering Focused Ultrasound Therapy for Parkinson's patients.
Focused Ultrasound Complications and Risks
Tremor improves in most people when ultrasound lesions are well-placed in the thalamus. Similar to classical thalamotomies, the most common side effects include face or arm numbness, weakness, and poor balance. Procedures on both sides of the brain carry a high side effect risk.
Though persistent side effects have not been reported as common in larger trials at experienced centers, there have been concerns about lasting side effects, even with procedures on one side of the brain. As with other lesion-based therapies, it is not possible to correct problems, improve benefits, or reduce side effects that do not go away over time.
Disclaimer: The information found within the Surgery section of the Parkinson Association of Alabama Parkinson's Disease Resource Center is for educational and awareness purposes only. The PAA does not condone nor endorse any specific procedure or medical product. Discussion about whether or not you are a candidate for a surgical procedure should be discussed between you, your care partner, and your medical team.
Davis Phinney Foundation for Parkinson's. Surgical Therapies- Chapter 8. Page 138. Every Victory Counts, Your Go-To Resource of Essential Information and Inspiration for Living Well with Parkinson's. "Manual." Sixth Edition, 2021.
Parkinson's Foundation. Surgical Options Guide. Focused Ultrasound, Page 67-69. "Booklet." 2022.