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Focused Ultrasound for Essential Tremor: Review of the Evidence and Discussion of Current Hurdles
Open accessAbstract
Background: While there is no breakthrough progress in the medical treatment of essential tremor (ET), in the past decades several remarkable achievements happened in the surgical field, such as radiofrequency thalamotomy, thalamic deep brain stimulation, and gamma knife thalamotomy. The most recent advance in this area is magnetic resonance-guided focused ultrasound (MRgFUS). Methods: The purpose of this review is to discuss the new developments and trials of MRgFUS in the treatment of ET and other tremor disorders. Results: MRgFUS is an incisionless surgery performed without anesthesia and ionizing radiation (no risk of cumulative dose and delayed side effects). Studies have shown the safety and effectiveness of unilateral MRgFUS-thalamotomy in the treatment of ET. It has been successfully used in a few patients with Parkinson’s disease-related tremor, and in fewer patients with fragile X-associated tremor/ataxia syndrome. The safety and long-term effects of the procedure are still unclear, as temporary and permanent adverse events have been reported as well as recurrence of tremor. Discussion: MRgFUS is a promising new surgical approach with a number of unknowns and unsolved issues. It represents a valuable option particularly for patients who refused or could not be candidates for other procedures, deep brain stimulation in particular.
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“In summary, surgery, DBS, and focused ultrasound are effective second-line treatments (50–52).”
From A Review on Wearable Technologies for Tremor Suppression (2021) · cites this paper as [52]
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Tremor habituation to deep brain stimulation: Underlying mechanisms and solutions
Fasano, A. A., & Helmich, R. C. G. (2019) · Movement Disorders · doi:10.1002/mds.27821 · Cited by 112
Self-citationFocused Ultrasound for Immunomodulation of the Tumor Microenvironment
Joiner, J. B., Pylayeva‐Gupta, Y., & Dayton, P. A. (2020) · The Journal of Immunology · doi:10.4049/jimmunol.1901430 · Cited by 90
Giordano, M., Caccavella, V. M., Zaed, I., Manzillo, L. F., Montano, N., Olivi, A., & Polli, F. M. (2020) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2020-323216 · Cited by 87
A Review on Wearable Technologies for Tremor Suppression
Lora-Millan, J. S., Delgado-Oleas, G., Benito-León, J., & Rocon, E. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.700600 · Cited by 62
Kapadia, A., Elias, G., Boutet, A., Germann, J., Pancholi, A., Chu, P. P. W., Zhong, J., Fasano, A., Munhoz, R., Chow, C., et al. (2020) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2020-322745 · Cited by 53
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Metadata
- Authors
- Rohani, M., & Fasano, A.
- Affiliations
- Iran University of Medical Sciences (IR)
- University of Toronto (CA)
- Corresponding author
- Fasano, Alfonso
- Venue
- Tremor and Other Hyperkinetic Movements
- Publisher
- Ubiquity Press, Ltd.
- Published
- 2017-05-05
- Volume
- 7
- Issue
- 0
- Pages
- 462
- ISSN
- 2160-8288 (ISSN-L)
- OpenAlex
- W4232352638
- Cited by
- 73
- References
- 0
- Citations by year
- 2026: 5 · 2025: 16 · 2024: 10 · 2023: 5 · 2022: 8 · 2021: 5 · 2020: 9 · 2019: 8 · 2018: 7
- FWCI
- 4.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- creativecommons.org/licenses/by/4.0 (vor)
- Locations
- Tremor and Other Hyperkinetic Movements (publishedVersion, cc-by-nc-nd)
- Columbia Academic Commons (Columbia University)
- Funders
- Michael J. Fox Foundation for Parkinson's Research
- University of Toronto
- Topics
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Physical Sciences › Engineering › Biomedical Engineering › Ultrasound and Hyperthermia Applications
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- essential tremor, MR-guided focused ultrasound, MRgFUS thalamotomy, tremor disorders, fragile X-associated tremor/ataxia syndrome, deep brain stimulation, adverse events
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