Essential Tremor

Focused ultrasound treatment for essential tremor has been approved by the Food and Drug Administration (FDA) in July 2016.

Medicare approved the treatment in all US states as of July 12, 2020.

The FDA approved staged bilateral treatment for essential tremor on December 20, 2022. Treatments are approved for the second side at least 9 months after the initial treatment.

Essential tremor (ET) is the most common movement disorder, affecting an estimated 3% of the population, or approximately 10 million individuals in the United States. ET is commonly viewed as a relatively benign disease.

However, the associated disabling aspects of ET, such as significant tremor of the hands, can impair patients’ ability to eat, shave, write, perform household activities, and function in the workplace.

The underlying etiology of ET is unclear, but cases often run in families (familial tremor). It has been estimated that approximately 50% of all cases are due to a genetic mutation, and the pattern of inheritance is most consistent with autosomal dominant transmission (i.e. dominant trait).

Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with essential tremor. This novel technology focuses multiple beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.

How it Works
Where the focused ultrasound beams converge, they produce precise ablation (thermal destruction of tissue), enabling ET to be treated noninvasively. The primary target is a region in the thalamus called the ventral intermediate nucleus (Vim), but other adjacent targets and white matter pathways are also in use.

Advantages

• It is a noninvasive, single treatment that enables patients to recover rapidly and quickly return to activities of normal life (usually the next day).
• Compared to RF ablation or DBS, focused ultrasound offers a reduced risk of infection, of damage to the non-targeted area, and of blood clot formation.
• Focused ultrasound offers rapid resolution of symptoms.
• In contrast to lesioning performed with stereotactic radiosurgery, focused ultrasound does not use ionizing radiation, thus avoiding the side effects of exposure to radiation.
• Because it is non-invasive, focused ultrasound could be an option for medically refractory ET patients (those who do not respond well to medication) who do not want to undergo surgery.

Clinical Trials

A clinical trial is recruiting patient for 3-D tractography targeting for essential tremor.

A clinical trial is using transcranial ultrasound to treat essential tremor in the USA.

There is a clinical trial in Toronto for patients with essential tremor. 

There is a clinical trial in China for patients with a reduced SDR.

Treatment Sites

Please see a list of possible treatment sites here.

Regulatory & Reimbursement

The Exablate system manufactured by Insightec earned FDA approval to treat essential tremor in July 2016. It is also approved for treating essential tremor in Europe, Korea, Canada, Japan, Russia, Taiwan, and the Middle East. 

In the US, all treatment sites have been approved for payment under Medicare.

Commercial coverage and Medicaid will typically follow Medicare but should be evaluated with each company and region. Some facilities have a cash payment option, for those who are not willing to wait for insurance decisions for payment. Prices vary, but a rough estimate is $40,000.

Device manufacturer, Insightec has established an informational website, including patient stories and access to treatment site information. They have also set up a Reimbursement Support Manager, who can help with questions about the status of reimbursements. Her contact information is: Kim Martin, Reimbursement Support Manager, 1-(866) 392-8478.

Additional Information 

• The Diann Shaddox Foundation for Essential Tremor Research
• The International Essential Tremor Foundation 
• Hope Net
• APTES 
• Tremor Action Network

Notable Papers

Suggested Reading: Focused Ultrasound: Transforming treatment of Neurodegenerative Diseases August 2022

Suggested Reading: Focused Ultrasound for Essential Tremor Market Study (2021)

Vila-Chã N, Chamadoira C, Araújo R, Oliveira D, Alves Costa J. Initial outcomes and safety of MR guided focused ultrasound (MRgFUS) thalamotomy for essential tremor of the first FUS Medical Unit in Portugal. [Original Title: Resultados iniciais e segurança da talamotomia por ultrassons focalizados guiados por RM (MrgFUS) no tremor essencial da primeira Unidade Médica de FUS em Portugal.] Arq Neuropsiquiatr. 2024 Aug;82(8):1-7. doi: 10.1055/s-0044-1788668. Epub 2024 Aug 26. PMID: 39187258 

