Advertisement

Essential Tremor: Lesions

  • Shayan Moosa
  • W. Jeffrey EliasEmail author
Chapter
  • 96 Downloads

Abstract

The treatment of medication-refractory tremor with cerebral lesioning has significantly evolved since its inception in the 1930s. While originally a highly morbid procedure, innovations in stereotactic localization and image guidance have led to several safe and efficacious methods for the surgical treatment of essential tremor. Current targets include the ventral intermediate nucleus of the thalamus and posterior subthalamic area. Radiofrequency ablation, Gamma Knife radiosurgery, and magnetic resonance-guided focused ultrasound are modern lesioning modalities in the treatment of essential tremor, and individual patient characteristics and expectations are taken into account when choosing a particular technique. The irreversibility of cerebral lesioning in the setting of current neuromodulation technology has reduced its enthusiasm; but recent advancements in transcranial procedures, patient-specific targeting, and image guidance are reinvigorating lesioning as a surgical option for tremor.

Keywords

Essential tremor Movement disorders Cerebral lesioning Ablative surgery Thalamotomy Ventral intermediate nucleus Stereotactic surgery Radiofrequency ablation Gamma Knife radiosurgery Focused ultrasound 

Abbreviations

AAN

American Academy of Neurology

AC

Anterior commissure

AChA

Anterior choroidal artery

ADC

Apparent diffusion coefficient

ADL

Activities of daily living

CRST

Clinical Rating Scale for Tremor

CSF

Cerebrospinal fluid

CT

Computed tomography

DBS

Deep brain stimulation

DRT

Dentatorubrothalamic tract

DWI

Diffusion-weighted imaging

GK

Gamma Knife

GKRS

Gamma Knife radiosurgery

ICL

Intercommissural line

MCP

Midcommissural point

MER

Microelectrode recording

MPR

MP-RAGE

MRgFUS

Magnetic resonance-guided focused ultrasound

MRI

Magnetic resonance imaging

PC

Posterior commissure

PD

Parkinson’s disease

PSA

Posterior subthalamic area

RF

Radiofrequency

SDR

Skull density ratio

SWI

Susceptibility-weighted imaging

Vc

Ventralis caudalis

Vim

Ventral intermediate

VL

Ventrolateral

Vop

Ventralis oralis posterior

References

  1. 1.
    Bucy PC. Surgical relief of tremor at rest. Ann Surg. 1945;122:933–41.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Koehler PJ, Keyser A. Tremor in Latin texts of Dutch physicians: 16th–18th centuries. Mov Disord. 1997;12(5):798–806.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Putnam TJ. Relief from unilateral paralysis agitans by section of the pyramidal tract. Arch Neurol Psychiatr. 1938;40:1049–50.Google Scholar
  4. 4.
    Walker AE. Cerebral pedunculotomy for the relief of involuntary movements; hemiballismus. Acta Psychiatr Neurol. 1949;24(3–4):723–9.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Walker AE. Cerebral pedunculotomy for the relief of involuntary movements. II. Parkinsonian tremor. J Nerv Ment Dis. 1952;116(6):766–75.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Bucy PC, Keplinger JE, Siqueira EB. Destruction of the “pyramidal tract” in man. J Neurosurg. 1964;21:285–98.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Jane JA, Yashon D, Becker DP, Beatty R, Sugar O. The effect of destruction of the corticospinal tract in the human cerebral peduncle upon motor function and involuntary movements. Report of 11 cases. J Neurosurg. 1968;29(6):581–5.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Abel TJ, Walch T, Howard MA 3rd. Russell Meyers (1905–1999): pioneer of functional and ultrasonic neurosurgery. J Neurosurg. 2016;125(6):1589–95.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Guiot G, Brion S. Treatment of abnormal movement by pallidal coagulation. Rev Neurol (Paris). 1953;89(6):578–80.Google Scholar
  10. 10.
    Spiegel EA, Wycis HT. Pallidothalamotomy in chorea. Arch Neurol Psychiatr. 1950;64(2):295–6.Google Scholar
  11. 11.
