MRI-Guided Focused Ultrasound

The University of Kansas Health System is our region’s 1^st provider to offer an innovative, noninvasive treatment for essential tremor or Parkinson’s disease with tremor as the main symptom. It is an MRI-guided focused ultrasound called Exablate® Neuro.

Doctors use an MRI to direct the focused ultrasound precisely at the location in the brain causing the hand tremor. It destroys that tissue without risk or damage to the surrounding brain tissue. There is no need for surgical incisions.

MRI-guided focused ultrasound is a noninvasive method of treatment that uses precisely directed ultrasound to create heat. This heat ablates, or burns, the specific area that causes the tremors. Doctors use magnetic resonance imaging to identify the precise location in the brain during the procedure, leaving surrounding tissue unaffected.

MRI-guided focused ultrasound may be a treatment option for people with essential tremor or with Parkinson’s disease when hand tremor is the primary symptom and medications have not worked. Patients with essential tremor must be at least 22 years old and patients with tremor-dominant Parkinson’s disease must be at least 30 years old to receive this treatment.

MRI-guided focused ultrasound is not suitable for all patients. You may not be eligible if you have:

• Metallic implants such as a pacemaker, neurostimulator, spine or bone fixation device, total joint replacement, metal clips, screws or cochlear implants
• Heart or spine issues that may make it difficult to tolerate the treatment or lie still for about 3 hours
• Extensive scarring on your scalp
• Tumors inside your skull
• Health conditions that require dialysis
• Active infection or severe uncontrolled disease

Talk with your doctor to determine your best treatment option.

Advanced technology allows this treatment technique to deliver focused ultrasound energy deep into the brain without requiring surgical incisions. Your neurosurgeon will use an MRI to target precisely the brain tissue that causes tremors. The ultrasound creates heat burning away the problem cells. By ablating the tissue, surgeons can safely reduce or stop tremors. Focused ultrasound has been shown to provide immediate tremor reduction with little or no hospitalization required.

This treatment offers several benefits:

• Patients experience nearly immediate results with a single treatment.
• MRI-guided focused ultrasound requires no surgical incisions, which reduces the risk of infection and shortens recovery time.
• It requires no implants and no radiation.
• The procedure requires only local anesthesia, so patients are relaxed and awake while the care team continuously monitors the patient’s comfort.
• The treatment usually takes only a few hours and most patients go home the same day.

There are some risks to the treatment. For short periods of time during the procedure, you may experience nausea, pain or other sensations. There is a risk of temporary or permanent numbness or tingling, unsteadiness, some abnormality in walking, or muscle weakness.

Before your procedure you will have an MRI, which your care team will use to pinpoint the area of your brain to be treated.

During the treatment, you will lie in an MRI scanner with your head fitted into a water-filled helmet. The helmet circulates cool water around your head to prevent overheating during the ultrasound. The energy is first applied at a low level and your doctor will ask you to provide feedback on the effect it has on your hand tremor.

You will be engaged throughout the process and may be asked to report the sensations you feel and to perform tasks such as writing or tracing lines to monitor improvement of your tremor. Your doctor will then adjust the focused ultrasound treatment in response to your input, increasing the energy level to perform the amount of ablation needed.

The focused ultrasound energy waves pass through the helmet to meet at the identified point in your brain. The energy makes a small lesion in the brain, targeting the tissue where the tremors originate.

After treatment, you’ll be moved to a recovery room for monitoring. Most patients go home the same day. Many return to work and other activities within a couple of days. You will receive specific discharge instructions from your doctor.

The University of Kansas Health System is the only medical center in the region that provides MRI-guided focused ultrasound to treat essential tremor and Parkinson’s disease with hand tremor as the primary symptom. Our health system is 1 of only 47 medical centers around the world that the Parkinson’s Foundation has designated a Center of Excellence for Parkinson’s disease care.

When you choose The University of Kansas Health System for MRI-guided focused ultrasound, you will be cared for by a team of neurologists who are specialists in their fields. A dedicated nurse navigator will help you as you go through the processes needed leading up to your treatment. Our neurology and neurosurgery program is nationally ranked by U.S. News and World Report.