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Semin Neurol
DOI: 10.1055/a-2789-0271
Review Article

Current Approach to Surgical Management of Tremor Disorders

Authors

  • Gerardo Chavira-Hernandez

    1   Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
    2   Division of Neurology, University of Toronto, Toronto, Ontario, Canada

  • Alfonso Fasano

    1   Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
    2   Division of Neurology, University of Toronto, Toronto, Ontario, Canada
    3   Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
    4   Department of Biomedical Sciences, Humanitas University, Milan, Italy
    5   IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

Funding Information This work was supported by the University of Toronto and the University Health Network Chair in Neuromodulation to AF.
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Abstract

Essential tremor (ET) is the most common cause of tremor worldwide and can become profoundly disabling in many patients, with pharmacological treatments often providing insufficient relief. Surgical interventions have emerged as effective strategies for long-term tremor control. This review summarizes the current evidence on surgical therapies, including deep brain stimulation (DBS), radiofrequency (RF) thalamotomy, magnetic resonance-guided focused ultrasound (MRgFUS), and Gamma Knife radiosurgery (GKSR) for ET and other tremor-inducing syndromes. These techniques demonstrate comparable efficacy. DBS offers the advantage of adjustable parameters, allowing optimization of the therapeutic window while minimizing adverse effects. MRgFUS is particularly attractive due to its minimally invasive nature, whereas RF thalamotomy and GKSR remain viable alternatives for patients who are ineligible for DBS or MRgFUS. Bilateral interventions are increasingly feasible, and treatment selection should be individualized, considering clinical characteristics and patient preference. Ongoing advances in magnetic resonance imaging (MRI) technology and neurostimulation are poised to further refine surgical management and improve outcomes for patients with tremor.

Keywords

tremor - deep brain stimulation - Gamma Knife stereotactic radiosurgery - magnetic resonance-guided focused ultrasound - radiofrequency thalamotomy

Contributors' Statement

G.C-H. contributed to the investigation and methodology and was involved in writing the original draft as well as review and editing. A.F. was responsible for conceptualization, formal analysis, investigation, methodology, project administration, resources, supervision, validation, visualization, and writing, including review and editing.