    Spiegel EA, Wycis HT, Thur C. The stereoencephalotome (model III of our stereotaxic apparatus for operations on the human brain). J Neurosurg. 1951;8(4):452–3.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Spiegel EA, Wycis HT. Ansotomy in paralysis agitans. AMA Arch Neurol Psychiatry. 1954;71(5):598–614.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Cooper IS. Anterior choroidal artery ligation for involuntary movements. Science. 1953;118(3059):193.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Das K, Benzil DL, Rovit RL, Murali R, Couldwell WT. Irving S. Cooper (1922–1985): a pioneer in functional neurosurgery. J Neurosurg. 1998;89(5):865–73.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Cooper IS. Surgical alleviation of parkinsonism; effects of occlusion of the anterior choroidal artery. J Am Geriatr Soc. 1954;2(11):691–718.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Cooper IS. Chemopallidectomy: an investigative technique in geriatric parkinsonians. Science. 1955;121(3137):217–8.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Hassler R, Riechert T. Indications and localization of stereotactic brain operations. Nervenarzt. 1954;25(11):441–7.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Hassler R, Riechert T. Symptomatology & surgery of extrapyramidal movement disorders. Med Klin. 1958;53(19):817–24.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Bravo GJ, Cooper IS. A clinical and radiological correlation of the lesions produced by chemopallidectomy and thalamectomy. J Neurol Neurosurg Psychiatry. 1959;22(1):1–10.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Cooper IS. Results of 1,000 consecutive basal ganglia operations for parkinsonism. Ann Intern Med. 1960;52:483–99.CrossRefGoogle Scholar
  21. 21.
    Louis ED, Ferreira JJ. How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Mov Disord. 2010;25(5):534–41.CrossRefGoogle Scholar
  22. 22.
    Deuschl G, Wenzelburger R, Loffler K, Raethjen J, Stolze H. Essential tremor and cerebellar dysfunction clinical and kinematic analysis of intention tremor. Brain. 2000;123(Pt 8):1568–80.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Koller WC, Vetere-Overfield B. Acute and chronic effects of propranolol and primidone in essential tremor. Neurology. 1989;39(12):1587–8.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Diaz NL, Louis ED. Survey of medication usage patterns among essential tremor patients: movement disorder specialists vs. general neurologists. Parkinsonism Relat Disord. 2010;16(9):604–7.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Zesiewicz TA, Elble R, Louis ED, Hauser RA, Sullivan KL, Dewey RB Jr, et al. Practice parameter: therapies for essential tremor (ET): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2005;64(12):2008–20.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Zesiewicz TA, Elble RJ, Louis ED, Gronseth GS, Ondo WG, Dewey RB Jr, et al. Evidence-based guideline update: treatment of essential tremor (ET): report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology. 2011;77(19):1752–5.PubMedCentralCrossRefPubMedGoogle Scholar
  27. 27.
    Dallapiazza RF, Lee DJ, De Vloo P, Fomenko A, Hamani C, Hodaie M, et al. Outcomes from stereotactic surgery for essential tremor. J Neurol Neurosurg Psychiatry. 2019;90:474–82.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Schaltenbrand G, Wahren W. Atlas for stereotaxy of the human brain. New York: Thieme; 1977.Google Scholar
  29. 29.
    Hirai T, Ohye C, Nagaseki Y, Matsumura M. Cytometric analysis of the thalamic ventralis intermedius nucleus in humans. J Neurophysiol. 1989;61(3):478–87.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Kelly PJ, Derome P, Guiot G. Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control. Surg Neurol. 1978;9(5):307–15.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Laitinen LV. Brain targets in surgery for Parkinson’s disease. Results of a survey of neurosurgeons. J Neurosurg. 1985;62(3):349–51.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Hamani C, Dostrovsky JO, Lozano AM. The motor thalamus in neurosurgery. Neurosurgery. 2006;58(1):146–58; discussion −58.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Pouratian N, Zheng Z, Bari AA, Behnke E, Elias WJ, Desalles AA. Multi-institutional evaluation of deep brain stimulation targeting using probabilistic connectivity-based thalamic segmentation. J Neurosurg. 2011;115(5):995–1004.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Sammartino F, Krishna V, King NK, Lozano AM, Schwartz ML, Huang Y, et al. Tractography-based ventral intermediate nucleus targeting: novel methodology and intraoperative validation. Mov Disord. 2016;31(8):1217–25.PubMedCentralCrossRefPubMedGoogle Scholar
