Focused ultrasound (FUS), also known as high-intensity focused ultrasound (HIFU), is a minimally invasive treatment option for patients with a disabling tremor – a neurological condition in which uncontrollable tremor occurs during movement. In addition, it has been recently approved for use in select patients with Parkinson’s disease experiencing stiffness, slowness, and medication-induced dyskinesias affecting predominantly one side of the body. This groundbreaking treatment option is guided by magnetic resonance imaging (MRI) and does not require incisions or invasive probes. During treatment, ultrasound waves pass safely through a patient’s skull to precisely heat and destroy specific regions deep inside the brain that are involved in generating tremor. As such, disabling tremor is immediately abolished and the patients are sent home the same day.
Tampa General Hospital’s Neuroscience Institute is the first on the west coast of Florida to perform and offer this groundbreaking treatment.
What Are the Benefits of Focused Ultrasound?
Benefits of focused ultrasound treatment may include:
No incisions or implanted hardware
Reduced risk of infection to non-targeted areas of the brain
Immediate resolution of symptoms for many patients
Outpatient procedure (patients typically go home on the day of the procedure)
Quick recovery time (patients may return to daily activities within a day of the procedure)
FDA approved – safe and effective with minimal side effects
Overall, focused ultrasound treatment has been shown to be safe for treating disabling tremors and select patients with Parkinson’s disease with minimal risk. However, with any medical procedure, there are risks that may include speech issues or ataxia, which is a group of disorders that affect coordination, balance and speech. Speech-language pathologists and physical therapists provide care to patients for symptoms related to the procedure or the disease process.
Focused Ultrasound Details
To qualify for focused ultrasound treatment, the patient must not have metal implants and must be off blood thinners for the procedure.
In preparation for focused ultrasound, the patient must have a cleanly shaven head to ensure there is no obstruction of the sound waves. A local numbing medication is applied and a standard, helmet-like frame is secured to the patient’s head to minimize head movement during the treatment.
During a focused ultrasound treatment, the patient remains awake and lies inside an MRI scanner with his/her head in the focused ultrasound helmet-like device. The treating neurosurgeon identifies the target area based off of high-resolution MRI scans, and a total of 1,024 individual ultrasound transducers are then precisely focused on the targeted area. At first, low-energy ultrasound is applied to the targeted area, allowing the patient to provide feedback of tremor improvement as well as any potential side effects. This feedback allows the treating neurosurgeon to adjust the treatment before high-energy ultrasound is applied.
The treating neurosurgeon then proceeds to apply one or more treatments of high-intensity ultrasound to make the final ablation. After each one, the patient will perform tasks, such as touching his or her nose, allowing the physician to evaluate improvement until the targeted area is completely ablated. Each of the individual ultrasound beams are harmless, and it is only where they meet at the targeted area that tissues are heated to the point of ablation. The overall procedure typically takes two-and-a-half hours. Many patients show immediate improvement in their tremor and improvement is long-lasting.
Focused ultrasound is designed to be an outpatient procedure, meaning the patient can go home on the same day as the procedure.
Following the procedure, the patient will move to the recovery room, where the focused ultrasound helmet device is removed. The physician will let the patient know when they can go home and when they will need to return for a follow-up visit.
Follow-up appointments generally occur two weeks after the procedure and continue one month, three months, six months and a year after the procedure. Patients are also followed up with by their movement disorders neurologist over the course of that time.
Effective Focused Ultrasound Treatment at TGH
Tampa General Hospital’s Neuroscience Institute is the first on the west coast of Florida to perform and offer focused ultrasound. Equipped with a state-of-the-art intraoperative MRI surgical suite, our neurosurgeons have access to high-resolution, real-time images of the brain during and after procedures, allowing for an unprecedented level of precision and excellent outcomes. For those reasons and others, Tampa General Hospital ranks among the top 10% of hospitals in the United States for Neurology & Neurosurgery for 2021-2022 by U.S. News & World Report.
Focused Ultrasound is not covered by Medicare for Parkinson’s patients in Florida