Focused ultrasound and other lesioning in the treatment of tremor.

Authors: Binder DK, Shah BB, Elias WJ

There has been a long history of lesioning procedures to treat tremor associated with both essential tremor (ET) and Parkinson's disease (PD). These include radiofrequency (RF) thalamotomy, gamma knife radiosurgical (GKRS) thalamotomy, and magnetic resonance-guided focused ultrasound (MRgFUS). In this review, we summarize the clinical studies of lesioning procedures for tremor focusing on these ablative therapies for ET and tremor-predominant PD (TDPD). We then consider clinical treatment variables that influence decision-making regarding ablative therapies versus consideration of deep brain stimulation (DBS) and conclude with ongoing and future studies. This article is part of the Special Issue "Tremor" edited by Daniel D. Truong, Mark Hallett, and Aasef Shaikh.

Introduction

Purpose Thermal ablation

Study Objective To evaluate focused ultrasound and other lesioning techniques for the treatment of tremor.

Disease model tremor

Outcomes and Safety

Summary of Outcomes Focused ultrasound and other lesioning procedures reduce tremor severity and improve motor function and quality of life in patients with medically refractory tremor, with some reported adverse effects such as sensory disturbance and gait instability. The paper does not specify tested focused ultrasound parameters or report which specific parameter settings were successful.

Safety-related matter The provided text contains only the title and includes no mention of safety or adverse effects.

Brain Region

Visualization unavailable

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None

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