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Non-invasive ultrasound therapy brings lasting improvement to tremor patients. Unique in southern Germany therapy can also be used to treat Parkinson's disease and neuropathic pain.

Holding a cup of hot coffee in your hand without shaking – a moment that means a new lease on life for many tremor patients. At the Medical Center - University of Freiburg, there is now a new, gentle treatment option for essential tremor: For the first time in southern Germany, a therapy is available that targets the brain – without surgery, without opening the skull, without incisions, and without implants. Focused ultrasound (HiFUS) can be used to treat specific areas of the brain with millimeter precision, eliminating tremors safely, precisely, and with a short recovery time. The therapy is also approved for Parkinson's disease and neuropathic pain.

“With the new system, we can offer a safe, gentle, and long-lasting treatment to tremor patients for whom surgery is not an option,” says Prof. Dr. Volker A. Coenen, Head of Stereotactic Neurosurgery at the Department of Neurosurgery at the Medical Center - University of Freiburg. “The effect is immediate, and after the treatment, patients can drink, eat, and write without tremors, which was often nearly impossible before. This allows them to lead a normal life again.”

What is a tremor?

A tremor is a form of movement disorder that causes involuntary shaking, most commonly in the hands or arms, less commonly in the head or trunk. In Germany, about one in 100 people are affected by what is known as essential tremor – shaking with no apparent neurological cause. This form often runs in families and intensifies when muscles are actively tensed, such as when writing or drinking. In Parkinson's patients with tremor, the opposite is usually true: the shaking tends to decrease with deliberate movements.

Precise treatment without incisions – a new option for severely affected patients

The painless HiFUS treatment is performed entirely without incisions or implants: During the procedure, patients lie in a magnetic resonance imaging (MRI) scanner, which monitors the treatment in real time. A special helmet is used to bundle over 1,000 ultrasound beams and direct them precisely to an area of the thalamus that serves as an important relay station for tremor signals in the brain. The heat generated selectively deactivates the overactive nerve cells without damaging surrounding tissue.

“Patients are awake during the entire HiFUS treatment and experience the effect on their tremors directly. This is a very special moment for both patients and practitioners,” explains neurosurgeon Dr. Bastian Sajonz, senior physician in the Department of Stereotactic Neurosurgery at the Medical Center - University of Freiburg. The method is particularly suitable for patients who do not respond adequately to medication or do not want deep brain stimulation.

Fast and lasting recovery

The new HiFUS therapy is impressive not only because of its precision, but also because of its short recovery time and low risk of complications. The latest generation of ultrasound equipment also provides improved visualization of the target region in the brain as well as an optimized workflow for the treatment team. This allows for even greater precision and shorter procedures.

“Many patients can leave the hospital after just a few days and quickly return to their everyday lives,” says Dr. Sajonz. International studies have shown a lasting improvement in symptoms over several years. HiFUS treatment in Freiburg is part of routine clinical care.

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