MRI-guided focused ultrasound for essential tremor.
Authors: Agopyan-Miu AH, Simmons GB, Baltuch GH
This video depicts a left-sided MRI-guided focused ultrasound (MRgFUS) thalamotomy for a right-arm tremor in a 76-year-old, right-handed man with bilateral upper-extremity tremors. The patient tolerated the procedure well, with immediate tremor reduction that persisted at the 1-month follow-up, and there were no adverse events noted during intraoperative testing, postoperative testing, or follow-up. This case highlights MRgFUS as an effective, safe, incision-free treatment option for medically refractory essential tremor. Additional research is required to establish the long-term efficacy of MRgFUS compared with other surgical treatment options such as deep brain stimulation (DBS) and radiosurgery. The video can be found here: https://stream.cadmore.media/r10.3171/2024.7.FOCVID2472.
Introduction
Purpose
Thermal ablation
Study Objective
To demonstrate the safety and efficacy of MRI-guided focused ultrasound (MRgFUS) thalamotomy as an incision-free treatment for medically refractory essential tremor.
Animal model / Human subject
Homo sapiens (human), strain: N/A, 76 years old, male
Disease model
Essential tremor
MRI or image guidance method
MRI-guided focused ultrasound (MRgFUS)
Targeted brain region(s)
Thalamus
Outcomes and Safety
Summary of Outcomes
MRI-guided focused ultrasound thalamotomy produced immediate and sustained (1‑month) reduction of a right‑arm essential tremor with no adverse events; no specific ultrasound parameter variants were reported or tested.
Duration of biological effect
1 month
Safety-related matter
The patient tolerated the MRgFUS procedure well with immediate tremor reduction and no adverse events during intraoperative testing, postoperative testing, or at 1-month follow-up. The authors describe MRgFUS as an effective, safe, incision-free treatment option but note that additional research is needed to establish long-term efficacy compared with DBS and radiosurgery.
Brain Region
Ultrasound Parameters
Ultrasound instrument
MRI-guided focused ultrasound transducer
FUS Mode
continuous
Focal Characteristics
focal depth: None; focal length: None; aperture size: None
Treatment frequency
single
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