An open-label, uncontrolled pilot study using transcranial MRI-guided focused ultrasound thalamotomy for essential tremor was recently published by Elias et al in the New England Journal of Medicine. The unilateral ventral intermediate (VIM) nucleus of the thalamus was targeted, with thermal ablation in all 15 patients associated with improving scores for hand tremor (P=0.001), total tremor scores (P=0.001), disability scores (P=0.001) and quality of life scores (P=0.001) significantly at 12 months. Several adverse effects were noted including: transient sensory disturbances, cerebellar, motor, and speech abnormalities and persistent paresthesias in 4 patients. The authors conclude that larger studies are needed to assess and validate the procedure's long-term safety and efficacy.
New England Journal of Medicine