Zhang D, Xiong Y, Lu H, Duan C, Huang J, Li Y, Bian X, Zhang D, Zhou J, Pan L, Lou X. Predicting tremor improvement after MRgFUS thalamotomy in essential tremor from preoperative spontaneous brain activity: A machine learning approach. Sci Bull (Beijing). 2024 Aug 16:S2095-9273(24)00588-7. doi: 10.1016/j.scib.2024.05.049. PMID: 39191568 

Chua MMJ, LeBlang S, Powlovich L, Gilbertson T, Krishna V, Guttmann CRG, Eames MDC, Poulsen FR, Cosgrove GR. Brain targeting for focused ultrasound essential tremor ablation: proceedings from the 2023 Focused Ultrasound Foundation workshop. Neurosurg Focus. 2024 Sep 1;57(3):E3. doi: 10.3171/2024.6.FOCUS2494. PMID: 39217630 

Mortezaei A, Essibayi MA, Mirahmadi Eraghi M, Alizadeh M, Taghlabi KM, Eskandar EN, Faraji AH. Magnetic resonance-guided focused ultrasound in the treatment of refractory essential tremor: a systematic review and meta-analysis. Neurosurg Focus. 2024 Sep 1;57(3):E2. doi: 10.3171/2024.6.FOCUS24326. PMID: 39217634 

Fura Ł, Tymkiewicz R, Kujawska T. Numerical studies on shortening the duration of HIFU ablation therapy and their experimental validation. Ultrasonics. 2024 Aug;142:107371. doi: 10.1016/j.ultras.2024.107371. Epub 2024 Jun 4. PMID: 38852549 

Nishida N, Sugita Y, Sawada M, Ishimori T, Taruno Y, Otsuki K, Motoie R, Kitamura K, Yoshizaki W, Kasashima K, Sugiyama J, Yamashita M, Hanyu T, Takahashi M, Kaneko S, Toda H. Minimum and early high-energy sonication protocol of MR-guided focused ultrasound thalamotomy for low-skull density ratio patients with essential tremor and Parkinson’s disease. Neurosurg Focus. 2024 Sep 1;57(3):E4. doi: 10.3171/2024.6.FOCUS24330. PMID: 39217631 

Gonzalez-Quarante LH, Gonzalez-Crespo A, Arcadi A, Macias-de-la-Corte M, Aviles-Olmos I, Sanchez-Catasus CA, Cacho-Asenjo E, Honorato-Cia C, Martinez-Simon A, Gorospe A, Martin-Bastida A, Corral-Alonso P, Rodriguez-Oroz MC, Guridi J. 3-T MR-guided focused ultrasound thalamotomy for tremor in patients with a cardiac pacemaker: case series and review of the literature. Neurosurg Focus. 2024 Sep 1;57(3):E5. doi: 10.3171/2024.6.FOCUS24171. PMID: 39217637 

Phipps MA, Manuel TJ, Sigona MK, Luo H, Yang PF, Newton A, Chen LM, Grissom W, Caskey CF. Practical Targeting Errors During Optically Tracked Transcranial Focused Ultrasound Using MR-ARFI and Array- Based Steering. IEEE Trans Biomed Eng. 2024 Sep;71(9):2740-2748. doi: 10.1109/TBME.2024.3391383. Epub 2024 Aug 21. PMID: 38640051 

Gopinath G, Scantlebury N, Sewell IJ, Rohringer CR, Sivadas S, McSweeney M, Boshmaf SZ, Lam B, Hamani C, Abrahao A, Schwartz ML, Lipsman N, Rabin JS. Changes in Caregiver Burden Following Unilateral Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Essential Tremor. Mov Disord Clin Pract. 2024 Jul;11(7):905-908. doi: 10.1002/mdc3.14034. Epub 2024 Apr 4. PMID: 38576099 