Publication History

Received: 20 December 2025

Accepted: 14 January 2026

Accepted Manuscript online:
15 January 2026

Article published online:
06 February 2026

© 2026. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Bhatia KP, Bain P, Bajaj N. et al; Tremor Task Force of the International Parkinson and Movement Disorder Society. Consensus Statement on the classification of tremors. From the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord 2018; 33 (01) 75-87
    Search in Google Scholar
  • 2 Louis ED, McCreary M. How common is essential tremor? Update on the worldwide prevalence of essential tremor. Tremor Other Hyperkinet Mov (N Y) 2021; 11: 28
    Search in Google Scholar
  • 3 Song P, Zhang Y, Zha M. et al; Global Health Epidemiology Reference Group (GHERG). The global prevalence of essential tremor, with emphasis on age and sex: A meta-analysis. J Glob Health 2021; 11: 04028
    Search in Google Scholar
  • 4 Gerbasi ME, Nambiar S, Reed S. et al. Essential tremor patients experience significant burden beyond tremor: A systematic literature review. Front Neurol 2022; 13: 891446
    Search in Google Scholar
  • 5 Siokas V, Aloizou AM, Tsouris Z. et al. Genetic risk factors for essential tremor: A review. Tremor Other Hyperkinet Mov (N Y) 2020; 10: 4
    Search in Google Scholar
  • 6 Mavroudis I, Petridis F. Neuropathological findings in essential tremor. Folia Neuropathol 2025; 63 (01) 11-18
    Search in Google Scholar
  • 7 Younger E, Ellis EG, Parsons N. et al. Mapping essential tremor to a common brain network using functional connectivity analysis. Neurology 2023; 101 (15) e1483-e1494
    Search in Google Scholar
  • 8 Morris AE, Adeyemo B, Campbell MC. et al. Thalamic and visual network dysfunction relates to tremor response in thalamic deep brain stimulation. Tremor Other Hyperkinet Mov (N Y) 2025; 15: 34
    Search in Google Scholar
  • 9 Erro R, Fasano A, Barone P, Bhatia KP. Milestones in tremor research: 10 Years later. Mov Disord Clin Pract 2022; 9 (04) 429-435
    Search in Google Scholar
  • 10 Ferreira JJ, Mestre TA, Lyons KE. et al; MDS Task Force on Tremor and the MDS Evidence Based Medicine Committee. MDS evidence-based review of treatments for essential tremor. Mov Disord 2019; 34 (07) 950-958
    Search in Google Scholar
  • 11 Okelberry T, Lyons KE, Pahwa R. Updates in essential tremor. Parkinsonism Relat Disord 2024; 122: 106086
    Search in Google Scholar
  • 12 Fasano A, Deuschl G. Therapeutic advances in tremor. Mov Disord 2015; 30 (11) 1557-1565
    Search in Google Scholar
  • 13 Hariz M. Pros and cons of ablation for functional neurosurgery in the neurostimulation age. Neurosurg Clin N Am 2023; 34 (02) 291-299
    Search in Google Scholar
  • 14 Horisawa S, Nonaka T, Kohara K, Mochizuki T, Kawamata T, Taira T. Bilateral radiofrequency ventral intermediate thalamotomy for essential tremor. Stereotact Funct Neurosurg 2023; 101 (01) 30-40
    Search in Google Scholar
  • 15 Akbostanci MC, Slavin KV, Burchiel KJ. Stereotactic ventral intermedial thalamotomy for the treatment of essential tremor: Results of a series of 37 patients. Stereotact Funct Neurosurg 1999; 72 (2-4): 174-177
    Search in Google Scholar
  • 16 Ishihara BK, Hart MG, Barrick TR, Howe FA, Morgante F, Pereira EA. Radiofrequency thalamotomy for tremor produces focused and predictable lesions shown on magnetic resonance images. Brain Commun 2023; 5 (06) fcad329
    Search in Google Scholar
  • 17 Iorio-Morin C, Mathieu D, Franzini A. et al. Radiosurgical thalamotomy for essential tremor: State of the art, current challenges and future directions. Expert Rev Neurother 2024; 24 (06) 597-605
    Search in Google Scholar
  • 18 Scantlebury N, Rohringer CR, Rabin JS. et al. Safety of bilateral staged magnetic resonance-guided focused ultrasound thalamotomy for essential tremor. Mov Disord Clin Pract 2023; 10 (10) 1559-1561
    Search in Google Scholar
  • 19 Denier A. Ultra-sons et diencéphale. J Radiol Electrol 1948; 29: 278-279
    Search in Google Scholar
  • 20 Jagannathan J, Sanghvi NT, Crum LA. et al. High-intensity focused ultrasound surgery of the brain: Part 1–A historical perspective with modern applications. Neurosurgery 2009; 64 (02) 201-210 , discussion 210–211
