Parkinson's disease affects nearly 1 million people in the United States, but emerging brain treatments are offering hope where medications alone fall short. Two advanced interventions, high-intensity focused ultrasound and deep brain stimulation (DBS), are helping patients regain control of their movements and reclaim daily activities that the disease had stolen from them.

What Happens When Parkinson's Medications Stop Working?

Parkinson's occurs when brain cells that produce dopamine, a chemical that coordinates movement, stop working or die. This leads to tremor, slowness, stiffness, and balance problems. Early on, medications like levodopa can manage these symptoms effectively. But as the disease progresses, the drugs become less effective, and increasing doses can cause debilitating side effects like involuntary movements.

For patients whose medications no longer provide adequate relief, advanced surgical options have emerged. These procedures don't cure Parkinson's, but they can provide meaningful, lasting symptom reduction that allows people to reduce medication doses, regain independence, and participate in activities they thought were lost.

How Does High-Intensity Focused Ultrasound Work for Parkinson's?

High-intensity focused ultrasound represents a newer approach to treating Parkinson's symptoms. During the procedure, doctors aim 1,024 ultrasound beams at specific spots deep in the brain while the patient lies in an MRI machine. The sound waves, the same type used in pregnancy ultrasounds, pass through the skull and intersect at a precise target, creating heat that burns problematic tissue.

The U.S. Food and Drug Administration approved the earliest version of this treatment in 2018. The latest version, approved in 2025, extends the treatment to include a new brain target that eases not just tremors but also slowness and stiffness. Importantly, the treatment can now be performed on both sides of the brain, providing relief to the entire body.

The results have been striking. In a clinical trial of 40 people, when the treatment was delivered to both sides of the brain, it improved movement disability symptoms by an average of about one-third compared to symptoms when patients were not taking medication. Three months after the procedure, 86 percent of study participants reported that their overall Parkinson's symptoms had improved.

One patient, Robert Goings, experienced dramatic relief. The night before his procedure at Oregon Health and Science University in November 2025, his symptoms were so severe that he couldn't sleep because stopping movement caused pain. The day after his ultrasound treatment, his wife Diana watched in amazement as he held out his hand completely still. "Oh my God, I don't believe this. It's gone. Absolutely gone," she recalled thinking.

What Are the Key Advantages of These Brain Treatments?

Both high-intensity focused ultrasound and deep brain stimulation offer distinct benefits for patients who have exhausted medication options:

• No Incisions Required: High-intensity focused ultrasound involves no cutting into the head, no anesthesia, and no hospital recovery, making it less invasive than traditional brain surgery.
• Adjustability: Deep brain stimulation uses a battery-powered pulse generator implanted near the collarbone that delivers electrical impulses to modulate brain activity. Unlike ablative procedures that permanently destroy tissue, DBS parameters can be changed wirelessly at any time by a neurologist, making it adjustable, reversible, and improvable over time.
• Dramatic Tremor Reduction: Patients with essential tremor treated with DBS targeting the thalamus often experience tremor reduction exceeding 80 to 90 percent improvement.
• Reduced Medication Dependence: Both treatments can help patients reduce medication doses, which is particularly valuable for those experiencing medication side effects.

How to Determine if You're a Candidate for Advanced Parkinson's Treatment?

Not every patient with Parkinson's is appropriate for these advanced interventions. Doctors use specific criteria to identify good candidates:

• Disease Duration: For Parkinson's disease, patients typically need a confirmed diagnosis of at least 5 years and a clear past response to levodopa, even if medications are now causing problems.
• Medication Challenges: Candidates should have motor fluctuations or involuntary movements that cannot be adequately controlled with medication adjustment alone.
• Cognitive Status: Patients must have no significant cognitive impairment or dementia, and no active psychiatric illness.
• Realistic Expectations: Candidates should understand that these treatments relieve symptoms but don't stop or slow the underlying brain destruction caused by the neurodegenerative disease.

A thorough pre-operative evaluation, including neuropsychological testing, brain MRI, and assessment by a neurologist and neurosurgeon team, determines whether a patient is suitable for surgery.

What Does Recovery Look Like After These Procedures?

Recovery timelines differ between the two approaches. High-intensity focused ultrasound is performed in under an hour with no incisions, allowing patients to go home the same day. Deep brain stimulation involves a more complex surgical process with two stages: electrode implantation into the brain, followed by implantation of the pulse generator under the collarbone. Total surgical time ranges from 3 to 8 hours depending on whether one or both sides of the brain are treated.

Recovery after DBS unfolds over weeks and months, with genuine improvements continuing for 12 to 24 months as device programming is optimized. Patients typically experience initial grogginess and headache in the first day or two, with activity levels gradually increasing as healing progresses.

The emotional impact of recovery can be profound. Neurosurgeon Daniel Cleary, who has performed focused ultrasound procedures at Oregon Health and Science University, noted that many patients come into the procedure skeptical. "People go into it not believing," he explained. "But the before-and-after experience can be profound. Families get very emotional. The patients get emotional. We get emotional. It's a big thing".

What Role Do Lifestyle and Support Play in Parkinson's Management?

While advanced surgical treatments offer symptom relief, comprehensive Parkinson's care extends beyond procedures. When patients are evaluated in specialized clinics, doctors discuss lifestyle modifications including the role of exercise, stress reduction, and dietary approaches that may be beneficial. Patients also have the opportunity to participate in new-patient Parkinson's disease programs through referrals to physical therapy, occupational therapy, and speech therapy services.

Support groups have also proven valuable for managing the day-to-day realities of living with Parkinson's. The opportunity to swap stories and share resources can be therapeutic, helping people reduce stress and connect with others who understand their experience. Care partners and family members also benefit from sharing questions and concerns with like-minded others.

One patient, Dan Alperin, a 61-year-old radio salesman and avid marathon runner, was diagnosed with Parkinson's in 2024 after his wife noticed a tremor during a trip to Japan. Rather than letting the diagnosis sideline him, Alperin has become an advocate for staying active with Parkinson's. He is developing a website called Runningwithparkinsons.org to encourage people living with the disease to stay active through running and movement, and plans to launch a podcast featuring interviews with remarkable athletes who have Parkinson's.

What's Next for Parkinson's Treatment?

High-intensity focused ultrasound for Parkinson's is not yet widely available. In the United States, mainly large academic medical centers have the expertise to perform it. Because the technique is relatively new, questions remain about long-term effects. However, the procedure holds promise as a way to ease severe symptoms for millions of people with Parkinson's worldwide.

Ongoing clinical trials continue to offer hope for the development of newer therapies that may better address disease progression and symptom management. Researchers are also exploring whether ultrasound techniques could treat other neurological conditions, including dementia, multiple sclerosis, and amyotrophic lateral sclerosis (ALS).

For patients and families navigating Parkinson's, these advances represent a meaningful shift in what's possible. While no treatment yet stops the disease itself, the combination of optimized medications, advanced surgical options, lifestyle modifications, and comprehensive support is allowing people to live fuller, more independent lives despite their diagnosis.