[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/share-dev.upmc.com\/2025\/07\/focused-ultrasound-tremor-treatment\/#Article","mainEntityOfPage":"https:\/\/share-dev.upmc.com\/2025\/07\/focused-ultrasound-tremor-treatment\/","headline":"What Is Focused Ultrasound? About This Innovative Treatment for Essential Tremor","name":"What Is Focused Ultrasound? About This Innovative Treatment for Essential Tremor","description":"

Focused ultrasound is a noninvasive treatment option for people with essential tremor. Learn how it works and who's a candidate.<\/p>","datePublished":"2025-07-24","dateModified":"2025-12-02","author":{"@type":"Organization","@id":"https:\/\/www.upmc.com\/services\/neurosurgery-regions","name":"Neurosurgery","url":"https:\/\/www.upmc.com\/services\/neurosurgery-regions","sameAs":"https:\/\/share-dev.upmc.com\/neurosurgery\/","parentOrganization":"UPMC"},"publisher":{"@type":"Organization","name":"UPMC HealthBeat","logo":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2025\/07\/GettyImages-1778188472-e1753297586782.jpg","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2025\/07\/GettyImages-1778188472-e1753297586782.jpg","height":856,"width":2000},"url":"https:\/\/share-dev.upmc.com\/2025\/07\/focused-ultrasound-tremor-treatment\/","about":["Health Topics A-Z","Neurosurgery and Brain Health"],"wordCount":1130,"articleBody":"If you have essential tremor, an innovative treatment known as focused ultrasound may help.Focused ultrasound is an incisionless, nonsurgical treatment option for essential tremor. It combines ultrasound and magnetic resonance imaging (MRI) technology. High-intensity, precisely targeted ultrasound waves create a lesion in the brain area that is causing the patient’s tremors.Although focused ultrasound can’t cure tremors permanently, it can reduce them significantly.\u201cWe never say that we can improve 100%, but what we see is a great improvement that’s probably higher than 80% tremor reduction,\u201d says Jorge Gonz\u00e1lez-Mart\u00ednez, MD, neurosurgeon and director, Epilepsy and Movement Disorders Division, UPMC Department of Neurosurgery.Learn more about focused ultrasound, how it works, and who\u2019s a candidate for it.Who Is a Candidate for Focused Ultrasound?People with essential tremor are potential candidates for focused ultrasound if multiple medications haven’t resolved their tremors.\u201cThat’s the first line for every surgical intervention: We try to control (the condition) with medication,\u201d Dr. Gonz\u00e1lez-Mart\u00ednez says. \u201cThey need to have a very fair try of medications before we indicate the focused ultrasound treatment.\u201dDeep brain stimulation (DBS) is another option for these patients. DBS is a more versatile procedure and doesn’t create a permanent lesion. Because of this, it’s often preferable, Dr. Gonz\u00e1lez-Mart\u00ednez says. However, not every patient can undergo DBS; those people may get better results from focused ultrasound.\u201cSome patients cannot undergo DBS because they cannot go through general anesthesia or they take blood thinners that can prevent them from an open procedure,\u201d he says. \u201cThose are the patients who are also optimal candidates for the focused ultrasound.\u201dFocused ultrasound requires MRI technology, so patients with metal in their bodies or who meet other MRI exclusion criteria can’t undergo the procedure. Patients with poor bone density are also poor candidates.Patients go through thorough testing to determine if they’re candidates. This testing includes a full neurology exam, MRI imaging, and a bone density test.How Does Focused Ultrasound Work?Focused ultrasound treats one side of the body at a time. On the day of the procedure, a member of your care team will completely shave your head. Hair can interfere with the ultrasound beams.Your team will give you local anesthesia before attaching a specialized crown-like device to your scalp. This device contains ultrasound transmitters and also allows the neurosurgeon to see the coordinates of the area responsible for the tremors inside your brain.You’ll then move to the treatment area where you’ll lie on a table that slides in and out of an MRI machine. Your neurosurgeon will stay in another room, seated at a computer. There, they can see the MRI images of your brain and control the ultrasound beams.When the procedure begins, the table will slide into the machine. The ultrasound waves converge on the area of your brain responsible for your tremors. They raise the temperature in that area high enough to create a lesion.The area of your brain targeted is 2 millimeters, or about the size of a standard pencil lead.After creating the lesion, your care team will test you to see if your tremor has improved. They’ll have you write your name, draw a spiral, or perform another simple task.