    Search in Google Scholar
  • 21 Miller WK, Becker KN, Caras AJ. et al. Magnetic resonance-guided focused ultrasound treatment for essential tremor shows sustained efficacy: A meta-analysis. Neurosurg Rev 2022; 45 (01) 533-544
    Search in Google Scholar
  • 22 Mendelson B, Melott JC, Gelman K. et al. Enhancing precision in MRgFUS for tremor treatment: A systematic review of tractography-based VIM targeting approaches. Neurosurg Rev 2025; 48 (01) 479
    Search in Google Scholar
  • 23 Paff M, Boutet A, Neudorfer C. et al. Magnetic resonance-guided focused ultrasound thalamotomy to treat essential tremor in nonagenarians. Stereotact Funct Neurosurg 2020; 98 (03) 182-186
    Search in Google Scholar
  • 24 Hino S, Maki F, Yamaguchi T. et al. Effectiveness and safety of MR-guided focused ultrasound thalamotomy in patients with essential tremor and low skull density ratio: A study of 101 cases. J Neurosurg 2024; 141 (01) 212-220
    Search in Google Scholar
  • 25 Vetkas A, Boutet A, Sarica C. et al. Successful magnetic resonance-guided focused ultrasound treatment of tremor in patients with a skull density ratio of 0.4 or less. J Neurosurg 2023; 140 (03) 639-647
    Search in Google Scholar
  • 26 Ng PR, Blitz SE, Chua MMJ, Cosgrove GR. Magnetic resonance-guided focused ultrasound thalamotomy for essential tremor patients with low skull density ratio: A case-matched analysis. Front Neurol 2024; 15: 1370574
    Search in Google Scholar
  • 27 Thomas B, Bellini G, Lee WY, Shi Y, Mogilner A, Pourfar MH. High intensity focused ultrasound - Longitudinal data on efficacy and safety. Tremor Other Hyperkinet Mov (N Y) 2025; 15: 18
    Search in Google Scholar
  • 28 Chua MMJ, Blitz SE, Ng PR. et al. Focused ultrasound thalamotomy for tremor in Parkinson's disease: Outcomes in a large, prospective cohort. Mov Disord 2023; 38 (10) 1962-1967
    Search in Google Scholar
  • 29 Elias WJ, Lipsman N, Ondo WG. et al. A randomized trial of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2016; 375 (08) 730-739
    Search in Google Scholar
  • 30 Cosgrove GR, Lipsman N, Lozano AM. et al. Magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor: 5-year follow-up results. J Neurosurg 2022; 138 (04) 1028-1033
    Search in Google Scholar
  • 31 Rohringer CR, Sewell IJ, Gandhi S. et al. Cognitive effects of unilateral thalamotomy for tremor: A meta-analysis. Brain Commun 2022; 4 (06) fcac287
    Search in Google Scholar
  • 32 Wang KL, Ren Q, Chiu S. et al. Deep brain stimulation and other surgical modalities for the management of essential tremor. Expert Rev Med Devices 2020; 17 (08) 817-833
    Search in Google Scholar
  • 33 Yamamoto K, Sarica C, Elias GJB. et al. Ipsilateral and axial tremor response to focused ultrasound thalamotomy for essential tremor: Clinical outcomes and probabilistic mapping. J Neurol Neurosurg Psychiatry 2022; jnnp- 2021-328459
    Search in Google Scholar
  • 34 Iorio-Morin C, Yamamoto K, Sarica C. et al. Bilateral Focused Ultrasound Thalamotomy for Essential Tremor (BEST-FUS Phase 2 Trial). Mov Disord 2021; 36 (11) 2653-2662
    Search in Google Scholar
  • 35 Kaplitt MG, Krishna V, Eisenberg HM. et al. Safety and efficacy of staged, bilateral focused ultrasound thalamotomy in essential tremor: An open-label clinical trial. JAMA Neurol 2024; 81 (09) 939-946
    Search in Google Scholar
  • 36 Gagliardo C, Cannella R, Quarrella C. et al. Intraoperative imaging findings in transcranial MR imaging-guided focused ultrasound treatment at 1.5T may accurately detect typical lesional findings correlated with sonication parameters. Eur Radiol 2020; 30 (09) 5059-5070
    Search in Google Scholar
  • 37 Kyle K, Peters J, Jonker B. et al. Magnetic resonance-guided focused ultrasound for treatment of essential tremor: Ventral intermediate nucleus ablation alone or additional posterior subthalamic area lesioning?. Mov Disord Clin Pract 2024; 11 (05) 504-514
    Search in Google Scholar
  • 38 Gallay MN, Moser D, Rossi F. et al. Incisionless transcranial MR-guided focused ultrasound in essential tremor: Cerebellothalamic tractotomy. J Ther Ultrasound 2016; 4: 5
    Search in Google Scholar
