Parkinson’s disease patients often face persistent symptoms despite receiving optimal medical therapy. Dual-target MRgFUS offers a promising, incisionless alternative to traditional deep brain stimulation. Recently, clinicians reported a 70-year-old male patient who underwent this specialized procedure to manage severe motor symptoms. Initially, the surgical team targeted the left subthalamic nucleus (STN) to alleviate his bradykinesia and rigidity.

The Clinical Impact of Dual-target MRgFUS

Although the STN ablation significantly improved the patient’s motor speed, a residual tremor remained. Consequently, the team decided to perform an additional ablation of the ventral intermediate nucleus (VIM) during the same session. This adaptive approach resulted in the complete resolution of the tremor. Furthermore, the patient experienced no adverse neurological effects following the dual-target session. This landmark case illustrates the safety and feasibility of combining multiple targets to achieve optimal symptom control.

Why Targeted Ablation Matters

Traditionally, neurosurgeons choose a single target based on the most prominent symptom. However, Parkinson’s disease typically involves a complex mix of motor deficits. Using Dual-target MRgFUS allows for intraoperative flexibility. If one target fails to provide total relief, the surgeon can immediately address secondary targets. This technique could potentially redefine standard protocols for movement disorder clinics in India. Moreover, the non-invasive nature of this procedure makes it an attractive option for geriatric patients who may not tolerate invasive surgery.

FAQs

How does dual-target MRgFUS differ from standard focused ultrasound?

Standard procedures typically target only one brain region, such as the VIM for tremors. Dual-target MRgFUS allows clinicians to ablate two distinct areas, like the STN and VIM, in a single session to treat multiple symptoms comprehensively.

What are the primary benefits for patients with Parkinson's disease?

This approach provides comprehensive relief from both tremors and akinetic symptoms like rigidity. Moreover, it remains a non-invasive option, which reduces the risks associated with hardware implantation or general anesthesia.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice. Always seek the advice of a physician or other qualified health provider with any questions regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Rivera F et al. Dual-target magnetic resonance-guided focused ultrasound of the subthalamic and ventral intermediate nuclei for Parkinson's disease: illustrative case. J Neurosurg Case Lessons. 2026 Mar 30. doi: undefined. PMID: 41911604.

Martínez-Fernández R et al. Unilateral subthalamotomy of the subthalamic nucleus by focused ultrasound for Parkinson disease. N Engl J Med. 2020;383(26):2501-2513.

Krishna V et al. Magnetic Resonance–Guided Focused Ultrasound: A Practical Guide for Neurologists. Neurol India. 2026;74(2):184-193.