Research News

Incisionless transcranial MR-guided focused ultrasound in essential tremor: cerebellothalamic tractotomy

13 Feb 2016

In the late 1960s and early 1970s, targeting of the “posterior subthalamic area (PSA)” was explored by different functional neurosurgical groups applying the radiofrequency (RF) technique to treat patients suffering from essential tremor (ET). Recent advances in magnetic resonance (MR)-guided focused ultrasound (MRgFUS) technology offer the possibility to perform thermocoagulation of the cerebellothalamic fiber tract in the PSA without brain penetration, allowing a strong reduction of the procedure-related risks and increased accuracy. This study describes the first results of the MRgFUS cerebellothalamic tractotomy (CTT) as an effective and safe approach for patients with therapy-refractory essential tremor, combining neurological function sparing with precise targeting and the possibility to treat patients bilaterally.

Journal of Therapeutic Ultrasound

Agnosia for head tremor in essential tremor: prevalence and clinical correlates

12 Feb 2016

Lack of awareness of involuntary movements is a curious phenomenon in patients with certain movement disorders. An interesting anecdotal observation is that patients with essential tremor (ET) often seem unaware of their own head tremor. In this study, ET patients were asked whether they were aware of head tremor while it was occurring on examination, thereby allowing us to gauge real-time awareness of their involuntary movement.

Journal of Clinical Movement Disorders

A suggested Minimum Standard deep brain stimulation evaluation for essential tremor

21 Jan 2016

The study aims to determine the number of essential tremor (ET) referrals excluded from surgery and why, in order to develop recommendations for a minimum standard DBS evaluation process.

Journal of the Neurological Sciences

Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor

3 Dec 2015

Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms. This study aims to develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy as a viable method to differentiate between essential and dystonic voice tremor syndromes.

Science Direct

The UK’s first MR-Guided Focussed Ultrasound Machine will be sited at St. Mary’s Hospital in London

27 Nov 2015

I am delighted to inform the National Tremor Foundation that after considerable activity by my colleagues Professor Wladyslaw Gedroyc (consultant radiologist), Mr Dipankar Nandi (consultant neurosurgeon) and me, we have obtained £1,250,000 from the Imperial College Healthcare Charity trustees to purchase a MR-Guided Focussed Ultrasound (MRgFUS) machine for Imperial College Healthcare NHS Trust.

Functional assessment and quality of life in essential tremor with bilateral or unilateral DBS and focused ultrasound thalamotomy

17 Nov 2015

Thalamic deep brain stimulation (DBS) has largely replaced radiofrequency thalamotomy as the treatment of choice for disabling, medication-refractory essential tremor. Recently, the development of transcranial, high-intensity focused ultrasound has renewed interest in thalamic lesioning. This study compares functional outcomes and quality of life in essential tremor patients treated with either bilateral Vim DBS or unilateral procedures (focused ultrasound or DBS).

International Parkinson and Movement Disorder Society

Non-invasive central and peripheral stimulation: new hope for essential tremor?

1 Nov 2015

Essential tremor usually manifests as a postural and kinematic tremor of the arms, but may also involve the head, voice, lower limbs and trunk. An oscillatory network has been proposed as a neural correlate of ET, and is mainly composed of the olivocerebellar system, thalamus and motor cortex. Their non-invasiveness, along with their side effects profile, makes them an appealing treatment option. In addition, peripheral stimulation has been applied in the same perspective. The aim of this review is to shed light on the emergent use of noninvasive central and peripheral stimulation techniques in this interesting context.


Essential tremor is associated with disruption of functional connectivity in the ventral intermediate Nucleus—Motor Cortex—Cerebellum circuit

15 Oct 2015

The clinical benefits of targeting the ventral intermediate nucleus (VIM) for the treatment of tremors in essential tremor (ET) patients suggest that the VIM is a key hub in the network of tremor generation and propagation and that the VIM can be considered as a seed region to study the tremor network. Findings from this study provide the first evidence that the pathological tremors observed in ET patients might be based on a physiologically pre-existing VIM-motor cortex (MC)-cerebellum (CBLM) network and that disruption of functional connectivity in this physiological network is associated with ET. 

Human Brain Mapping

A prospective single-blind study of Gamma Knife thalamotomy for tremor

7 Oct 2015

Study to evaluate the safety and efficacy of unilateral Gamma Knife thalamotomy (GKT) for treatment of severe tremor with a prospective blinded assessment. This blinded prospective assessment demonstrates that unilateral GKT is a safe and efficient procedure for severe medically refractory tremor. Side effects were rare and transient in this study.

American Academy of Neurology

International Essential Tremor Foundation Seeks Grant Proposals

24 Sep 2015

The International Essential Tremor Foundation (IETF) is pleased to announce proposals are now being accepted from researchers whose investigation addresses the nosology, etiology, pathogenesis, treatment or other topics relevant to essential tremor (ET). The submission deadline for proposals is February 28, 2016. The announcement of the award will take place on June 1, 2016 with the funding period to begin July 1, 2016.

International Essential Tremor Foundation

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