High-intensity focused ultrasound (HIFU) delivered to the thalamus improved essential tremor in 15 patients, according to a pilot study published in the New England Journal of Medicine.
Transcranial MRI-guided focused ultrasound was used to target the unilateral ventral intermediate nucleus of the thalamus in 15 patients with severe, medication-refractory essential tremor, wrote Dr. W. Jeffrey Elias and colleagues from the University of Virginia Health Sciences Center.
Treatment effectiveness was measured using a clinical rating scale for tremor pre- and post-treatment, and patients' perceptions of improvement were also gauged via a questionnaire (NEJM, August 15, 2013, Vol. 369:7, pp. 640-648).
Thermal ablation of the target was successful in all patients, but adverse effects included transient sensory, cerebellar, motor, and speech abnormalities, with persistent parasthesias in four patients. Hand-tremor, total-tremor, disability, and quality-of-life scores all improved significantly (p = 0.001 for all four), according to the authors.
Randomized, controlled studies are needed to confirm the efficacy of the technique, they wrote.
