Increased Awareness for Essential Tremor Treatment, MR-guided Focused Ultrasound: Justin Martello, MD

WATCH TIME: 5 minutes

"It’s true, you’re less of a surgical candidate the more medical issues you have and the older you are. There’s no technical age limit for either procedure, but if you have [comorbidities] going through a more invasive procedure like DBS is less appealing, and you may be less able to go through with it surgically compared [with] focused ultrasound, which is completely outpatient."

MR-guided focused ultrasound is an emerging, noninvasive neurosurgical technique that enables precise targeting of deep brain structures without incisions, potentially offering immediate therapeutic effects for patients. Currently, high-intensity forms of MR-guided focused ultrasound are approved for treating medication-refractory Parkinson disease and essential tremor through targeted thermoablation while its low-intensity counterpart holds promise as a research and clinical tool for noninvasively modulating brain activity and function.¹

At the 4th Annual Advanced Therapeutics in Movement and Related Disorders (ATMRD) Congress, held by the PMD Alliance from June 27-30, 2025, Justin Martello, MD, gave a talk on the clinical applications and patient selection criteria for MR-guided focused ultrasound, along with an overview of the procedure, underlying mechanisms, safety considerations, and future directions.²To dive into a deeper discussion on MR-guided focused ultrasound as a potential treatment for patients, Martello, movement disorders neurologist at Christiana Care Health System, sat down with NeurologyLive^®.

During the conversation at the meeting, he explained how patient selection can be guided by skull density ratio via specialized CT imaging, and why MR-guided focused ultrasound may be favored over deep brain stimulation, especially among older adults or those with significant medical comorbidities. Additionally, Martello emphasized the importance of providing patients with a balanced education about both treatment options and outlined how his institution integrates counseling and procedural support for both therapies.

Click here for more coverage of ATMRD 2025.

REFERENCES
1. Natera-Villalba E, Ruiz-Yanzi MA, Gasca-Salas C, Matarazzo M, Martínez-Fernández R. MR-guided focused ultrasound in movement disorders and beyond: Lessons learned and new frontiers. Parkinsonism Relat Disord. 2024;122:106040. doi:10.1016/j.parkreldis.2024.106040
2. Martello J. Reimagining Ablation in Movement Disorders: Magnetic Resonance Focused Ultrasound (MRfUS). Presented at: ATMRD; June 27-30, 2025; Washington, DC.