One woman suddenly started walking with a more fluid gait. Another patient could pick up a fork and eat — something she couldn't do moments before. Both were in advanced stages of Parkinson's disease, and both felt their severe tremor vanish in a single afternoon.
The tool behind these dramatic results is called high-intensity focused ultrasound, or HIFU. Doctors aim sound waves at two tiny targets in the brain that sit just six to nine millimeters apart — about the width of a pencil eraser. The treatments happened in Aurora, Colorado, performed by the Advanced Therapies in Movement Disorders (ATMD) Program at CU Anschutz, and they were the first dual-target procedures using this method in the entire Rocky Mountain region.
"You never get ahead of the science" might be the cautious doctor's motto — but the results here were immediate. Dr. Drew Kern, a neurologist, and Dr. Daniel Kramer, a neurosurgeon, led the team. One patient was a woman whose motor problems were worst on her left side. After treating the first target, she saw her resting tremor improve by 60 to 70 percent. After the second target was treated, her tremor dropped to zero, and her stiffness improved by at least 70 percent.
The other patient was a man who also had dementia. After the procedure, he had zero rigidity, very little slowness of movement, and no tremor at all. His wife told the doctors it was the best night of sleep they'd had in years — because he wasn't shaking. And for the first time in a long time, he ate breakfast without any difficulty.
"Sure enough, afterward he had zero rigidity and very little slowness of movement, plus no tremor," Kern said. "His wife said that was the best night of sleep they've had in years."
Parkinson's is a progressive neurological disorder with no cure, affecting more than 1.2 million Americans. It causes dyskinesia (involuntary movement), bradykinesia (slowness of movement), and the tremors most people picture. For decades, surgeons treated these symptoms with deep brain stimulation, which means implanting electrodes in the brain. But that surgery isn't an option for everyone — some patients face infection risks or simply don't respond to it.
That's where HIFU comes in. It's incisionless, meaning no cuts and no implants. The U.S. Food and Drug Administration first approved HIFU to treat tremor-dominant Parkinson's, which affects about 10 to 20 percent of people with the disease. That early procedure targets a brain tract called the DRTT, which controls tremor. More recently, the FDA also approved HIFU for a second target called the PTT, which is linked to stiffness, slowness, and involuntary movement.
The ATMD team has already treated more than 100 patients with the first target, and Dr. Kern says the benefits have held for at least five years. The whole dual-target procedure takes about 90 minutes and is done as an outpatient visit — patients go home the same day.
For people living with advanced Parkinson's who had run out of options, this offers a new kind of hope. And with time, doctors will learn just how long the relief can last. "As time goes on," Kern said, "we will be able to evaluate even longer outcomes."