Tremor in PD? Skip the Knife

  From neuropsychologists at the U of Virginia, focused ultrasound thalamotomy (that strategically makes a hole deep in the brain) improves the quality of life in patient's with drug resistant tremor associated with Parkinson's disease.
Neurology 2018. 91(14):e1275-e1284

Ultrasound Thalamotomy Treatment For Essential Tremor

  From the U of VirginiaCOM 15 study patients with essential tremor were treated with MRI-guided focused high-intensity ultrasound waves (sonification) to ablate the ventral us intermedius nucleus of the thalamus. Significant improvement was seen in all patients that were heretofore unresponsive to drug treatment (typically 50% of patients with ET which is inherited).
  The down side: this treatment, unlike deep brain stimulation, is irreversible and therefore adverse events are permanent including four patients in this study that suffered persistent paresthesias.
  The up side: US thalamotomy may be applicable to other disorders : brain tumors, other movement disorders, epilepsy and central pain disorders.
NEJM 2013;369:640-648
Lancet Neurology 2013;12(5):462-468