Depth is a problem; the deeper you go, the less effective it is. Heat is another issue; you can inadvertently damage nearby tissue. Targeting accuracy is vital, especially near critical structures (think nerves), and we're not at sub-millimeter precision yet. Also, real-time monitoring like MRI-guided FUS is expensive and complicated, and without it you have to guess that you're affecting the right tissue. Great promise, but multiple engineering hurdles to clear before FUS lives up to the hype.