\u201cIf the tremor is not improved or is only partially improved, we can repeat the procedure as many times as we judge necessary,\u201d Dr. Gonz\u00e1lez-Mart\u00ednez says. \u201cIn general, we repeat the procedure twice. Very rarely, we repeat it three times.\u201dPatients’ tremors often improve during the procedure itself.\u201cIt’s a light bulb switch: on and off,\u201d Dr. Gonz\u00e1lez-Mart\u00ednez says. \u201cThat’s the beauty of this treatment because they improve right away. They go home better.\u201dThe procedure lasts one to two hours, and patients can go home the same day. They can return a month or more later to have the procedure create a lesion on the other side of their brain.Because the target area is tiny, the procedure won’t harm any surrounding brain tissue.Is Focused Ultrasound Safe?Focused ultrasound creates a permanent lesion in your brain. If it creates the lesion in the wrong brain area, it can affect other brain and motor functions. That’s why surgical teams take great care and use advanced imaging to ensure they’re in the right place.\u201cThe smaller the lesion, the more precise you need to be,\u201d Dr. Gonz\u00e1lez-Mart\u00ednez says.As an added safety measure, your neurosurgeon will create a \u201ctest lesion\u201d before creating the permanent lesion. They’ll use the ultrasound beams to raise the temperature in the target area high enough for the neurons to stop working but not high enough to create a lesion. Then they’ll test the tremor.If they see an improvement in the tremor, that means they’re in the right place. If not, they can recalibrate the machine to target the correct area.Other side effects of the procedure are generally mild. They include:Balance issues.Changes in tasting ability.Dizziness.Headache.Nausea.Numbness or tingling in the lips, mouth, or tongue.Pain.Scalp irritation.Slurred speech.These side effects typically go away within a couple of weeks after the procedure.Dr. Gonz\u00e1lez-Mart\u00ednez says it’s important for patients to get focused ultrasound done at an experienced center.\u201cLike any other surgical procedure, it needs to be performed with very careful hands and minds,\u201d he says.Is Focused Ultrasound Effective?Focused ultrasound isn’t a cure \u2014 patients often need to redo the procedure several years later. However, it can improve tremors by 80% or more in the meantime.That can make a major difference for people living with essential tremor, Dr. Gonz\u00e1lez-Mart\u00ednez says. These people are living with constant tremors in their hands, arms, head, or other areas of their bodies. It can make eating, drinking, writing, and even talking difficult.\u201cThese people cannot do things (like) being able to eat their meals or being able to drink a cup of coffee without spilling all the coffee on their clothes because they are shaking, or even signing or writing,\u201d Dr. Gonz\u00e1lez-Mart\u00ednez says. \u201cSome people have speech problems, and they cannot talk normally because they have a tremor in their speech. These people cannot walk normally because they have tremor in their legs.\u201dFocused ultrasound can improve their tremor, leading to a better quality of life, Dr. Gonz\u00e1lez-Mart\u00ednez says.\u201cIf you reduce the tremor by 50%, they\u2019ll be very, very happy because no medication can provide that,\u201d he says. \u201cBut when they see the tremors improve 80%, it\u2019s kind of a dream for them.\u201dTo learn more about focused ultrasound at UPMC, visit our website.Sources"},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"2025","item":"https:\/\/share-dev.upmc.com\/2025\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"07","item":"https:\/\/share-dev.upmc.com\/2025\/\/07\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"What Is Focused Ultrasound? 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