Ultrasound, long regarded as a diagnostic mainstay, is now poised to reshape how the medical community approaches treatment, particularly in the field of neurology. In a keynote presentation at the American Institute of Ultrasound in Medicine (AIUM) annual meeting, Dr. Ali Rezai of West Virginia University offered a compelling overview of how focused ultrasound is rapidly gaining traction as a therapeutic tool. His message was clear: the future of ultrasound will not be limited to imaging. It will play an increasingly vital role in treating complex brain disorders.
The use of focused ultrasound, whether high- or low-intensity, is opening new avenues in managing diseases like Parkinson’s, Alzheimer’s, epilepsy, and even addiction. These technologies deliver targeted soundwaves to precise regions of the brain, allowing clinicians to modify neural activity, open the blood-brain barrier for drug delivery, or ablate diseased tissue, all without a surgical incision.
High-intensity focused ultrasound (HIFU), which uses frequencies ranging from 20 kHz to 200 MHz, is already being used to treat patients with movement disorders such as essential tremor and Parkinson’s disease. The procedure is performed under MRI guidance, with patients wearing a specialized helmet containing around 1,000 ultrasound transducers. These transducers concentrate energy on specific brain structures involved in abnormal motor control. According to Dr. Rezai, patients often see immediate improvement, regaining function within hours and returning home the same day, an outcome that significantly reduces both recovery time and risk.
On the other end of the spectrum, low-intensity focused ultrasound (LIFU) is being investigated for its ability to transiently open the blood-brain barrier, which is a major challenge in the treatment of central nervous system conditions. This technique allows therapeutic agents that would otherwise be blocked to reach their targets more effectively. One area of active research is Alzheimer’s disease. Clinical trials suggest that LIFU can reduce amyloid plaque burden, a hallmark of the disease, simply by enabling targeted delivery or enhancing the brain’s own clearance mechanisms. In one study led by Dr. Rezai, patients receiving both focused ultrasound and anti-amyloid antibody therapy experienced greater reductions in plaque levels with minimal side effects.
LIFU is also being explored for neuromodulation—altering brain activity to treat psychiatric and behavioral disorders. By targeting deep brain structures involved in reward and craving, ultrasound has the potential to help patients with substance use disorders or behavioral addictions. Preliminary data from a small clinical study show that even a single treatment session aimed at the brain’s nucleus accumbens reduced cravings, with some patients reporting sustained effects.
Dr. Rezai emphasized that these breakthroughs are not theoretical. His team at the Rockefeller Neuroscience Institute is performing these procedures weekly, and demand is increasing. “We’re in desperate need for therapeutic strategies because people are living longer,” he said.
As this field matures, the implications extend far beyond traditional neurology. Focused ultrasound for therapeutic use is drawing interest from neurosurgeons, psychiatrists, biomedical engineers, and data scientists. The integration of real-time imaging, precision targeting, and noninvasive energy delivery makes it a uniquely versatile platform. It may not be long before therapeutic ultrasound becomes a standard tool in multidisciplinary care, ushering in a new era where sound not only reveals what’s happening inside the body but also helps restore function and quality of life.
The future is very bright for therapeutics and using focused ultrasound
— Dr. Ali Rezai
Cynthia Owens, BA, is the Publications Coordinator for the American Institute of Ultrasound in Medicine (AIUM).