Cammaroto S, Acri G, Hartwig V, Morabito R, Militi A, Smorto C, Ielo A, Bonanno L, Anfuso C, Quartarone A. Could the Anatomic Variants of the Superior Thalamic Vein (STV) Be Considered a Possible Landmark for Target Identification in Magnetic-Resonance-Guided Focused Ultrasound Procedures? A Pilot Study Using Susceptibility Weighted Imaging Sequences. Diagnostics (Basel). 2024 Jul 2;14(13):1409. doi: 10.3390/diagnostics14131409. PMID: 39001299 

van der Stouwe AMM, Jameel A, Gedroyc W, Jones B, Charlesworth G, Molloy S, Tai Y, Nandi D, Bain PG. Double lesion MRgFUS thalamotomy for essential tremor: 4.5-year outcomes and framework for assessing loss of efficacy and tremor progression. Br J Neurosurg. 2024 Jul 17:1-4. doi: 10.1080/02688697.2024.2354282. PMID: 39016204 

Hopfner F, Buhmann C, Classen J, Holtbernd F, Klebe S, Koschel J, Kohl Z, Paus S, Pedrosa DJ. Tips and tricks in tremor treatment. J Neural Transm (Vienna). 2024 Jul 24. doi: 10.1007/s00702-024-02806-x. PMID: 39043978 

Khu KJO, Jamora RDG, Aguilar JA, Pascual JSG, Chan KIP, Espenido TMR, Mata JL, Nievera AMP, Legaspi GD. Establishing and developing a magnetic resonance-guided focused ultrasound program in a resource-limited setting: the Philippine experience. Neurosurg Rev. 2024 Jul 30;47(1):372. doi: 10.1007/s10143-024-02624-5. PMID: 39078417 

Kadowaki M, Sugiyama K, Nozaki T, Yamasaki T, Namba H, Shimizu M, Kurozumi K. Scalp Nerve Block Alleviates Headaches Associated With Sonication During Transcranial Magnetic Resonance-Guided Focused Ultrasound. Neurosurgery. 2024 Aug 1;95(2):447-455. doi: 10.1227/neu.0000000000002962. Epub 2024 Apr 30. PMID: 38687082 

Kaplitt MG, Krishna V, Eisenberg HM, Elias WJ, Ghanouni P, Baltuch GH, Rezai A, Halpern CH, Dalm B, Fishman PS, Buch VP, Moosa S, Sarva H, Murray AM. Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor: An Open-Label Clinical Trial. JAMA Neurol. 2024 Jul 29:e242295. doi: 10.1001/jamaneurol.2024.2295. PMID: 39073822 

Sheth SA, Ostrem JL, Hariz M. Bilateral Focused Ultrasound Thalamotomy for Tremor-Is It Really Safe? JAMA Neurol. 2024 Jul 29. doi: 10.1001/jamaneurol.2024.2294. PMID: 39073802 

Hino S, Maki F, Yamaguchi T, Kaburagi M, Nakano M, Iwamuro H, Takasaki M, Iijima K, Kanouchi M, Sasanuma J, Watanabe K, Hasegawa Y, Yamano Y. Effectiveness and safety of MR-guided focused ultrasound thalamotomy in patients with essential tremor and low skull density ratio: a study of 101 cases. J Neurosurg. 2024 Jul 1;141(1):212-220. doi: 10.3171/2023.11.JNS231799. PMID: 38306635 

Gironell A, Marín-Lahoz J, Póveda S. Essential Tremor: Update of Therapeutic Strategies. [Original Title: Temblor esencial: actualización de las estrategias terapéuticas.] Med Clin (Barc). 2024 Jun 28;162(12):599-605. doi: 10.1016/j.medcli.2023.12.013. Epub 2024 Mar 28. PMID: 38553256 

Arcadi A, Aviles-Olmos I, Gonzalez-Quarante LH, Gorospe A, Jiménez-Huete A, de la Corte MM, Parras O, Martin-Bastida A, Riverol M, Villino R, Guridi J, Rodríguez-Oroz MC. Magnetic Resonance-Guided Focused Ultrasound (MRgFUS)-Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes. Mov Disord. 2024 Jun;39(6):1015-1025. doi: 10.1002/mds.29801. Epub 2024 Apr 14. PMID: 38616324 

