High-Intensity Focused Ultrasound (HIFU) Treatment

How HIFU Works

During HIFU treatment, multiple ultrasound beams are focused on a specific target in the thalamus region of your brain—the area where tremor signals originate. The principle is similar to using a magnifying glass to focus sunlight: while individual ultrasound beams pass harmlessly through tissue, their convergence at the focal point creates a therapeutic effect.

The focused ultrasound energy creates a small, precise lesion in the targeted brain tissue, interrupting the abnormal neural pathways that cause tremors. This targeted approach allows for symptom relief while preserving surrounding healthy brain tissue.

Real-Time Monitoring and Adjustment

Throughout the procedure, advanced MRI thermometry allows our team to:

• Monitor tissue temperature in real-time
• Verify lesion formation and size
• Assess immediate treatment response
• Make adjustments to optimize outcomes
• Ensure patient safety throughout the process

This real-time feedback system enables our specialists to customize treatment parameters for each individual patient, maximizing therapeutic benefit while minimizing any potential side effects.

Conditions Treated with HIFU

Our neurological specialists use HIFU to treat various tremor-related conditions, with particular success in the following areas:

Primary Conditions

• Essential Tremor – The most common movement disorder affecting hands, arms, and sometimes head and voice, particularly when performing specific tasks or holding positions
• Tremor-Dominant Parkinson’s Disease – Specifically targeting the tremor component of Parkinson’s disease while preserving other motor functions
• Medication-Resistant Tremor – For patients who haven’t responded adequately to traditional therapies or experience intolerable side effects
• Failed Deep Brain Stimulation – As an alternative for patients who are not candidates for or have not succeeded with DBS therapy

Special Considerations

HIFU may also benefit patients with:

• Bilateral tremors – Though typically treated one side at a time
• Functional tremors – In carefully selected cases where organic causes have been ruled out
• Secondary tremors – Related to other neurological conditions affecting the thalamus
• Medication-induced tremors – Particularly those caused by certain psychiatric medications

Treatment Success Rates

Clinical studies demonstrate impressive outcomes:

• 80-90% of patients experience significant tremor reduction
• 70-80% maintain improvement at 2-year follow-up
• Most patients can reduce or eliminate tremor medications
• Quality of life improvements are sustained long-term

Benefits of HIFU Treatment

Non-Invasive Advantages

• No incisions or surgery – Completely external treatment approach
• No anesthesia required – Patients remain awake and alert during the procedure
• No implanted devices – Eliminates risks associated with hardware complications
• Immediate results – Many patients experience tremor improvement during the procedure
• Minimal downtime – Return to normal activities within days, not weeks

Clinical Benefits

• Precise targeting – MRI guidance ensures accuracy within millimeters
• Reduced side effects – Lower risk profile compared to traditional surgery
• Long-lasting relief – Durable symptom improvement for most patients
• Improved quality of life – Restored ability to perform daily activities

What to Expect During HIFU Treatment

Pre-Procedure Evaluation

Your journey begins with a comprehensive neurological assessment, including:

• Complete medical history and physical examination
• Tremor severity assessment using validated scales (CRST, TETRAS)
• Neuropsychological testing to establish baseline cognitive function
• CT scan to evaluate skull density ratio (SDR) for treatment feasibility
• Advanced brain MRI for detailed treatment planning and target identification
• Multidisciplinary team review to confirm candidacy and optimize treatment approach

The Day of Treatment

Preparation Phase (30-45 minutes)

• Arrival and pre-procedure check-in
• Final neurological assessment and tremor documentation
• Head shaving in the treatment area (if required)
• Administration of anti-anxiety medication if needed
• Attachment of the stereotactic head frame for precise positioning

The Treatment Process (3-4 hours total)

1. Setup and Positioning – Comfortable positioning in the MRI scanner with the specialized transducer helmet
2. Initial Imaging – High-resolution MRI to confirm target location and treatment parameters
3. Low-Energy Test Treatments – Gradual energy delivery to test patient response and refine targeting
4. Tremor Assessment – Real-time evaluation of tremor improvement between energy deliveries
5. Progressive Energy Increase – Stepwise increases in ultrasound energy to optimize treatment effect
6. Final High-Energy Treatment – Definitive treatment delivery once optimal parameters are established
7. Immediate Post-Treatment Imaging – Confirmation of lesion creation and treatment success

Advanced Monitoring During Treatment

Our state-of-the-art system provides:

• Continuous vital sign monitoring throughout the procedure
• MRI thermometry to track tissue temperature changes in real-time
• Immediate tremor assessment using standardized rating scales
• Patient comfort monitoring with regular check-ins and adjustments
• Neurological testing between treatments to assess function and side effects

Recovery and Results

Immediate Post-Procedure (2-4 hours)

• Recovery in a comfortable observation area
• Neurological assessment to document immediate improvement
• Light refreshments and hydration
• Final MRI scan to confirm treatment success
• Discharge planning and follow-up scheduling

Short-Term Recovery (1-2 weeks)

• Most patients notice immediate tremor improvement
• Gradual reduction in any temporary side effects
• Return to normal daily activities within 24-48 hours
• Medication adjustments may be initiated by your neurologist
• Follow-up appointment to assess progress and address any concerns

Long-Term Benefits (3-12 months)

• Continued improvement often occurs over several months
• Maximum benefit typically achieved within 3-6 months
• Potential for medication reduction or elimination
• Sustained quality of life improvements
• Annual follow-ups to monitor long-term outcomes

Patient Candidacy

HIFU may be appropriate for you if:

• You have medically confirmed essential tremor or Parkinson’s disease diagnosed by a movement disorder specialist
• Tremors significantly interfere with daily activities such as eating, writing, or drinking
• You’ve tried at least two different medications without adequate symptom control
• You prefer to avoid traditional brain surgery or are not a candidate for deep brain stimulation
• You have realistic expectations about treatment outcomes and potential limitations

Special Population Considerations

Elderly Patients: Age alone is not a contraindication, but overall health status and cognitive function are carefully evaluated.

