MRI-guided focused ultrasound (MRgFUS) is a common procedure for Essential Tremor and, more recently, has been used for Parkinson’s tremor.
There are two types, thallidomity and pallidomity, and they treat different areas of the brain. A laser causes a permanent lesion, or scarring, in the brain in the target area, which, e.g. fixes tremor and does not affect speech.
Who is a likely candidate?
MRgFUS is best for people who:
- Have Essential Tremor or Parkinson’s tremor that doesn’t respond well to medication.
- Are not suitable for open brain surgery (like Deep Brain Stimulation).
- Have one-sided tremor (usually treated one side at a time).
- Have a good skull density ratio (SDR) because this affects how well ultrasound passes through the skull
Pros: Incision-less for those with co-morbidities that make them not good surgical candidates (e.g. for DBS). Post-MRgFUS, you can see immediate results. As the condition progresses, you will still be able to take levodopa and adjunct therapies.
Cons: Permanent, hard to re-treat the same area if the lesion is not large enough (but can have re-treatment). Scarring around the original lesion. The second side may be harder to treat. Being a fairly new procedure, long-term data is lacking, but it is showing about 70% improvement in tremor over 5 years.
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