The Pros and Cons of Focused Ultrasound Thalamotomy for Essential Tremor

In a randomized trial, the treatment was associated with improvement in hand tremors, but the improvements declined during follow-up.

Researchers evaluated focused ultrasound thalamotomy with magnetic resonance imaging guidance for treatment of essential tremor. In a prospective, multicenter, industry-supported trial, 76 patients with medication-resistant essential tremor were randomized 3:1 to unilateral ultrasound thalamotomy or a sham procedure. Scores on the 32-point tremor scale at baseline and at 1, 3, 6, and 12 months were blindly rated by independent investigators using videotaped footage. The primary outcome was the between-group difference in the change in hand tremor scores from baseline to 3 months. Patients in the sham group were allowed to cross over at 3 months.

The ultrasound group had a more robust improvement in hand tremors (from a mean score of 18.1 at …

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)