Essential Tremor – Deep Brain Stimulation vs. Focused Ultrasound

Borges, Yuri Ferreira Felloni; Cheyuo, Cletus; Lozano, Andrés M.; Fasano, Alfonso

doi:10.1080/14737175.2023.2221789

Cited by 8 publications

(4 citation statements)

References 228 publications

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“…The occurrence of disease-related lesions within this loop has been associated with the cessation of tremor, as evidenced by the impact of small, strategic strokes [ 182 ]. The success of stimulation and therapeutic lesions further reinforces this conceptual framework [ 183 ].…”

Section: The Therapeutic Results Of Dbs Of the Region Involving Vim/psamentioning

confidence: 85%

The role of the motor thalamus in deep brain stimulation for essential tremor

Neudorfer,

Kultas-Ilinsky,

Ilinsky

et al. 2024

Neurotherapeutics

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Section: The Therapeutic Results Of Dbs Of the Region Involving Vim/psamentioning

confidence: 85%

The role of the motor thalamus in deep brain stimulation for essential tremor

Neudorfer,

Kultas-Ilinsky,

Ilinsky

et al. 2024

Neurotherapeutics

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“…DBS for tremor has been widely used in PD and ET ( 15 , 25 ). It is highly effective in reducing tremor in these disease states but carries risks and limitations across all applications ( 17 ). As an invasive procedure, it carries innate risks including infection (in approximately 4% of patients) and hemorrhage (in approximately 2.4% of patients) ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…MRgFUS could potentially be a more applicable tool in patients with psychiatric conditions where the use of DBS can be complicated. Recently, bilateral MRgFUS has been shown to be effective for ET if one side is done at a time and sufficient time elapses between procedures and was recently approved by the FDA ( 17 , 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

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MR-guided focused ultrasound thalamotomy for lithium-induced tremor: a case report and literature review

Gelman,

Melott,

Thakur

et al. 2024

Front. Neurol.

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Drug-induced tremor is a common side effect of lithium with an occurrence of approximately 25% of patients. Cessation of the offending drug can be difficult, and many medical treatments for drug-induced tremor are ineffective. Deep brain stimulation (DBS) has been shown in a limited number of case reports to effectively reduce drug-induced tremor, however, which remains an invasive therapeutic option. MR-guided focused ultrasound (MRgFUS) thalamotomy is an FDA-approved non-invasive treatment for essential tremor (ET). To the best of our knowledge, MRgFUS thalamotomy has never been reported to treat drug-induced tremor. Here, we present a case of a left-handed 55-year-old man with a progressive, medically refractory lithium-induced tremor of the bilateral upper extremities. The patient underwent MRgFUS thalamotomy targeting the right ventral intermediate nucleus (VIM) of the thalamus to treat the left hand. There was almost complete resolution of his left-hand tremor immediately following MRgFUS. There were no side effects. The patient continues to show excellent tremor control at 90-day follow-up and remains free from side effects. This case demonstrates MRgFUS thalamotomy as a possible novel treatment option to treat drug-induced tremor.

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Safety and efficacy of unilateral focused ultrasound pallidotomy on motor complications in Parkinson’s disease (PD): a systematic review and meta-analysis

Abbas,

Hassan,

Shaheen

et al. 2024

Neurol Sci

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To systematically review and conduct a meta-analysis to evaluate the safety and efficacy of the unilateral focused ultrasound (FUS) pallidotomy on motor complications in Parkinson’s disease (PD) patients. A comprehensive search strategy was implemented through August 15, 2023, and updated on February 13, 2024, across six databases, identifying studies relevant to unilateral focused ultrasound pallidotomy and PD. Eligibility criteria included observational studies, clinical trials, and case series reporting on the impact of the intervention on motor complications in PD patients. The screening and data extraction were done by two independent reviewers. Risk of bias assessment utilized appropriate tools for different study designs. Statistical analysis involved narrative synthesis and meta-analysis. Subgroup analyses and leave-one-out analyses were performed. Five studies were included in our study, involving 112 PD patients undergoing FUS pallidotomy. UPDRS-II analysis revealed a significant improvement from baseline (mean difference (MD): -3.205, 95% CI: -4.501, -1.909, P < 0.001). UPDRS-III overall change was significant (MD: -10.177, 95% CI: [-12.748, -7.606], P < 0.001). UPDRS-IV showed a significant change from baseline (MD: -5.069, 95% CI: [-5.915, -4.224], P < 0.001). UDysRS demonstrated a significant overall improvement (MD: -18.895, 95% CI: [-26.973, -10.818], P < 0.001). The effect of FUS pallidotomy on motor complications in PD patients was effective, with a significant decrease in the UPDRS and UDysRS, reflecting improvement. The incidence of adverse events (headaches, pin-site pain, difficulty walking, and sonication-related head pain) of the FUS pallidotomy was not statistically significant, indicating its safety.

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Essential Tremor – Deep Brain Stimulation vs. Focused Ultrasound

Cited by 8 publications

References 228 publications

The role of the motor thalamus in deep brain stimulation for essential tremor

The role of the motor thalamus in deep brain stimulation for essential tremor

MR-guided focused ultrasound thalamotomy for lithium-induced tremor: a case report and literature review

Safety and efficacy of unilateral focused ultrasound pallidotomy on motor complications in Parkinson’s disease (PD): a systematic review and meta-analysis

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