  • 39 Pérez-Sánchez JR, Martínez-Álvarez R, Martínez Moreno NE. et al. Gamma Knife® stereotactic radiosurgery as a treatment for essential and Parkinsonian tremor: Long-term experience. Neurologia (Engl Ed) 2020; S0213-4853 (20)30217-6
    Search in Google Scholar
  • 40 Niranjan A, Raju SS, Kooshkabadi A, Monaco III E, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for essential tremor: Retrospective analysis of a 19-year experience. Mov Disord 2017; 32 (05) 769-777
    Search in Google Scholar
  • 41 Gonçalves OR, Lima HF, Borges CES. et al. Efficacy and safety of stereotactic radiosurgery with gamma knife machine in patients with essential tremor: A systematic review and single-arm meta-analysis. Neurosurg Rev 2024; 47 (01) 862
    Search in Google Scholar
  • 42 Horisawa S, Hayashi M, Tamura N. et al. Gamma Knife thalamotomy for essential tremor: A retrospective analysis. World Neurosurg 2023; 175: e90-e96
    Search in Google Scholar
  • 43 Kondapavulur S, Silva AB, Molinaro AM, Wang DD. A systematic review comparing focused ultrasound surgery with radiosurgery for essential tremor. Neurosurgery 2023; 93 (03) 524-538
    Search in Google Scholar
  • 44 Larcipretti ALL, Gomes FC, Udoma-Udofa OC, Jannotti JBN, Bannach MA. Radiosurgical thalamotomy for the management of tremors: A systematic review and meta-analysis. Neurol Sci 2025; 46 (01) 79-88
    Search in Google Scholar
  • 45 Tuleasca C, Carey G, Barriol R. et al. Impact of biologically effective dose on tremor decrease after stereotactic radiosurgical thalamotomy for essential tremor: A retrospective longitudinal analysis. Neurosurg Rev 2024; 47 (01) 73
    Search in Google Scholar
  • 46 Niranjan A, Raju SS, Monaco EA, Flickinger JC, Lunsford LD. Is staged bilateral thalamic radiosurgery an option for otherwise surgically ineligible patients with medically refractory bilateral tremor?. J Neurosurg 2018; 128 (02) 617-626
    Search in Google Scholar
  • 47 Murakami M, Horisawa S, Kim K. et al. Long-term follow-up of task-specific tremor after thalamotomy: A retrospective observational study. Ann Clin Transl Neurol 2024; 11 (02) 321-327
    Search in Google Scholar
  • 48 Benabid AL, Pollak P, Gervason C. et al. Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 1991; 337 (8738) 403-406
    Search in Google Scholar
  • 49 Zesiewicz TA, Elble R, Louis ED. et al; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: therapies for essential tremor [RETIRED]: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2005; 64 (12) 2008-2020
    Search in Google Scholar
  • 50 Vetkas A, Yang A, Boutet A. et al. One side or two? A systematic review of deep brain stimulation approaches in movement disorders. Mov Disord Clin Pract 2025; 12 (12) 2080-2091
    Search in Google Scholar
  • 51 Kremer NI, Pauwels RWJ, Pozzi NG. et al. Deep brain stimulation for tremor: Update on long-term outcomes, target considerations and future directions. J Clin Med 2021; 10 (16) 3468
    Search in Google Scholar
  • 52 Liu Z, He S, Li L. General anesthesia versus local anesthesia for deep brain stimulation in Parkinson's disease: A meta-analysis. Stereotact Funct Neurosurg 2019; 97 (5-6): 381-390
    Search in Google Scholar
  • 53 Patel B, Chiu S, Wong JK. et al. Deep brain stimulation programming strategies: segmented leads, independent current sources, and future technology. Expert Rev Med Devices 2021; 18 (09) 875-891
    Search in Google Scholar
  • 54 Smeets S, Boogers A, Van Bogaert T. et al. Deep brain stimulation with short versus conventional pulse width in Parkinson's disease and essential tremor: A systematic review and meta-analysis. Brain Stimul 2024; 17 (01) 71-82
    Search in Google Scholar
  • 55 Lu G, Luo L, Liu M. et al. Outcomes and adverse effects of deep brain stimulation on the ventral intermediate nucleus in patients with essential tremor. Neural Plast 2020; 2020: 2486065
    Search in Google Scholar
  • 56 Ruckart KW, Wilson C, Moya-Mendez ME, Madden LL, Laxton A, Siddiqui MS. Effect of ventral intermediate nucleus deep brain stimulation on vocal tremor in essential tremor. Tremor Other Hyperkinet Mov (N Y) 2023; 13: 13
    Search in Google Scholar
  • 57 Cabral AM, Pereira AA, Vieira MF, Pessôa BL, de Oliveira Andrade A. Prevalence of distinct types of hardware failures related to deep brain stimulation. Neurosurg Rev 2022; 45 (02) 1123-1134