Folz C, Seas A, Chinyengetere F, Beasley C, Harris A, Oyedeji C, Ortel TL, Shah BR, Lad S, Harward SC. Magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor in a patient with von Willebrand disease: perioperative optimization for patients with coagulopathies. Illustrative case. J Neurosurg Case Lessons. 2024 Jun 10;7(24):CASE23766. doi: 10.3171/CASE23766. PMID: 38857545 

García-de Soto J, Pouso-Diz JM, Fernández-Pajarín G, Román-Pena P, Arán-Echabe E, Mosqueira AJ, Blanco-Ulla M, Ares B, Sesar A. Unilateral thalamotomy with high intensity focal ultrasound in patients with refractory essential tremor: a comparative study between patients under and over 70 years of age. [Original Title: Talamotomía unilateral con ultrasonidos focales de alta intensidad en pacientes con temblor esencial refractario: un estudio comparativo entre pacientes menores y mayores de 70 años.] Rev Neurol. 2024 Jun 16;78(12):335-341. doi: 10.33588/rn.7812.2024104. PMID: 38867682 

Martínez-Fernández R. Focused ultrasound brain therapy is a new tool in the box. Nat Rev Neurol. 2024 Jul 1. doi: 10.1038/s41582-024-00975-7. PMID: 38951598 

Saporito G, Sucapane P, Bruno F, Catalucci A, Masciocchi C, Pistoia ML, Splendiani A, Ricci A, Di Cesare E, Marini C, Mazza M, Totaro R, Pistoia F. Cognitive safety of focused ultrasound thalamotomy for tremor: 1-year follow-up results of the COGNIFUS part 2 study. Front Neurol. 2024 Jun 17;15:1395282. doi: 10.3389/fneur.2024.1395282. eCollection 2024. PMID: 38952468 

Bruno F, Badini P, Innocenzi A, Saporito G, Catalucci A, Sucapane P, Barile A, Cesare ED, Marini C, Pistoia F, Splendiani A. Early re-emerging tremor after MRgFUS thalamotomy: case-control analysis of procedural and imaging features. Front Neurol. 2024 Jun 6;15:1356613. doi: 10.3389/fneur.2024.1356613. eCollection 2024. PMID: 38903176 

Iorio-Morin C, Mathieu D, Franzini A, Hodaie M, Villeneuve SA, Hamel A, Lozano AM. Radiosurgical thalamotomy for essential tremor: state of the art, current challenges and future directions. Expert Rev Neurother. 2024 Jun;24(6):597-605. doi: 10.1080/14737175.2024.2351512. Epub 2024 May 7. PMID: 38713485 

Bancel T, Béranger B, Daniel M, Didier M, Santin M, Rachmilevitch I, Shapira Y, Tanter M, Bardinet E, Fernandez Vidal S, Attali D, Galléa C, Dizeux A, Vidailhet M, Lehéricy S, Grabli D, Pyatigorskaya N, Karachi C, Hainque E, Aubry JF. Sustained reduction of essential tremor with low-power non-thermal transcranial focused ultrasound stimulations in humans. Brain Stimul. 2024 May 9;17(3):636-647. doi: 10.1016/j.brs.2024.05.003. PMID: 38734066 

Kong D, Liu G, Cheng B, Qi X, Zhu J, He Q, Xing H, Gong Q. A novel transcranial MR Guided focused ultrasound method based on the ultrashort echo time skull acoustic model and phase retrieval techniques. Sci Rep. 2024 May 24;14(1):11876. doi: 10.1038/s41598-024-62500-6. PMID: 38789537 

Patel MD, Patel M, Jani R, Patel KG, Patel P, Gandhi SK. Essential Tremors: A Literature Review of Current Therapeutics. Cureus. 2024 May 1;16(5):e59451. doi: 10.7759/cureus.59451. eCollection 2024 May. PMID: 38826876 

Vogt L, Quiroz V, Ebrahimi-Fakhari D. Emerging therapies for childhood-onset movement disorders. Curr Opin Pediatr. 2024 Jun 1;36(3):331-341. doi: 10.1097/MOP.0000000000001354. Epub 2024 Apr 4. PMID: 38655812 

