A 72-year-old Air Force veteran was experiencing significant tremors from his Parkinson’s disease for nearly a decade until he underwent MRI-guided high-intensity focused ultrasound therapy in April of this year. Bud Leavell struggled with simple everyday tasks like eating with a fork or holding tools. He was diagnosed with Parkinson’s disease in 2017 and has been experiencing progressive tremors since then. Leavell was still tremor-free on his follow-up visit.

The outpatient procedure is not a cure for the disease, but it helps patients regain control of their movements. It does not require an incision, general anesthesia, or implanted hardware. Patients are awake inside an MRI scanner while a specialized helmet delivers more than 1,000 ultrasound beams through the intact skull. The beams precisely target the ventral intermediate nucleus of the thalamus for tremors, which is approximately the size of a grain of rice. Sometimes the target is the globus pallidus or pallidothalamic tract for broader motor symptoms.

The focused energy heats and destroys the tissue that generates abnormal signals, interrupting the pathway that produces tremors, stiffness, or slowness. Real-time MRI guides the procedure. Doctors deliver low-energy test pulses that temporarily reduce the tremor to confirm the target is correct before applying higher-energy pulses to create a permanent ablation.

“We’re using a higher energy to destroy small tracts in the brain, or small bundles of nerves,” explained Dr. Bhavya R. Shah, who leads the focused ultrasound program at UT Southwestern and treated Leavell. Results are often immediate, and many patients go home the same day.

The Exablate Neuro system from Insightec was approved by the FDA for medication-refractory essential tremor in 2016, tremor-dominant Parkinson’s in 2018, and expanded indications in 2021 for other Parkinson’s motor complications including rigidity, bradykinesia, and dyskinesia. In 2025, it was approved for staged bilateral treatment for advanced disease, now allowing treatment on both sides of the brain.

A randomized trial published in the New England Journal of Medicine showed focused ultrasound subthalamotomy significantly improved motor scores on the more affected side compared with the placebo. Other reviews show average tremor reductions of 40-70% and overall motor symptom improvements around 40% on standardized scales like the MDS-UPDRS. Benefits can last for months to years in patients, but some experience partial relapse. The treatment only manages symptoms and does not prevent disease progression.

Jimmy Hiner was the first patient in Texas to receive the technology at UT Southwestern for essential tremor, which he had experienced for decades. Within about 45 minutes, the shaking disappeared, and he celebrated by eating chocolate cake, which he previously couldn’t do. Joyce Clifton experienced 25 years of essential tremor until she underwent the procedure in 2025. She was immediately able to draw a straight line and legibly write her name for the first time in years. Other patients have been able to hold cell phones, pour drinks, or smile again shortly after receiving the treatment.

“It feels like a miracle. My tremor has completely gone – it’s as though I never had it. I’m now able to do exactly what I could before,” said patient Ian Keir after receiving the treatment in 2024. “I can pour a jug of water, my handwriting is back, and I’m now able to do things without thinking about them beforehand. Now I’m able to cut my own food. I was obviously nervous, but the improvement was almost immediate. While I’m aware this isn’t a cure for Parkinson’s, it is a cure for some of my symptoms. I’m so grateful and just want to make the most of every day.”

Side effects of the treatment can include imbalance, speech changes, numbness, or sensory changes. These side effects are usually temporary, but can sometimes continue for longer periods of time. Candidates for this treatment are usually those who have medication-refractory or asymmetric symptoms. Teams of neurologists, neuroradiologists, and neurosurgeons carefully select patients for the treatment.

“Side effects occur approximately 20% to 30% of the time and generally improve over time,” Dr. Shah told Fox News.

Anette Schrag, PhD, a professor of clinical neurosciences at University College London, said the treatment has short-term efficacy, but one-third of patients in the treatment group did not respond at three months, and only one-third had improved motor function and reduced dyskinesia. Dr. Shrag said side effects are mild or moderate, but the procedure still carries risk, even though it is incisionless.

“The results suggest that not all patients derived a meaningful benefit from the intervention,” Dr. Schrag said. “The results of this trial are promising, but given the non-reversible nature of the intervention and the progressive nature of the disease, it will be important to establish whether improvements in motor complications are maintained over longer periods and whether treatment results in improved overall functioning and quality of life for patients.”

“While this is not a panacea for Parkinson’s, it is a dramatic and life-changing procedure,” Dr. Shah said.

Steven Middendorp

Steven Middendorp is an investigative journalist, musician, and teacher. He has been a freelance writer and journalist for over 20 years. More recently, he has focused on issues dealing with corruption and negligence in the judicial system. He is a homesteading hobby farmer who encourages people to grow their own food, eat locally, and care for the land that provides sustenance to the community.

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