Focused Ultrasound for Movement Disorders: Evidence from a Systematic Review of Efficacy and Safety

Abstract

This systematic review evaluates the clinical efficacy and safety of focused ultrasound (FU) as a non-invasive neurosurgical modality for treating movement disorders, including Parkinson’s disease (PD), essential tremor (ET), and dystonia. FU enables precise targeting of deep brain structures without incisions or implanted devices, using advanced imaging guidance to ablate or modulate dysfunctional neural circuits. Magnetic resonance-guided focused ultrasound (MRgFUS), the most widely adopted technique, is examined in detail to assess therapeutic outcomes and procedural characteristics.

Recent clinical studies consistently demonstrate that MRgFUS offers significant symptom relief, particularly in tremor reduction, with a favorable safety profile. Compared to conventional lesioning surgeries, MRgFUS produces smaller, more controlled lesions, minimizing adverse effects while preserving surrounding tissue integrity. In PD patients, improvements in tremors and bradykinesia have been observed following unilateral MRgFUS, which is currently considered the standard approach. However, bilateral applications remain under active investigation due to concerns regarding cumulative risk and long-term neurocognitive outcomes.

Overall, MRgFUS represents a promising and precise intervention for select movement disorders, with growing evidence supporting its integration into neurosurgical practice. Further longitudinal studies are warranted to refine patient selection criteria, optimize targeting strategies, and evaluate the durability of clinical benefits.