Kyle K, Peters J, Jonker B, Barnett Y, Maamary J, Barnett M, Maller J, Wang C, Tisch S. Magnetic Resonance-Guided Focused Ultrasound for Treatment of Essential Tremor: Ventral Intermediate Nucleus Ablation Alone or Additional Posterior Subthalamic Area Lesioning? Mov Disord Clin Pract. 2024 May;11(5):504-514. doi: 10.1002/mdc3.14005. Epub 2024 Mar 12. PMID: 38469997 

Ciocca M, Jameel A, Yousif N, Patel N, Smith J, Akgun S, Jones B, Gedroyc W, Nandi D, Tai Y, Seemungal BM, Bain P. Illusions of Self-Motion during Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Tremor. Ann Neurol. 2024 May 6. doi: 10.1002/ana.26945. PMID: 38709569 

Natera-Villalba E, Ruiz-Yanzi MA, Gasca-Salas C, Matarazzo M, Martínez-Fernández R. MR-guided focused ultrasound in movement disorders and beyond: Lessons learned and new frontiers. Parkinsonism Relat Disord. 2024 May;122:106040. doi: 10.1016/j.parkreldis.2024.106040. Epub 2024 Feb 12. PMID: 38378311 

Hashida M, Maesawa S, Kato S, Nakatsubo D, Tsugawa T, Torii J, Tanei T, Ishizaki T, Mutoh M, Ito Y, Tsuboi T, Mizuno S, Suzuki M, Wakabayashi T, Katsuno M, Saito R. Outcomes and Prognostic Factors of Magnetic Resonance-guided Focused Ultrasound Thalamotomy for Essential Tremor at 2-year Follow-up. Neurol Med Chir (Tokyo). 2024 Feb 15. doi: 10.2176/jns-nmc.2023-0202. PMID: 38355128 

Stoycheva T, Jameel A, Bain P, Nandi D, Jones B, Honeyfield L, Gedroyc W, Moore J. ‘Am I fixed, am I better now?’: undergoing MR-guided focused ultrasound for essential tremor: an interpretative phenomenological analysis. Front Neurol. 2024 Feb 8;15:1352581. doi: 10.3389/fneur.2024.1352581. eCollection 2024. PMID: 38390595 

Bagarinao E, Maesawa S, Kato S, Mutoh M, Ito Y, Ishizaki T, Tanei T, Tsuboi T, Suzuki M, Watanabe H, Hoshiyama M, Isoda H, Katsuno M, Sobue G, Saito R. Cerebellar and thalamic connector hubs facilitate the involvement of visual and cognitive networks in essential tremor. Parkinsonism Relat Disord. 2024 Feb 14;121:106034. doi: 10.1016/j.parkreldis.2024.106034. PMID: 38382401 

Gelman K, Melott J, Thakur V, Tarabishy AR, Brandt A, Konrad P, Ranjan M, Memon AA. MR-guided focused ultrasound thalamotomy for lithium-induced tremor: a case report and literature review. Front Neurol. 2024 Feb 1;14:1331241. doi: 10.3389/fneur.2023.1331241. eCollection 2023. PMID: 38362012 

Riis TS, Losser AJ, Kassavetis P, Moretti P, Kubanek J. Noninvasive modulation of essential tremor with focused ultrasonic waves. J Neural Eng. 2024 Feb 27;21(1). doi: 10.1088/1741-2552/ad27ef. PMID: 38335553 

Germann J, Santyr B, Boutet A, Sarica C, Chow CT, Elias GJB, Vetkas A, Yang A, Hodaie M, Fasano A, Kalia SK, Schwartz ML, Lozano AM. Comparative neural correlates of DBS and MRgFUS lesioning for tremor control in essential tremor. J Neurol Neurosurg Psychiatry. 2024 Jan 11;95(2):180-183. doi: 10.1136/jnnp-2022-330795. PMID: 37722831 

