Thalamotomy using MRI-guided focused ultrasound significantly improves contralateral symptoms and quality of life in essential tremor

Commentary on: Elias WJ, Lipsman N, Ondo WG, et al.. A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor. N Engl J Med 2016;375:730–9. Context Propranolol and primidone significantly reduce tremor by around 60% in 50% of patients with essential tremor (ET). When medication is ineffective or causes intolerable side effects, neurosurgical intervention may be considered. Until recently, radiofrequency (RF) ablation or deep brain stimulation (DBS) of the ventralis intermedius (VIM) thalamic nucleus were the main surgical options. Gamma knife thalamotomy avoids a burrhole but delayed effects make intraoperative validation impossible.1 Recent technical advances have enabled transcranial delivery of high-intensity focused ultrasound to create a thalamotomy with MRI guidance and real-time monitoring. Previous uncontrolled studies suggested that this may be a safe and effective alternative for patients with ET.2 Methods This randomised controlled trial examined the effect of unilateral focused...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Therapeutics/Prevention Source Type: research