Brain targeting for focused ultrasound essential tremor ablation: proceedings from the 2023 Focused Ultrasound Foundation workshop

Essential tremor (ET) is the most common movement disorder globally and has negative impacts on quality of life. While medical treatments exist, approximately 50% of patients have tremor that is refractory to medication or experience intolerable medication side effects. Magnetic resonance-guided foc...

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Bibliographic Details
Published inNeurosurgical focus Vol. 57; no. 3; p. E3
Main Authors Chua, Melissa M J, LeBlang, Suzanne, Powlovich, Lauren, Gilbertson, Tom, Krishna, Vibhor, Guttmann, Charles R G, Eames, Matthew D C, Poulsen, Frantz R, Cosgrove, G Rees
Format Journal Article
LanguageEnglish
Published United States 01.09.2024
Subjects
Brain - diagnostic imaging
Brain - surgery
Essential Tremor - diagnostic imaging
Essential Tremor - surgery
Essential Tremor - therapy
High-Intensity Focused Ultrasound Ablation - methods
Humans
Magnetic Resonance Imaging - methods
Thalamus - diagnostic imaging
Thalamus - surgery
thalamotomy
essential tremor
movement disorders
focused ultrasound
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Summary:Essential tremor (ET) is the most common movement disorder globally and has negative impacts on quality of life. While medical treatments exist, approximately 50% of patients have tremor that is refractory to medication or experience intolerable medication side effects. Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is an option for these patients and while incisionless, it is still invasive, although less so than other surgical treatments such as deep brain stimulation and radiofrequency thalamotomy. Despite MRgFUS being FDA-approved since 2016, there is still no current consensus on the best approaches for targeting, imaging, and outcome measurement. A 2-day workshop held by the Focused Ultrasound Foundation in September of 2023 convened experts and critical stakeholders in the field to share their knowledge and experiences. The goals of the workshop were to determine the optimal target location within the thalamus and compare best practices for localizing the target and tracking patient outcomes. This paper summarizes the current landscape, important questions, and discussions that will help direct future treatments to improve patient care and outcomes.
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ISSN:1092-0684
1092-0684
DOI:10.3171/2024.6.FOCUS2494