    Search in Google Scholar
  • 58 Chiu SY, Nozile-Firth K, Klassen BT. et al. Ataxia and tolerance after thalamic deep brain stimulation for essential tremor. Parkinsonism Relat Disord 2020; 80: 47-53
    Search in Google Scholar
  • 59 Fung WKW, Justich MB, Hamani M. et al. Remote deep brain stimulation programming in Canada. Mov Disord Clin Pract 2024; 11 (05) 586-589
    Search in Google Scholar
  • 60 Peters J, Tisch S. Habituation after deep brain stimulation in tremor syndromes: Prevalence, risk factors and long-term outcomes. Front Neurol 2021; 12: 696950
    Search in Google Scholar
  • 61 Cury RG, Fraix V, Castrioto A. et al. Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia. Neurology 2017; 89 (13) 1416-1423
    Search in Google Scholar
  • 62 Su KG, Kim HM, Martinez V. Repeated group alternation as a programming strategy for essential tremor patients experiencing rapid habituation with deep brain stimulation treatment. Int J Neurosci 2021; 131 (08) 828-832
    Search in Google Scholar
  • 63 Martinez-Nunez AE, Sarmento FP, Chandra V. et al. Management of essential tremor deep brain stimulation-induced side effects. Front Hum Neurosci 2024; 18: 1353150
    Search in Google Scholar
  • 64 Kim MJ, Chang KW, Park SH, Chang WS, Jung HH, Chang JW. Stimulation-induced side effects of deep brain stimulation in the ventralis intermedius and posterior subthalamic area for essential tremor. Front Neurol 2021; 12: 678592
    Search in Google Scholar
  • 65 Barbe MT, Reker P, Hamacher S. et al. DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial. Neurology 2018; 91 (06) e543-e550
    Search in Google Scholar
  • 66 Kvernmo N, Konglund AE, Reich MM. et al. Deep brain stimulation for arm tremor: A randomized trial comparing two targets. Ann Neurol 2022; 91 (05) 585-601
    Search in Google Scholar
  • 67 Blomstedt Y, Stenmark Persson R, Awad A. et al. 10 Years follow-up of deep brain stimulation in the caudal zona incerta/posterior subthalamic area for essential tremor. Mov Disord Clin Pract 2023; 10 (05) 783-793
    Search in Google Scholar
  • 68 Holslag JAH, Neef N, Beudel M. et al. Deep brain stimulation for essential tremor: A comparison of targets. World Neurosurg 2018; 110: e580-e584
    Search in Google Scholar
  • 69 Dallapiazza RF, Lee DJ, De Vloo P. et al. Outcomes from stereotactic surgery for essential tremor. J Neurol Neurosurg Psychiatry 2019; 90 (04) 474-482
    Search in Google Scholar
  • 70 Giordano M, Caccavella VM, Zaed I. et al. Comparison between deep brain stimulation and magnetic resonance-guided focused ultrasound in the treatment of essential tremor: A systematic review and pooled analysis of functional outcomes. J Neurol Neurosurg Psychiatry 2020; 91 (12) 1270-1278
    Search in Google Scholar
  • 71 Fleury V, Romascano D, Schneider D. et al. Successful MRI-guided focused ultrasound thalamotomy after ipsilateral gamma knife radiosurgery for essential tremor: A case report with video. Stereotact Funct Neurosurg 2023; 101 (06) 380-386
    Search in Google Scholar
  • 72 Ferreira Felloni Borges Y, Cheyuo C, Lozano AM, Fasano A. Essential tremor - deep brain stimulation vs. focused ultrasound. Expert Rev Neurother 2023; 23 (07) 603-619
    Search in Google Scholar
  • 73 Abusrair AH, Elsekaily W, Bohlega S. Tremor in Parkinson's disease: From pathophysiology to advanced therapies. Tremor Other Hyperkinet Mov (N Y) 2022; 12: 29
    Search in Google Scholar
  • 74 Fasano A, De Vloo P, Llinas M. et al. Magnetic resonance imaging-guided focused ultrasound thalamotomy in Parkinson tremor: Reoperation after benefit decay. Mov Disord 2018; 33 (05) 848-849
    Search in Google Scholar
  • 75 Braccia A, Golfrè Andreasi N, Ghielmetti F. et al. Magnetic resonance-guided focused ultrasound thalamotomy in a prospective cohort of 52 patients with Parkinson's disease: A possible critical role of age and lesion volume for predicting tremor relapse. Mov Disord 2025; 40 (03) 478-489
    Search in Google Scholar
  • 76 Higuchi Y, Matsuda S, Serizawa T. Gamma Knife radiosurgery in movement disorders: Indications and limitations. Mov Disord 2017; 32 (01) 28-35
    Search in Google Scholar
