Open Label Study for the Use of Low Intensity Focused Ultrasound for Essential Tremor

Inclusion criteria

• Confirmed clinical diagnosis of ET
• Isolated tremor syndrome, at least 3 years duration
• Subjective complaint of tremor assessed and validated by physician
• Must be willing to comply with the study protocol
• English Proficiency
• At least 18 years of age
• At most 90 years of age

Exclusion criteria

• Severe microvascular disease or structural brain lesions equivalent to Fazekas scale of 3 or higher in the periventicular or deep white matter.
• Subjects on blood thinning medications (e.g. Eliquis)
• Recent stroke (within the last 6 months)
• Implanted electrodes (e.g. DBS) in brain
• History of aneurysm
• History of cranial trauma resulting in fracture or traumatic brain injury
• Subjects who are unable to cooperate with the testing.
• Subjects who lack capacity to consent
• Subjects with severe cardiac disease, increased intracranial pressure, or using a transcutaneous electrical nerve stimulation (TENS) unit.
• Severe cardiac disease will be defined as any of the following:

i) History of myocardial infarction within the past 6 months ii) Diagnosis of congestive heart failure with NYHA Class III or IV symptoms iii) History of unstable angina, life-threatening arrhythmias, or use of an implantable cardioverter-defibrillator (ICD) iv) Uncontrolled hypertension (SBP >180 mmHg or DBP >110 mmHg) despite medication v) Any condition judged by the study physician to place the subject at increased risk from study participation

• Subjects with implanted medical devices
• Subjects with a history of seizure disorder.
• Subjects with contraindications to enter MRI environment
• Subjects with a history of substance abuse.
• Subjects who are currently pregnant. This will be verified by a urine test prior to beginning the study.