Focused
Ultrasonic

With HiFUS, we precisely target specific brain disorders with focused ultrasound waves – such as essential tremor, Parkinson's disease, or other movement disorders. This is done without opening the skull or damaging the surrounding tissue.

High-intensity focused ultrasound (HIFUS), what is it?

Dear readers: The information presented here is for general guidance only and is not a substitute for a personal or therapeutic consultation. Please feel free to contact us directly if you have any questions.

Focused ultrasound – correctly termed high-intensity focused ultrasound (HiFUS) – is a modern procedure for treating brain disorders. Sound waves are focused and precisely directed to a defined region in the brain. Terms like FUS or MRgFUS (MR-guided focused ultrasound) are also used in this context – they all refer to the same procedure. Unlike traditional neurosurgical operations, this procedure does not require opening the skull.

The innovative HiFUS technology uses the energy of ultrasound waves to treat small areas in the brain with pinpoint accuracy – leaving the surrounding healthy tissue unharmed.

Applications of HiFUS

Focused ultrasound is used in a number of neurological conditions:

  • Essential tremor:
    Uncontrollable trembling of the hands, often during everyday movements
  • Parkinson's tremor:
    Tremors as a symptom of Parkinson's Disease 
  • Parkinson's disease:
    Various conditions, mostly occurring predominantly on one side of the body (reduced or increased mobility, muscle stiffness), can be treated
  • Movement disorders:
    Involuntary movements of various kinds
  • Neuropathic pain:
    Persistent pain resulting from nerve damage 

What happens during focused ultrasound treatment?

  • Ultrasound waves are sound waves that lie beyond the human hearing threshold and are therefore not perceived
  • During the treatment, several hundred individual ultrasound waves are precisely directed at a small target point in the brain
  • Where the sound waves converge, the tissue heats up locally to around 60 °C
  • This heat generation causes a controlled, precise and permanent elimination of nerve cells in the target area, which is only a few millimeters in size
  • The adjacent tissue remains unaffected

How HiFUS works and the treatment process

  • The actual treatment usually lasts about two to four hours.

  • At the beginning, the shaved head is fixed in a special stereotactic frame to precisely align the ultrasound waves. This is done with local anesthesia at four points.

  • Following this, a MRI performed to determine the exact target area inside the brain.
  • During the actual treatment, the patient remains awake and can speak with the doctors.

  • Vital signs (heart rate, blood pressure and blood oxygen levels) are continuously monitored during treatment. 

  • First, a test heating is carried out, in which the temperature in the tissue is only slightly increased to approximately 41–43 °C.
  • If the result is satisfactory, the target area is further heated to 56–58 °C, thereby permanently switching off a small area of ​​about 2 mm in diameter.

  • The effect is immediate in cases of essential tremor and Parkinson's disease, while symptom relief in neuropathic pain develops gradually over weeks to months.

Advantages over conventional methods

Treatment with focused ultrasound offers the following advantages compared to conventional neurosurgical procedures:

  • No surgery required: The skull is not opened
  • No radiation exposure
  • Short inpatient Stay
  • Low complication rate
  • Rapid recovery
  • Precise action and continuous MRI monitoring
  • Immediate symptom control, treatment success immediately detectable

Potential risks

The possible side effects of MRgFUS treatment are usually mild and often temporary.

This includes:

  • Gait instability or Balance Disorder , which usually subsides within a few days to weeks
  • mild headaches or fatigue after treatment
  • A feeling of swelling or tension in the head due to the fixation, which usually subsides within a few hours after removal of the frame
  • Nausea or dizziness during or shortly after treatment
  • Post-bleeding (very rare)
  • Sensory disturbances such as numbness or tingling in the hands or face, depending on the chosen target point
  • Temporary speech disorders, which occur very rarely

In very rare cases, permanent side effects can occur if surrounding tissue is affected by the treatment.

Frequently Asked Questions

Most patients do not find the treatment itself painful. Occasionally, a slight sensation of warmth may occur.

Most patients experience an improvement immediately after treatment. The full effect may develop over several weeks.

No, a complete shave of the head is required for HiFUS treatment. During the treatment, the helmet containing the ultrasound sources is filled with water. A membrane seals the helmet, allowing the water to circulate between the inside of the helmet and your head. If the hair isn't shaved, air bubbles will become trapped in the stubble. This air would weaken the ultrasound waves. cereneo offers a partner salon to address this concern; they will be happy to advise you beforehand and discuss possible alternative solutions.

HiFUS treatment typically lasts between 2 and 4 hours, a large part of which takes place in the MRI scanner, where the ultrasound treatment is monitored.

Since the treatment takes place entirely within an MRI scanner, it can be challenging for those with claustrophobia. The use of sedatives is limited, as these can affect tremors and other symptoms, complicating safe treatment. Our experienced treatment team will be happy to discuss with you individually whether solutions can be found for your specific situation.

For patients with implanted pacemakers, treatment can only be performed if both the pacemaker and the electrodes are approved for MRI scans. If you have an implanted pacemaker, you will need to send a copy of your identification along with any relevant documents.

We conduct the preliminary examinations for treatment at our cereneo Clinic . Therefore, we require documentation from you regarding any pre-existing medical conditions and medications you are currently taking. Before treatment, we perform an MRI scan of the head and a special computed tomography scan of the head. A neurological examination documents the severity of your symptoms. Should we determine that, as an alternative to focused ultrasound treatment, you have a good chance of successful treatment without any intervention, using only medication, we would discuss this with you beforehand. A neuropsychological and a psychiatric evaluation are also necessary beforehand to assess tolerability and risks.

In Switzerland, treatment is generally covered by health insurance. However, as we are a private clinic , this would need to be clarified individually with your health insurance provider.

CERENEO PREVENTION