  35. 35.
    Starr PA, Vitek JL, Bakay RA. Ablative surgery and deep brain stimulation for Parkinson’s disease. Neurosurgery. 1998;43(5):989–1013; discussion −5.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Lenz FA, Kwan HC, Martin RL, Tasker RR, Dostrovsky JO, Lenz YE. Single unit analysis of the human ventral thalamic nuclear group. Tremor-related activity in functionally identified cells. Brain. 1994;117(Pt 3):531–43.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Magnin M, Morel A, Jeanmonod D. Single-unit analysis of the pallidum, thalamus and subthalamic nucleus in parkinsonian patients. Neuroscience. 2000;96(3):549–64.CrossRefGoogle Scholar
  38. 38.
    Lenz FA, Normand SL, Kwan HC, Andrews D, Rowland LH, Jones MW, et al. Statistical prediction of the optimal site for thalamotomy in parkinsonian tremor. Mov Disord. 1995;10(3):318–28.CrossRefGoogle Scholar
  39. 39.
    Vitek JL, Ashe J, Kaneoke Y. Spontaneous neuronal activity in the motor thalamus: alteration in pattern and rate in parkinsonism. Soc Neurosci Abstr. 1994;20:561.Google Scholar
  40. 40.
    Gallay MN, Jeanmonod D, Liu J, Morel A. Human pallidothalamic and cerebellothalamic tracts: anatomical basis for functional stereotactic neurosurgery. Brain Struct Funct. 2008;212(6):443–63.PubMedCentralCrossRefPubMedGoogle Scholar
  41. 41.
    Blomstedt P, Sandvik U, Fytagoridis A, Tisch S. The posterior subthalamic area in the treatment of movement disorders: past, present, and future. Neurosurgery. 2009;64(6):1029–38; discussion 38–42.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Plaha P, Patel NK, Gill SS. Stimulation of the subthalamic region for essential tremor. J Neurosurg. 2004;101(1):48–54.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Plaha P, Khan S, Gill SS. Bilateral stimulation of the caudal zona incerta nucleus for tremor control. J Neurol Neurosurg Psychiatry. 2008;79(5):504–13.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Blomstedt P, Sandvik U, Tisch S. Deep brain stimulation in the posterior subthalamic area in the treatment of essential tremor. Mov Disord. 2010;25(10):1350–6.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Elias WJ, Sansur CA, Frysinger RC. Sulcal and ventricular trajectories in stereotactic surgery. J Neurosurg. 2009;110(2):201–7.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Vitek JL, Bakay RA, Hashimoto T, Kaneoke Y, Mewes K, Zhang JY, et al. Microelectrode-guided pallidotomy: technical approach and its application in medically intractable Parkinson’s disease. J Neurosurg. 1998;88(6):1027–43.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Nagaseki Y, Shibazaki T, Hirai T, Kawashima Y, Hirato M, Wada H, et al. Long-term follow-up results of selective VIM-thalamotomy. J Neurosurg. 1986;65(3):296–302.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Mohadjer M, Goerke H, Milios E, Etou A, Mundinger F. Long-term results of stereotaxy in the treatment of essential tremor. Stereotact Funct Neurosurg. 1990;54–55:125–9.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Goldman MS, Ahlskog JE, Kelly PJ. The symptomatic and functional outcome of stereotactic thalamotomy for medically intractable essential tremor. J Neurosurg. 1992;76(6):924–8.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Jankovic J, Cardoso F, Grossman RG, Hamilton WJ. Outcome after stereotactic thalamotomy for parkinsonian, essential, and other types of tremor. Neurosurgery. 1995;37(4):680–6; discussion 6–7.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Shahzadi S, Tasker RR, Lozano A. Thalamotomy for essential and cerebellar tremor. Stereotact Funct Neurosurg. 1995;65(1–4):11–7.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Zirh A, Reich SG, Dougherty PM, Lenz FA. Stereotactic thalamotomy in the treatment of essential tremor of the upper extremity: reassessment including a blinded measure of outcome. J Neurol Neurosurg Psychiatry. 1999;66(6):772–5.PubMedCentralCrossRefPubMedGoogle Scholar
  53. 53.
