Focused Ultrasound and Parkinson’s Disease: New Noninvasive Treatment Options

Parkinson’s disease (PD) is a progressive neurological disorder that affects movement and can dramatically impact quality of life. While medication remains the first-line therapy for most patients, many people eventually experience symptoms that are no longer well controlled with medication, such as tremor, rigidity, slowness of movement, and medication-related dyskinesia.

Focused ultrasound as a treatment for Parkinson’s disease recently received new attention when Rebecca King-Crews, wife of actor Terry Crews, detailed her focused ultrasound treatment for Parkinson’s-related tremor on TODAY, People.com, and other outlets, helping raise awareness of this emerging option.

Background

In the U.S., focused ultrasound has been helping to address a critical treatment need for years. This therapy was approved by the U.S. Food and Drug Administration (FDA) for tremor-dominant PD in 2018. Three years later, the FDA expanded its 2018 approval to include the treatment of mobility, rigidity, and dyskinesia symptoms.  

New Advances: Bilateral Treatment and New Target

In 2025, patients with PD benefitted from another significant step forward when the FDA approved bilateral focused ultrasound treatment. This approval meant that patients with certain expressions of PD now had the option to receive treatment on both sides of their brain in two sessions at least six months apart. This staged approach is designed to improve symptom control on both sides of the body while maintaining patient safety. The expansion is important because PD commonly affects both sides of the body, particularly as symptoms progress.

The latest approval is also different in that it specifically applies to targeting the brain’s pallidothalamic tract (PTT). Treating this target allows physicians to address a broader range of advanced motor symptoms, including rigidity and dyskinesia, in addition to tremor. This represents an important evolution in focused ultrasound therapy, expanding its potential benefit for patients with more complex or progressed Parkinson’s disease.

Additional Information for Patients

It is important to note that these current approved uses of focused ultrasound only address the symptoms of PD; they are not a cure for the primary disease. But for certain patients who need to address difficult symptoms, focused ultrasound offers a noninvasive alternative to surgery with a lower risk of complications and lower cost.

Patients who are interested in focused ultrasound for PD should talk to their neurologist about whether they may be a candidate for focused ultrasound. As of April 2026, staged bilateral treatment targeting the PTT is not covered by Medicare, although various parties are working toward reimbursement.

Treatment primarily targeting the ventral intermediate nucleus for Parkinsonian tremor is currently covered by Medicare in Alabama, Alaska, Arizona, California, Connecticut, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, Nevada, New York, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia, Wyoming.

Treatment targeting the globus pallidus for Parkinsonian dyskinesia is covered by Medicare in Connecticut, Illinois, Massachusetts, Maine, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin.  

Patients with medication-resistant movement disorders can take a short quiz on the Insightec website to see if they may be candidates. They can also speak with a program engagement team member at Insightec to learn more by calling 1-800-704-6797.

Tim Meakam, MD, is Co-Director of the Research and Education Team at the Focused Ultrasound Foundation.

Focused Ultrasound as a Therapeutic Tool

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.

Used with permission from AuntMinnie.com

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).