A New Jersey man has returned to hiking and pickleball after focused-ultrasound treatments for Parkinson's disease, according to a Weill Cornell Medicine profile. His experience also illustrates why doctors carefully weigh the risks before treating both sides of the brain.
Stan Au, of Essex Fells, had lived with Parkinson's for 12 years and struggled with hand tremors, eating and signing his name despite medication. He did not want deep-brain stimulation surgery, which involves implanted electrodes, according to the profile.
He and his wife, Pam, met neurologist Harini Sarva in 2020. She recommended a clinical trial of magnetic resonance-guided focused ultrasound, an outpatient procedure that directs ultrasound energy through the skull to create a small lesion in a movement-control pathway. MRI imaging and temperature monitoring guide the treatment.
The technique does not cure Parkinson's. It aims to reduce disabling motor symptoms by interrupting abnormal signals.
Neurosurgeon Michael Kaplitt co-led a multicenter trial with Howard Eisenberg of the University of Maryland School of Medicine. The study, published earlier this year in The Lancet Neurology, enrolled 54 patients and initially treated the brain side corresponding to each patient's more severely affected body side.
Patients could choose a second procedure at least six months later. Forty received treatment on both sides. Au underwent his second treatment nine months after the first.
The Food and Drug Administration approved the staged bilateral approach in July 2025, and Medicare began covering it in March 2026, Cornell reported. The FDA's review found that 86% of patients reported at least some improvement three months after the second procedure, while 62% reported satisfaction at that point.
The second treatment produced less additional motor improvement and increased the risk of speech, walking and balance problems. The FDA therefore limited the bilateral approach to carefully selected patients with disabling symptoms on the untreated side and no serious adverse effects from their first treatment.
Sarva said Au improved most after the first procedure, with some further benefit after the second. He also uses a body-worn pump that delivers carefully adjusted medication. She credited that combination with improving his daily life.
Au said he now has less stiffness, better coordination and more activity. He hopes to walk his daughter down the aisle at her wedding next fall.
The study was supported by Insightec, which manufactures the MRI-guided focused-ultrasound system used in the trial. Weill Cornell makes its physicians' outside relationships available through their public profiles.
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