Focused Ultrasound

Focused ultrasound thalamotomy is a more recent incisionless surgical option. A surgeon uses magnetic resonance imaging (MRI) to send sound waves through the skin and skull that target the thalamus. The sound waves generate heat that destroys the brain tissue that causes the tremors. The treatment is:

• Incision-free (no scalpels or open surgery)
• Performed while the patient is awake
• Often provides immediate results
• Requires little to no recovery time

Many patients walk out of the treatment room with noticeably steadier hands—often after just one session.

Who Is a Candidate for Focused Ultrasound?

Focused ultrasound is FDA-approved for patients with:

• Essential tremor
• Tremor-dominant Parkinson’s disease

It’s an excellent option for those who:

• Have not responded well to medications
• Want to avoid traditional brain surgery
• Prefer a quick recovery time

What can a patient expect during a focused ultrasound procedure?

Focused ultrasound is a two-hour procedure during which a patient lies in an MRI machine. The patient remains awake, which helps the neurosurgeon control the intensity and location of the sound waves so the treatment can be customized to each person. By the time the person comes out of the MRI, the tremor has been suppressed. 

What are the latest advances in focused ultrasound technology?

As of 2023, Columbia has expanded the focused ultrasound program to include staged bilateral procedures, allowing patients with tremor in both hands to be treated on each side of the brain, nine months apart per FDA guidelines. By 2026, Columbia will begin to treat additional Parkinson’s symptoms beyond tremor using newly FDA-approved technology targeting the pallidothalamic tract.

Dr. Baltuch: A Leader in Essential Tremor Care

Dr. Gordon Baltuch is a pioneer in using focused ultrasound for essential tremor and has dedicated his career to improving the lives of patients with movement disorders. Since joining Columbia Neurosurgery, he’s continued to lead innovation in non-invasive neurosurgical care—and his recent 500th procedure is a testament to that commitment.

Learn more about this treatment in our video interview with one of Dr. Gordon Baltuch's essential tremor patients.