    Akbostanci MC, Slavin KV, Burchiel KJ. Stereotactic ventral intermedial thalamotomy for the treatment of essential tremor (ET): results of a series of 37 patients. Stereotact Funct Neurosurg. 1999;72(2–4):174–7.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Fahn S, Tolosa E, Marin C. Clinical rating scale for tremor. In: Jankovic J, Tolosa E, editors. Parkinson’s disease and movement disorders. Baltimore/Munich: Urban & Schwarzenberg; 1988. p. 223–34.Google Scholar
  55. 55.
    Sobstyl M, Zabek M, Koziara H, Kadziolka B, Mossakowski Z. Stereotactic ventrolateral thalamotomy in the treatment of essential tremor. Neurol Neurochir Pol. 2006;40(3):179–85.PubMedPubMedCentralGoogle Scholar
  56. 56.
    Tasker RR. Deep brain stimulation is preferable to thalamotomy for tremor suppression. Surg Neurol. 1998;49(2):145–53; discussion 53–4.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Schuurman PR, Bosch DA, Bossuyt PM, Bonsel GJ, van Someren EJ, de Bie RM, et al. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N Engl J Med. 2000;342(7):461–8.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Pahwa R, Lyons KE, Wilkinson SB, Troster AI, Overman J, Kieltyka J, et al. Comparison of thalamotomy to deep brain stimulation of the thalamus in essential tremor. Mov Disord. 2001;16(1):140–3.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Anderson VC, Burchiel KJ, Hart MJ, Berk C, Lou JS. A randomized comparison of thalamic stimulation and lesion on self-paced finger movement in essential tremor. Neurosci Lett. 2009;462(2):166–70.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Leksell L. Cerebral radiosurgery. I. Gammathalanotomy in two cases of intractable pain. Acta Chir Scand. 1968;134(8):585–95.Google Scholar
  61. 61.
    Steiner L, Forster D, Leksell L, Meyerson BA, Boethius J. Gammathalamotomy in intractable pain. Acta Neurochir. 1980;52(3–4):173–84.CrossRefGoogle Scholar
  62. 62.
    Kooshkabadi A, Lunsford LD, Tonetti D, Flickinger JC, Kondziolka D. Gamma Knife thalamotomy for tremor in the magnetic resonance imaging era. J Neurosurg. 2013;118(4):713–8.CrossRefGoogle Scholar
  63. 63.
    Witjas T, Carron R, Krack P, Eusebio A, Vaugoyeau M, Hariz M, et al. A prospective single-blind study of Gamma Knife thalamotomy for tremor. Neurology. 2015;85(18):1562–8.CrossRefGoogle Scholar
  64. 64.
    Young RF, Li F, Vermeulen S, Meier R. Gamma Knife thalamotomy for treatment of essential tremor (ET): long-term results. J Neurosurg. 2010;112(6):1311–7.CrossRefGoogle Scholar
  65. 65.
    Ohye C, Higuchi Y, Shibazaki T, Hashimoto T, Koyama T, Hirai T, et al. Gamma Knife thalamotomy for Parkinson disease and essential tremor (ET): a prospective multicenter study. Neurosurgery. 2012;70(3):526–35; discussion 35–6.CrossRefGoogle Scholar
  66. 66.
    Young RF, Shumway-Cook A, Vermeulen SS, Grimm P, Blasko J, Posewitz A, et al. Gamma Knife radiosurgery as a lesioning technique in movement disorder surgery. J Neurosurg. 1998;89(2):183–93.CrossRefGoogle Scholar
  67. 67.
    Lim SY, Hodaie M, Fallis M, Poon YY, Mazzella F, Moro E. Gamma Knife thalamotomy for disabling tremor: a blinded evaluation. Arch Neurol. 2010;67(5):584–8.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Niranjan A, Raju SS, Kooshkabadi A, Monaco E 3rd, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for essential tremor (ET): retrospective analysis of a 19-year experience. Mov Disord. 2017;32(5):769–77.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Kondziolka D, Ong JG, Lee JY, Moore RY, Flickinger JC, Lunsford LD. Gamma Knife thalamotomy for essential tremor. J Neurosurg. 2008;108(1):111–7.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Fry WJ, Mosberg WH Jr, Barnard JW, Fry FJ. Production of focal destructive lesions in the central nervous system with ultrasound. J Neurosurg. 1954;11(5):471–8.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Jagannathan J, Sanghvi NT, Crum LA, Yen CP, Medel R, Dumont AS, et al. High-intensity focused ultrasound surgery of the brain: part 1--A historical perspective with modern applications. Neurosurgery. 2009;64(2):201–10; discussion 10–1.PubMedCentralCrossRefPubMedGoogle Scholar
  72. 72.