Zong R, Li X, Yin C, He J, Zhang D, Bian X, Huang L, Zhou J, Ling Z, Ma L, Lou X, Pan L, Yu X. Magnetic resonance-guided focused ultrasound for essential tremor: a prospective, single center, single-arm study. Neural Regen Res. 2024 Sep 1;19(9):2075-2080. doi: 10.4103/1673-5374.391192. Epub 2024 Jan 12. PMID: 38227538 

Odéen H, Shah LM, Rieke V, Parker DL, Rahimpour S. MR-Guided Focused Ultrasound Thalamotomy in the Setting of Aneurysm Clip. AJNR Am J Neuroradiol. 2024 Jan 25. doi: 10.3174/ajnr.A8109. PMID: 38272573 

Peters J, Maamary J, Kyle K, Olsen N, Jones L, Bolitho S, Barnett Y, Jonker B, Tisch S. Outcomes of Focused Ultrasound Thalamotomy in Tremor Syndromes. Mov Disord. 2024 Jan;39(1):173-182. doi: 10.1002/mds.29658. Epub 2023 Nov 14. PMID: 37964429 

Berger A, Chung J, Schnurman Z, Stepanov V, Pan L, Shepherd TM, Mogilner A. Comparison of Dentatorubrothalamic Tractography Methods Based on the Anatomy of the Rubral Wing. Oper Neurosurg (Hagerstown). 2024 Jan 30. doi: 10.1227/ons.0000000000001058. PMID: 38289086 

Golfrè Andreasi N, Braccia A, Levi V, Rinaldo S, Ghielmetti F, Cilia R, Romito LM, Bonvegna S, Elia AE, Devigili G, Telese R, Colucci F, Bruzzone MG, Messina G, Corradi M, Stanziano M, Caldiera V, Prioni S, Amami P, Fusar Poli M, Piacentini SHMJ, Grisoli M, Ciceri EFM, DiMeco F, Eleopra R. The Optimal Targeting for Focused Ultrasound Thalamotomy Differs between Dystonic and Essential Tremor: A 12-Month Prospective Pilot Study. Mov Disord Clin Pract. 2024 Jan;11(1):69-75. doi: 10.1002/mdc3.13911. Epub 2023 Nov 10. PMID: 38291839 

Free DB, Syndergaard I, Pigg AC, Muceli S, Hallett M, Farina D, Charles SK. Hand and distal tremor is most coherent with the activity of elbow flexors and wrist extensors in persons with Essential Tremor. J Appl Physiol (1985). 2023 Dec 21. doi: 10.1152/japplphysiol.00407.2023. PMID: 38126087 

Deveney CM, Surya JR, Haroon JM, Mahdavi KD, Hoffman KR, Enemuo KC, Jordan KG, Becerra SA, Kuhn T, Bystristky A, Jordan SE. Transcranial focused ultrasound for the treatment of tremor: A preliminary case series. Brain Stimul. 2023 Dec 19;17(1):35-38. doi: 10.1016/j.brs.2023.12.007. PMID: 38128826 

Gurgone S, De Salvo S, Bonanno L, Muscarà N, Acri G, Caridi F, Paladini G, Borzelli D, Brigandì A, La Torre D, Sorbera C, Anfuso C, Di Lorenzo G, Venuti V, D’Avella A, Marino S. Changes in cerebral cortex activity during a simple motor task after MRgFUS treatment in patients affected by essential tremor and Parkinson’s disease: a pilot study using functional NIRS. Phys Med Biol. 2023 Dec 15. doi: 10.1088/1361-6560/ad164e. PMID: 38100845 

Pérez-García C, López-Frías A, Arrazola J, Gil L, García-Ramos R, Fernández Revuelta A, Alonso-Frech F, López Valdés E, Trondin A, Yus-Fuertes M. Four-tract probabilistic tractography technique for target selection in essential tremor treatment with magnetic resonance-guided focused ultrasound. Eur Radiol. 2023 Nov 11. doi: 10.1007/s00330-023-10431-7. PMID: 37950079 

