Holmes Tremor

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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 Holmes tremor. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.

How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue) enabling treatment of Holmes tremor without surgery.

The primary options for treatment of Holmes tremor include medications or unilateral thalamotomy.

Some of focused ultrasound advantages include:

  • It is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
  • Focused ultrasound can reach the desired target without damaging surrounding tissue.
  • Focused ultrasound does not require the use of ionizing radiation.
  • It can be repeated, if necessary.

Clinical Trials

At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of Holmes tremor.

Regulatory Approval and Reimbursement

Focused ultrasound treatment for Holmes tremor is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Maesawa S, Torii J, Nakatsubo D, Noda H, Mutoh M, Ito Y, Ishizaki T, Tsuboi T, Suzuki M, Tanei T, Katsuno M, Saito R. A case report: Dual-lead deep brain stimulation of the posterior subthalamic area and the thalamus was effective for Holmes tremor after unsuccessful focused ultrasound thalamotomy. Front Hum Neurosci. 2022 Dec 15;16:1065459. doi: 10.3389/fnhum.2022.1065459. eCollection 2022.

Chang SJ, Mitchell R, Hukin J, Singhal A. Treatment-responsive Holmes tremor in a child with low-pressure hydrocephalus: video case report and systematic review of the literature. J Neurosurg Pediatr. 2022 Feb 11:1-8. doi: 10.3171/2021.12.PEDS21539.

Yamamoto K, Ito H, Fukutake S, Odo T, Kamei T, Yamaguchi T, Taira T. Factors Associated with Heating Efficiency in Transcranial Focused Ultrasound Therapy. Neurol Med Chir (Tokyo). 2020 Dec 15;60(12):594-599. doi: 10.2176/nmc.oa.2020-0225. Epub 2020 Nov 6.

Fasano A, Llinas M, Munhoz RP, Hlasny E, Kucharczyk W, Lozano AM. MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes. Neurology. 2017 Aug 22;89(8):771-775. doi: 10.1212/WNL.0000000000004268. Epub 2017 Jul 26.

Gabriela B. Raina, MD, Maria G. Cersosimo, MD, Silvia S. Folgar, MD, Juan C. Giugni, MD, Cristian Calandra, MD, Juan P. Paviolo, MD, Veronica A. Tkachuk, MD, Carlos Zuñiga Ramirez, MD, Andrea L. Tschopp, MD, Daniela S. Calvo, MD, Luis A. Pellene, MD, Marcela C. Uribe Roca, MD, Miriam Velez, MD, Rolando J. Giannaula, MD, Manuel M. Fernandez Pardal, MD, and Federico E. Micheli, MD, PhD. Holmes tremor: Clinical description, lesion localization, and treatment in a series of 29 cases. Neurology. 2016 Mar 8; 86(10): 931–938.

Click here for additional references from PubMed.

Clinical Trials