A transformative medical procedure that uses sound waves to perform brain surgery without a single incision is offering new hope to individuals disabled by severe tremors. This innovative therapy, known as magnetic resonance (MR)-guided focused ultrasound, has already improved the quality of life for hundreds of patients suffering from essential tremor and tremor-dominant Parkinson’s disease. The treatment provides an immediate and significant reduction in symptoms for many, allowing them to reclaim the ability to perform simple daily tasks that had become impossible, such as drinking from a cup or writing their own name.
Health systems across the United States are increasingly adopting this technology, which represents a significant leap forward in non-invasive neurological treatment. Novant Health, a pioneer in the Southeast, has treated over 500 patients since late 2020, with one of its neurosurgeons, Dr. Charles Munyon, having performed more than 100 of the procedures himself. More recently, in July 2025, Corewell Health in Grand Rapids, Michigan, became the first in the state to offer the treatment, further expanding access to this life-altering surgery. The procedure gives a new option to patients whose tremors do not respond to medication and who may not be candidates for more invasive surgeries like deep brain stimulation.
An Inside Look at Incisionless Surgery
MR-guided focused ultrasound is a novel surgical technique that requires no cuts to the skin, scalp, or skull. Instead, the technology harnesses the power of approximately 1,000 highly focused ultrasound waves, directing them to a precise point deep within the brain. Neurosurgeons target a specific area of the thalamus, a structure involved in the brain circuitry that causes tremors. By focusing the sound waves, the temperature at the target location is raised, creating a tiny lesion that interrupts the abnormal signals responsible for the shaking.
The entire procedure is guided in real-time by magnetic resonance imaging, which allows the surgical team to visualize the brain and monitor temperature changes with immense precision. This ensures the lesion is created exactly where intended, without affecting surrounding healthy tissue. The outpatient procedure typically takes only one to two hours to complete, and because it is non-invasive, it carries a lower risk of complications compared to traditional open-brain surgery.
The Patient’s Journey to a Steadier Hand
For those undergoing the procedure, the experience is often described as remarkable. Patients are awake and alert throughout the surgery, providing immediate feedback to the medical team. Surgeons often test the patient’s ability to draw spirals or straight lines during the treatment, observing the dramatic improvement as the tremor subsides in real-time. The reduction in tremor is typically immediate and profound, with many patients leaving the hospital with a steady hand for the first time in years.
Preparation and Recovery
One of the main requirements for the procedure is that the patient’s head must be shaved to ensure the ultrasound waves can pass through the skull without distortion. After the surgery, some patients may experience temporary side effects, such as imbalance, discoordination, or a tingling sensation on the treated side of the body. However, these effects are often manageable and resolve on their own. According to Dr. Munyon, there is about a 3% risk of long-term side effects. Most patients can return to their normal activities shortly after the procedure, without the lengthy recovery time associated with conventional surgery.
Expanding Access and Improving Technology
The availability of focused ultrasound is growing, with medical centers like Novant Health and Corewell Health leading the way in providing this advanced treatment. Novant Health, the only hospital system in the Southeast offering the procedure for both essential tremor and Parkinson’s-related tremors, has established itself as a high-volume treatment center. In early 2024, the health system upgraded to the more technologically advanced Exablate Prime system, making the treatment even faster for patients.
The technology, developed by companies like Insightec, is now in use at nearly 90 centers in the Americas and has been used in over 22,000 procedures globally. This wider adoption is crucial for the estimated 7 million Americans who suffer from essential tremor, a condition that can be debilitating and progressive. In December 2022, the FDA also approved a staged treatment for the second side of the body, meaning patients can eventually have the tremors in both hands treated.
Clinical Efficacy and Long-Term Outlook
The results of incisionless brain surgery are not only immediate but also lasting. Studies have shown that patients experience, on average, a 73% improvement in their tremors at a five-year follow-up. This sustained relief can be life-changing, restoring a patient’s independence and allowing them to return to hobbies and activities they once loved. For individuals like 73-year-old Don Stadt, who had been unable to sign his name or hold a coffee cup, the procedure was nothing short of miraculous, allowing him to regain control of his life.
While the procedure is highly effective, it is not considered a cure for essential tremor or Parkinson’s disease. It is designed to alleviate the symptoms of tremor, significantly improving a patient’s quality of life. The treatment offers a powerful new option for those whose condition is resistant to medication, providing a less invasive alternative to deep brain stimulation, which requires the surgical implantation of a device in the brain.
The Future of Focused Ultrasound
The potential applications for MR-guided focused ultrasound extend far beyond the treatment of tremors. Researchers are actively investigating its use for a variety of other neurological and medical conditions. Early clinical trials have shown success in treating patients with severe obsessive-compulsive disorder, certain pain disorders, and epilepsy.
One of the most promising areas of research involves using focused ultrasound to temporarily disrupt the blood-brain barrier. This could revolutionize cancer treatment by allowing chemotherapy drugs to more effectively reach tumors within the brain. As the technology continues to evolve, this form of “electronic scalpel” may one day make many forms of traditional, open surgery obsolete, heralding a future where major operations can be performed without a single cut.