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MR-guided focused ultrasound (MRgFUS) has been successfully applied in treating refractory tremors in Parkinson's disease (PD). It generates a precise thermal ablation in a specific nucleus or tract, such as ventral intermediate nucleus (VIM) or pallidothalamic tract (PTT). Despite a single lesion improving parts of the PD symptoms, the feasibility and efficacy of a stepwise dual-lesion in VIM and PTT are to be explored.