{Reference Type}: Journal Article
{Title}: Radiosurgical thalamotomy for essential tremor: state of the art, current challenges and future directions.
{Author}: Iorio-Morin C;Mathieu D;Franzini A;Hodaie M;Villeneuve SA;Hamel A;Lozano AM;
{Journal}: Expert Rev Neurother
{Volume}: 24
{Issue}: 6
{Year}: 2024 Jun 7
{Factor}: 4.287
{DOI}: 10.1080/14737175.2024.2351512
{Abstract}: UNASSIGNED: Essential tremor (ET) is the most frequent movement disorder, affecting up to 5% of adults > 65 years old. In 30-50% of cases, optimal medical management provides insufficient tremor relief and surgical options are considered. Thalamotomy is a time-honored intervention, which can be performed using radiofrequency (RF), stereotactic radiosurgery (SRS), or magnetic resonance-guided focused ultrasounds (MRgFUS). While the latter has received considerable attention in the last decade, SRS has consistently been demonstrated as an effective and well-tolerated option.
UNASSIGNED: This review discusses the evidence on SRS thalamotomy for ET. Modern workflows and emerging techniques are detailed. Current outcomes are analyzed, with a specific focus on tremor reduction, complications and radiological evolution of the lesions. Challenges for the field are highlighted.
UNASSIGNED: SRS thalamotomy improves tremor in > 80% patients. The efficacy appears comparable to other modalities, including DBS, RF and MRgFUS. Side effects result mostly from idiosyncratic hyper-responses to radiation, which occur in up to 10% of treatments, are usually self-resolving, and are symptomatic in < 4% of patients. Future research should focus on accumulating more data on bilateral treatments, collecting long-term outcomes, refining targeting, and improving lesion consistency.