Making Waves - Barnes-Jewish Hospital first to offer high intensity focused ultrasound for patients with ET

 By Tim Fox

Photo by Gregg Goldman
Photo by Gregg Goldman

Barnes-Jewish Hospital, in partnership with Washington University Physicians, is among the highest-volume treatment facilities for movement disorders in the U.S. “Patients choose our center because it has a long history of delivering the highest quality care and most advanced therapies, thanks to continuous research by its specialists and a multidisciplinary approach,” says Washington University neurologist Scott Norris, MD, PhD, head of the Movement Disorders Section.

“Deep brain stimulation (DBS) is our cornerstone surgical therapy for movement disorders, including Parkinson’s disease, essential tremor and dystonia,” Norris adds. “The approaches we have refined over two decades are safe and highly effective.”

Now, Washington University physicians at Barnes-Jewish Hospital are the first in Missouri to offer a new treatment that expands the options available to patients: high-intensity focused ultrasound, or HIFU. “HIFU is best indicated for people living with essential tremor or with tremor-predominant Parkinson’s disease,” explains Jon T. Willie MD, PhD, Washington University neurosurgeon at Barnes-Jewish Hospital. “Unlike deep brain stimulation, high-intensity focused ultrasound requires no incisions and no anesthesia, and it provides immediate reduction in tremors.”

During HIFU, high-intensity ultrasonic beams pass through the skull to the thalamus, where they ablate targeted areas without damaging surrounding areas. This ablation results in diminished tremors, “a result that should be permanent,” Willie notes.

“The ideal candidate for HIFU is someone who has not been helped by medical therapies and continues to experience moderate to severe tremors in one or both hands,” Willie says. “Candidates also should not have any neurological conditions other than essential tremor or Parkinson’s disease.”


People with essential tremor, Parkinson’s disease, dystonia and a specific form of epilepsy who are not eligible for HIFU may be good candidates for deep brain stimulation (DBS). This procedure involves the precise placement of electrical leads inside the brain and implantation of a pulse generator inside the chest through a small incision. When tuned by a specially trained neurologist, the generator emits electrical pulses to specific brain circuits, alleviating symptoms related to the targeted underlying condition.

Washington University specialists at Barnes-Jewish Hospital also have pioneered advanced approaches to delivering DBS treatment, including awake microelectrode recording and asleep intraoperative MRI-guided impulse generator implantation. Both Norris and Willie are excited about these and other advances that may further improve people’s lives.

Our team, which includes skilled neurologists, psychiatrists, engineers, radiologists and neurosurgeons, is developing novel interventions to ameliorate epilepsy, memory disorders, depression and post-traumatic stress disorder using minimally invasive and noninvasive brain stimulation,” Willie says. He adds: “Our depth of experience allows us to understand and enhance brain health today, which means we are able to help people obtain the best possible quality of life.”

For More Information and Referrals

To discuss a patient who has essential tremor and may benefit from high-intensity focused or deep brain stimulation, please reach out to Dr. Willie through Doximity or call 314.362.6908.