Using Focused Ultrasound to Treat Tremor Disorders

Spend a day watching Gordon Baltuch, MD, PhD, at work in the ultrasound suite and it is easy to believe the neurosurgeon is at least part magician.

“For people with tremor, the result is instantaneous. They go into a machine, then they come out with a functional hand that doesn’t shake anymore,” says Dr. Baltuch, who joined VP&S to expand his pioneering work in the use of focused ultrasound to treat symptoms of essential tremor and Parkinson’s disease. 

“It seems like magic.”

The technology behind focused ultrasound—a relatively new non-surgical treatment for essential tremor—is not based on magic, of course, but on physics and neuroscience. 

Treatments of movement disorders seek to disrupt circuitry in the brain that is causing the tremor. But unlike deep brain stimulation, in which wires are surgically implanted in the brain to interrupt the circuits electronically, focused ultrasound accomplishes the same thing by directing soundwaves to the affected area. No surgery is needed.

Formerly director of the Penn Center for Functional and Restorative Neurosurgery, Dr. Baltuch has long been considered one of the nation’s leading-edge neurosurgeons, particularly in the use of deep brain stimulation to reduce tremor and other motor symptoms in people with movement disorders.

When focused ultrasound was approved in 2016 to treat essential tremor, Dr. Baltuch was eager to add the procedure to his repertoire. He developed Penn’s focused ultrasound program and has performed the procedure hundreds of times, with positive results. 

At Columbia, Dr. Baltuch is co-chief of the Division of Functional Neurosurgery and professor of neurosurgery at VP&S.

Focused ultrasound is available only at select medical centers. Even though no incisions are made during focused ultrasound, only highly trained neurosurgeons can perform the procedure, in which sound waves are directed at the brain while the patient is inside an MRI machine. 

Crucially, the patient is awake, which enables the neurosurgeon to control the intensity and location of the treatment, customizing the technique to each unique brainscape. 

“You’re in an area of very high-priced real estate,” Dr. Baltuch says. “You can see where you’ve targeted and whether you’re suppressing the tremor before the patient leaves the machine. With focused ultrasound, you’re going to produce a result as good, if not better, than traditional techniques and much more safely.”

Dr. Baltuch has successfully performed the outpatient procedure on patients ranging in age from 21 to 94. And he is excited about what the treatment can mean for the nation’s approximately 12 million people with essential tremor and 1.5 million with Parkinson’s.

“Anyone who has essential tremor is a candidate for this procedure,” says Dr. Baltuch. “Typically, they’ve tried medications, and the medications have either stopped working or caused bad side effects.

“In medicine, it’s very rare to see such immediate effects from a treatment. To witness how people are changed: It’s just a complete privilege to be able to do this for people.” 

— Tom Mellana


For more information or to refer a patient, call (212) 305-7349 or email