Editors' note: MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes

Abstract

In “MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes,” Fasano et al. studied unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor (ET). They found that MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere improved the tremor of the contralateral hemibody at 6 months. Commenting on the article, Dr. Venketasubramanian is concerned about the potential side effect of the procedure, noting that 2 patients had persistent neurologic symptoms and deficits. He also mentions the absence of an adequate temporal bony window, seen in some individuals, which may limit use of MRgFUS. Authors Fasanol et al. agree with the safety concerns and that more studies are needed. They also explain that the problem of temporal bone window does not apply to focused ultrasound (FUS). However, they clarify that 15% of FUS candidates cannot receive the treatment due to the high bone density of their skull. In “MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes,” Fasano et al. studied unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor (ET). They found that MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere improved the tremor of the contralateral hemibody at 6 months. Commenting on the article, Dr. Venketasubramanian is concerned about the potential side effect of the procedure, noting that 2 patients had persistent neurologic symptoms and deficits. He also mentions the absence of an adequate temporal bony window, seen in some individuals, which may limit use of MRgFUS. Authors Fasanol et al. agree with the safety concerns and that more studies are needed. They also explain that the problem of temporal bone window does not apply to focused ultrasound (FUS). However, they clarify that 15% of FUS candidates cannot receive the treatment due to the high bone density of their skull.