MR-guided Focused Ultrasound (MRgFUS) for Essential Tremor

If you are one of the one million people in the UK affected by essential tremor, you will know just how disruptive and debilitating it can be. Simple tasks like signing your name, drinking a glass of water or using your touchscreen phone become impossible without frustration or embarrassment.

But there is hope. For patients with a moderate or severe tremor that has not responded to medication, MR-guided focused ultrasound (MRgFUS) is a safe, cutting-edge new treatment that can help you regain control of your life again.

What is MR-guided focused ultrasound?

MR-guided focused ultrasound is a safe, incision-less procedure for the treatment of essential tremor. 

It combines two technologies — high intensity focused ultrasound (FUS) is guided by magnetic resonance imaging (MRI) to destroy a small area of tissue in the brain responsible for the tremor. 

The outpatient procedure takes about 3–4 hours and results are comparable to deep brain stimulation (DBS) — but without the risks of general anaesthesia and invasive surgery. 

In successful procedures, patients see an average improvement of 75% in their hand tremor.

About essential tremor

Essential tremor is a neurological movement disorder that affects one million people in the UK and millions more worldwide.

People with essential tremor (ET) experience a rhythmic trembling that can affect their hands, head, legs, trunk and voice. Although it is commonly experienced in older individuals, essential tremor can affect anyone of any age, gender or race, and can begin as early as birth.

Sometimes confused with Parkinson’s disease, essential tremor is 8–10 times more common than Parkinson’s. It is a progressive neurological disorder, which means that essential tremor can become more severe over time, causing individuals to experience progressively worse symptoms that can have a debilitating impact on their quality of life.

While medication is the first line of treatment, an estimated 50% of people with essential tremor either do not find sufficient relief or experience too many side effects from the medication. For these individuals, more intensive essential tremor treatment options — including deep brain stimulation and MR-guided focused ultrasound — might be necessary.

Learn more about the symptoms, causes and treatment of ET in our essential tremor guide.

Benefits of MR-guided focused ultrasound for essential tremor treatment

  • Incision-free
  • Low to no risk of infection
  • Fast recovery
  • Immediate results
  • No hospitalisation

How it works

In a traditional ultrasound, sound waves pass safely through the body to generate an image. The most commonly known example of this is an ultrasound image of unborn babies. 

In focused ultrasound (FUS), the same sound waves are used, but a special device focuses the energy from over 1000 ultrasound sources, creating a point of intersection in a very precise spot in the thalamus. The focused ultrasound waves generate enough heat at this intersection point to create a permanent lesion in the brain tissue, interrupting the circuitry that is responsible for the tremor. 

The MRI acts as the ‘eyes’ of the neurosurgeon, allowing them to see the brain in real-time, accurately pinpoint the correct target location and monitor the temperature of the ultrasound waves.

About the procedure

The MR-guided focused ultrasound treatment will be carried out using our brand-new, start-of-the-art equipment at the Queen Square Imaging Centre. 

Our friendly and professional staff will explain every step of this essential tremor treatment and ensure your comfort in every way possible. 

Before the procedure, you will have your head shaved to prevent any obstruction of the sound waves. You will be given a local anaesthetic in the skin around your scalp so that a frame can then be secured to your head.  This frame ensures that your head remains completely still while in the MRI machine. During the procedure, you will be awake, which is essential for targeting the right area of the brain, assessing your improvement and minimising any potential side effects. 

Throughout the treatment, you will be moved into and out of the MRI machine and asked to do simple tasks like drawing a spiral to assess your improvement. Our team will talk to you throughout the procedure and will be able to answer any questions or concerns you may have.

The results

Individual results may vary, but patients reported an average of 76.5% improvement in tremor severity in clinical studies. Patients who were unable to sign their name or drink a glass of water without spilling before entering the MRI scanner find themselves able to do these simple, everyday tasks immediately after the procedure.

Clinical studies show that tremor improvement was mainly maintained three years after the procedure.

Because the treatment does not involve incisions or general anaesthesia, you can typically return to your regular routine after one day, and no hospital stay is necessary.

Although MR-guided focused ultrasound is not a cure and does not treat the underlying cause of essential tremor, this essential tremor treatment offers hope for patients whose hand tremor has made everyday tasks difficult. The results have been life-changing for the more than 3,500 patients who have undergone the treatment since its approval.

spiralgraphic (1)

MR-guided focused ultrasound is considered a safe and effective treatment for essential tremor.

As with any surgical procedure, there are some risks, and your medical team can discuss those with you. Although the treatment is generally painless, some patients report mild headaches or dizziness during the procedure.

Most side effects, or adverse effects, occur within 30 days of the treatment. These might include:

  • Imbalance/gait disturbance
  • Numbness or tingling
  • Muscle weakness
  • Slurred speech

    Although most reported side effects were reported as mild and resolved themselves in 30 days, there is a slight chance that some adverse effects could be permanent.

    Overall, MR-guided focused ultrasound is a safe and non-invasive treatment for essential tremor. Compared to deep brain stimulation, MR-guided focused ultrasound offers comparable results with a reduced risk of infection and bleeding, and no damage to the non-targeted area.

Our expert team

At the Queens Square Imaging Centre, we have a unique partnership with the National Hospital for Neurology and Neurosurgery (NHNN) — the UK’s largest dedicated neurological and neurosurgical hospital.

All MR-guided focused ultrasound treatments will be performed by a multidisciplinary team of expert partners from the NHNN.

Zrinzo Ludvic

Professor Ludvic Zrinzo

Consultant Neurosurgeon

Hyam

Mr Jonathan Hyam

Consultant Neurosurgeon

Akram_H__pic square

Mr Harith Akram

Consultant Neurosurgeon

Limousin

Professor Patricia Limousin

Consultant Neurologist

Foltynie

Professor Tom Foltynie

Consultant Neurologist

Transparent fixed-price packages

We offer a fully transparent, fixed-price service. The MR-guided focused ultrasound treatment is broken down into two distinct packages.

Our fixed price pre-assessment package includes:

  • A clinical examination
  • Multidisciplinary team meetings to discuss your suitability
  • All relevant diagnostic investigations (blood tests, MRI scan, CT scan)

Our MR-guided focused ultrasound treatment package includes:

  • Outpatient procedure
  • Follow-up appointment

Call today to learn more about our fixed-price packages for essential tremor treatment.

Frequently asked questions

If you have essential tremor and medication is either not effective or you cannot tolerate the side effects, then you might be a candidate for MR-guided focused ultrasound (MRgFUS).

You should first speak to your neurologist to discuss all your treatment options, but the neurological team at Queen Square Imaging Centre will ultimately assess your suitability.

Call today to speak with a member of our team about our fixed-priced pre-assessment package.

About Queen Square Imaging Centre

Providing specialist diagnostic imaging in Queen Square since 1985

The Queen Square Imaging Centre is Central London’s only dedicated independent neuroimaging facility.

With a specialist focus on the brain, spine and nervous system, our expert team of radiographers and highly specialised Consultant Neuroradiologists use our brand-new, state-of-the-art CT and MRI scanners to ensure that your scan and report are of the highest quality.

We work in partnership with the National Hospital for Neurology and Neurosurgery specialists to offer self-pay and insured patients fast access to high-quality examinations in unrivalled patient comfort and safety.

Make an enquiry

If you would like to find out more information about our MRI services please contact us using the form below.

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