    Clement GT, White PJ, King RL, McDannold N, Hynynen K. A magnetic resonance imaging-compatible, large-scale array for trans-skull ultrasound surgery and therapy. J Ultrasound Med. 2005;24(8):1117–25.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Gallay MN, Moser D, Jeanmonod D. Safety and accuracy of incisionless transcranial MR-guided focused ultrasound functional neurosurgery: single-center experience with 253 targets in 180 treatments. J Neurosurg. 2018;1:1–10.Google Scholar
  74. 74.
    Chang WS, Jung HH, Zadicario E, Rachmilevitch I, Tlusty T, Vitek S, et al. Factors associated with successful magnetic resonance-guided focused ultrasound treatment: efficiency of acoustic energy delivery through the skull. J Neurosurg. 2016;124(2):411–6.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Wang TR, Bond AE, Dallapiazza RF, Blanke A, Tilden D, Huerta TE, et al. Transcranial magnetic resonance imaging-guided focused ultrasound thalamotomy for tremor: technical note. Neurosurg Focus. 2018;44(2):E3.CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    Chang WS, Jung HH, Kweon EJ, Zadicario E, Rachmilevitch I, Chang JW. Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor (ET): practices and clinicoradiological outcomes. J Neurol Neurosurg Psychiatry. 2015;86(3):257–64.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Elias WJ, Huss D, Voss T, Loomba J, Khaled M, Zadicario E, et al. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med. 2013;369(7):640–8.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    Lipsman N, Schwartz ML, Huang Y, Lee L, Sankar T, Chapman M, et al. MR-guided focused ultrasound thalamotomy for essential tremor (ET): a proof-of-concept study. Lancet Neurol. 2013;12(5):462–8.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Elias WJ, Lipsman N, Ondo WG, Ghanouni P, Kim YG, Lee W, et al. A randomized trial of focused ultrasound thalamotomy for essential tremor. N Engl J Med. 2016;375(8):730–9.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Chang JW, Park CK, Lipsman N, Schwartz ML, Ghanouni P, Henderson JM, et al. A prospective trial of magnetic resonance-guided focused ultrasound thalamotomy for essential tremor (ET): results at the 2-year follow-up. Ann Neurol. 2018;83(1):107–14.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Fishman PS, Elias WJ, Ghanouni P, Gwinn R, Lipsman N, Schwartz M, et al. Neurological adverse event profile of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor. Mov Disord. 2018;33(5):843–7.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Wang TR, Dallapiazza RF, Moosa S, Huss D, Shah BB, Elias WJ. Thalamic deep brain stimulation salvages failed focused ultrasound thalamotomy for essential tremor (ET): a case report. Stereotact Funct Neurosurg. 2018;96(1):60–4.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Lanska DJ. Chapter 33: the history of movement disorders. Handb Clin Neurol. 2010;95:501–46.CrossRefPubMedPubMedCentralGoogle Scholar
  84. 84.
    Benabid AL, Chabardes S, Torres N, Piallat B, Krack P, Fraix V, et al. Functional neurosurgery for movement disorders: a historical perspective. Prog Brain Res. 2009;175:379–91.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Abosch A, Yacoub E, Ugurbil K, Harel N. An assessment of current brain targets for deep brain stimulation surgery with susceptibility-weighted imaging at 7 tesla. Neurosurgery. 2010;67(6):1745–56; discussion 56.PubMedCentralCrossRefPubMedGoogle Scholar
  86. 86.
    Tian Q, Wintermark M, Jeffrey Elias W, Ghanouni P, Halpern CH, Henderson JM, et al. Diffusion MRI tractography for improved transcranial MRI-guided focused ultrasound thalamotomy targeting for essential tremor. Neuroimage Clin. 2018;19:572–80.PubMedCentralCrossRefPubMedGoogle Scholar
  87. 87.
    Krishna V, Sammartino F, Agrawal P, Changizi BK, Bourekas E, Knopp MV, et al. Prospective tractography-based targeting for improved safety of focused ultrasound thalamotomy. Neurosurgery. 2018;84:160–8.Google Scholar
  88. 88.
    Alshaikh J, Fishman PS. Revisiting bilateral thalamotomy for tremor. Clin Neurol Neurosurg. 2017;158:103–7.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Neurological SurgeryUniversity of VirginiaCharlottesvilleUSA
  2. 2.Departments of Neurological Surgery and NeurologyUniversity of VirginiaCharlottesvilleUSA

Personalised recommendations