Radiosurgical thalamotomy for essential tremor: state of the art, current challenges and future directions.
In: Expert review of neurotherapeutics, Jg. 24 (2024-06-01), Heft 6, S. 597-605
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Zugriff:
Introduction: 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.
Areas Covered: 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.
Expert Opinion: 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.
Titel: |
Radiosurgical thalamotomy for essential tremor: state of the art, current challenges and future directions.
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Autor/in / Beteiligte Person: | Iorio-Morin, C ; Mathieu, D ; Franzini, A ; Hodaie, M ; Villeneuve, SA ; Hamel, A ; Lozano, AM |
Zeitschrift: | Expert review of neurotherapeutics, Jg. 24 (2024-06-01), Heft 6, S. 597-605 |
Veröffentlichung: | 2015- : Abingdon, Oxford : Taylor & Francis ; <i>Original Publication</i>: London : Future Drugs Ltd., 2001-, 2024 |
Medientyp: | academicJournal |
ISSN: | 1744-8360 (electronic) |
DOI: | 10.1080/14737175.2024.2351512 |
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