Bilateral Tremors: Typically treated one side at a time, with the dominant hand treated first. A waiting period of 3-6 months is usually recommended before considering treatment of the second side.

Parkinson’s Disease: Best results are seen in patients with tremor-dominant Parkinson’s disease. Patients with significant bradykinesia or rigidity may not be ideal candidates.

Why Choose The Morrison Clinic® for HIFU

Expertise and Experience

Our neurological team brings extensive experience in advanced tremor treatments, including pioneering work in non-invasive brain therapies. We’ve successfully treated numerous patients with HIFU, helping them regain control of their lives.

Comprehensive Care Approach

We believe in personalized treatment plans that consider your unique circumstances, symptoms, and goals. Our multidisciplinary team works collaboratively to ensure you receive the most appropriate treatment option.

State-of-the-Art Technology

Our facility is equipped with the latest HIFU technology, ensuring precise treatment delivery and optimal patient outcomes. We maintain the highest standards of safety and efficacy in all our procedures.

Patient-Centered Focus

From your initial consultation through post-treatment follow-up, we prioritize your comfort, understanding, and successful treatment outcome. Our team is committed to supporting you throughout your journey to tremor relief.

Frequently Asked Questions

Is HIFU painful? Most patients report minimal discomfort during the procedure. Some may experience mild sensations such as warmth, tingling, or brief headaches during energy delivery, but these are generally well-tolerated. We provide anti-anxiety medication and frequent comfort checks throughout the treatment.

How long do results last? Clinical studies show that tremor improvement from HIFU can be long-lasting, with many patients experiencing sustained benefits for years after treatment. Research indicates that 70-80% of patients maintain significant improvement at 2-year follow-up, with some studies showing benefit lasting 5+ years.

Can the procedure be repeated? In some cases, HIFU can be repeated if tremors recur or if initial treatment provides partial benefit. However, repeat treatments are carefully evaluated on a case-by-case basis, considering factors such as previous response, current symptoms, and anatomical considerations.

Will I need to continue medications? Many patients can significantly reduce or eliminate tremor medications after successful HIFU treatment. However, this process should be gradual and always supervised by your neurologist. Some patients may continue low-dose medications for optimal tremor control.

What are the potential side effects? Common temporary side effects may include:

• Mild headache (resolves within 24-48 hours)
• Slight numbness or tingling in the treated hand
• Mild balance issues (typically resolve within days)
• Temporary fatigue

Serious complications are rare but can include:

• Permanent weakness or numbness
• Speech difficulties
• Balance problems
• Cognitive changes

How does HIFU compare to deep brain stimulation (DBS)? HIFU offers several advantages over DBS:

• No surgery or implanted hardware
• Immediate results without device programming
• No risk of infection or hardware malfunction
• No need for battery replacements
• Can be performed as an outpatient procedure

However, DBS may be preferred for:

• Patients who want reversible treatment
• Those with bilateral tremors requiring treatment of both sides
• Patients with multiple Parkinson’s symptoms beyond tremor

Am I too old for HIFU treatment? Age alone is not a contraindication for HIFU. We’ve successfully treated patients in their 80s and 90s. The key factors are overall health status, cognitive function, and ability to cooperate during the procedure.

What should I expect in terms of recovery time? Most patients return to normal activities within 24-48 hours. Unlike traditional brain surgery, there are no incisions to heal, no risk of infection, and no need for extended recovery. You may experience some fatigue for a few days, which is normal after any medical procedure.

Will my insurance cover HIFU treatment? HIFU for essential tremor and Parkinson’s disease is FDA-approved and increasingly covered by insurance providers, including Medicare. Our financial counselors work with patients to verify coverage and explore payment options.

How do I know if I’m a good candidate? The best way to determine candidacy is through a comprehensive evaluation by our movement disorder specialists. This includes medical history review, neurological examination, tremor assessment, and imaging studies. We’ll discuss all treatment options and help you make an informed decision.

Take the Next Step Toward Tremor Relief

If you’re ready to explore whether HIFU treatment is right for your tremor condition, Morrison Clinic™ is here to help. Our experienced neurological team will conduct a thorough evaluation to determine if you’re a candidate for this innovative treatment.

Don’t let tremors control your life any longer. Contact Morrison Clinic™ today to schedule a consultation and learn more about how HIFU can help you regain the stability and confidence you deserve.

Schedule Your Consultation Call us at (561) 485-4104 or fill out the form below to request an appointment. Our patient care coordinators will help you understand the process and answer any questions you may have about HIFU treatment.