Hori H, Taira T, Abe K, Hori T. A novel high-precision fiber tractography for nuclear localization in transcranial magnetic resonance-guided focused ultrasound surgery: a pilot study. J Neurosurg. 2024 May 1;140(5):1471-1481. doi: 10.3171/2023.8.JNS231459. PMID: 37948701 

Peters J, Maamary J, Kyle K, Olsen N, Jones L, Bolitho S, Barnett Y, Jonker B, Tisch S. Outcomes of Focused Ultrasound Thalamotomy in Tremor Syndromes. Mov Disord. 2023 Nov 14. doi: 10.1002/mds.29658. PMID: 37964429 

Modi P, Qiu L, Fallah T, Courtwright A, Halpern CH. Magnetic Resonance Guided Focused Ultrasound Thalamotomy for Treatment of Severe Essential Tremor in a Lung Transplant Recipient-A Case Report. Transplant Proc. 2023 Oct;55(8):1988-1990. doi: 10.1016/j.transproceed.2023.06.012. Epub 2023 Jul 24. PMID: 37495484 

Yan X, Allen S, Lu M, Moore D, Meyer CH, Grissom WA. Dark band artifact in transcranial MR-guided focused ultrasound: Mechanism and mitigation with passive crossed wire antennas. Magn Reson Imaging. 2023 Nov;103:169-178. doi: 10.1016/j.mri.2023.07.018. Epub 2023 Aug 4. PMID: 37543175 

Lin J, Kang X, Lu H, Zhang D, Bian X, Zhou J, Hu J, Zhang D, Sepulcre J, Pan L, Lou X. Magnetic Resonance-Guided Focused Ultrasound Thalamotomy Rebalances Atypical Functional Hierarchy in Patients with Essential Tremor. Neurotherapeutics. 2023 Oct 16. doi: 10.1007/s13311-023-01442-9. PMID: 37843768 

Scantlebury N, Rohringer CR, Rabin JS, Yunusova Y, Huang Y, Jones RM, Meng Y, Hamani C, McKinlay S, Gopinath G, Sewell IJ, Marzouqah R, McSweeney M, Lam B, Hynynen K, Schwartz ML, Lipsman N, Abrahao A. Safety of Bilateral Staged Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Essential Tremor. Mov Disord Clin Pract. 2023 Sep 15;10(10):1559-1561. doi: 10.1002/mdc3.13882. eCollection 2023 Oct. PMID: 37868927 

Blitz SE, Chua MMJ, Ng P, Segar DJ, Jha R, McDannold NJ, DeSalvo MN, Rolston JD, Cosgrove GR. Longitudinal MR imaging after unilateral MR-guided focused ultrasound thalamotomy: clinical and radiological correlation. Front Neurol. 2023 Oct 6;14:1272425. doi: 10.3389/fneur.2023.1272425. eCollection 2023. PMID: 37869137 

A Systematic Review Comparing Focused Ultrasound Surgery With Radiosurgery for Essential Tremor: Erratum. Neurosurgery. 2023 Oct 27. doi: 10.1227/neu.0000000000002736. PMID: 37888997 

Fleury V, Romascano D, Schneider D, Tuleasca C, Lorton O, Tomkova E, Catalano Chiuve S, Chytas V, Lüscher C, Burkhard PR, Salomir R, Levivier M, Momjian S. Successful MRI-Guided Focused Ultrasound Thalamotomy after Ipsilateral Gamma Knife Radiosurgery for Essential Tremor: A Case Report with Video. Stereotact Funct Neurosurg. 2023 Nov 2:1-7. doi: 10.1159/000534014. PMID: 37918368 

Büchele F, Mahendran S, Uhl M, Freudinger C, Maric A, Heeb NS, Oertel MF, Baumann CR, Stieglitz LH. Impact of target depth on safety and efficacy outcomes in MR-guided focused ultrasound thalamotomy for tremor patients. J Neurosurg. 2024 May 1;140(5):1451-1458. doi: 10.3171/2023.8.JNS23472. PMID: 37922562 

Click here for additional references from PubMed.

Pre- and post-treatment assessment videos courtesy of University of Virginia