  • 77 Doshi PK. Radiofrequency lesioning for movement and psychiatric disorders-Experience of 107 cases. Front Hum Neurosci 2021; 15: 673848
    Search in Google Scholar
  • 78 Deuschl G, Antonini A, Costa J. et al. European Academy of Neurology/Movement Disorder Society-European Section Guideline on the Treatment of Parkinson's Disease: I. Invasive therapies. Mov Disord 2022; 37 (07) 1360-1374
    Search in Google Scholar
  • 79 Wong JK, Cauraugh JH, Ho KWD. et al. STN vs. GPi deep brain stimulation for tremor suppression in Parkinson disease: A systematic review and meta-analysis. Parkinsonism Relat Disord 2019; 58: 56-62
    Search in Google Scholar
  • 80 Yaseri A, Roozbeh M, Kazemi R, Lotfinia S. Brain stimulation for patients with multiple sclerosis: An umbrella review of therapeutic efficacy. Neurol Sci 2024; 45 (06) 2549-2559
    Search in Google Scholar
  • 81 Cummins DD, Bernabei JM, Wang DD. Focused ultrasound for treatment of movement disorders: A review of non-Food and Drug Administration approved indications. Stereotact Funct Neurosurg 2024; 102 (02) 93-108
    Search in Google Scholar
  • 82 Raju SS, Niranjan A, Monaco EA, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for medically refractory multiple sclerosis-related tremor. J Neurosurg 2018; 128 (04) 1214-1221
    Search in Google Scholar
  • 83 Zali A, Khoshnood RJ, Motavaf M. et al. Deep brain stimulation for multiple sclerosis tremor: A systematic review and meta-analysis. Mult Scler Relat Disord 2021; 56: 103256
    Search in Google Scholar
  • 84 Wang KL, Wong JK, Eisinger RS. et al. Therapeutic advances in the treatment of Holmes tremor: Systematic review. Neuromodulation 2022; 25 (06) 796-803
    Search in Google Scholar
  • 85 Kobayashi K, Katayama Y, Oshima H. et al. Multitarget, dual-electrode deep brain stimulation of the thalamus and subthalamic area for treatment of Holmes' tremor. J Neurosurg 2014; 120 (05) 1025-1032
    Search in Google Scholar
  • 86 Yilmaz A, Eray HA, Cakir M, Ceylan M, Blomstedt P. Deep brain stimulation with double targeting of the VIM and PSA for the treatment of rare tremor syndromes. Stereotact Funct Neurosurg 2024; 102 (04) 224-239
    Search in Google Scholar
  • 87 Pyrgelis ES, Agapiou E, Angelopoulou E. Holmes tremor: An updated review. Neurol Sci 2022; 43 (12) 6731-6740
    Search in Google Scholar
  • 88 Chung G, Ferraz HB. Scoping review of treatment strategies for Holmes tremor: Pharmacological and surgical interventions. Tremor Other Hyperkinet Mov (N Y) 2025; 15: 27
    Search in Google Scholar
  • 89 Fasano A, Sammartino F, Llinas M, Lozano AM. MRI-guided focused ultrasound thalamotomy in fragile X-associated tremor/ataxia syndrome. Neurology 2016; 87 (07) 736-738
    Search in Google Scholar
  • 90 Okoroafor F, Beattie H, Qiang Z, Yianni J. Fragile X-associated tremor/ataxia syndrome treated with multitarget deep brain stimulation. BMJ Case Rep 2024; 17 (05) e259452
    Search in Google Scholar
  • 91 Oyama G, Thompson A, Foote KD. et al. Deep brain stimulation for tremor associated with underlying ataxia syndromes: A case series and discussion of issues. Tremor Other Hyperkinet Mov (N Y) 2014; 4: 228
    Search in Google Scholar
  • 92 Paraguay IB, França C, Duarte KP. et al. Dentate nucleus stimulation for essential tremor. Parkinsonism Relat Disord 2021; 82: 121-122
    Search in Google Scholar
  • 93 Shih LC. Emerging deep brain stimulation targets in the cerebellum for tremor. Cerebellum 2025; 24 (02) 38
    Search in Google Scholar
  • 94 Tsuboi T, Wong JK, Eisinger RS. et al. Comparative connectivity correlates of dystonic and essential tremor deep brain stimulation. Brain 2021; 144 (06) 1774-1786
    Search in Google Scholar
  • 95 Tsuboi T, Au KLK, Deeb W. et al. Motor outcomes and adverse effects of deep brain stimulation for dystonic tremor: A systematic review. Parkinsonism Relat Disord 2020; 76: 32-41
    Search in Google Scholar
  • 96 Peters J, Maamary J, Kyle K. et al. Outcomes of focused ultrasound thalamotomy in tremor syndromes. Mov Disord 2024; 39 (01) 173-182
    Search in Google Scholar
  • 97 Babeliowsky WA, Meulepas MA, Buijink AWG, de Bie RMA, van Rootselaar AF. How to treat orthostatic tremor - Cohort study and systematic review. Clin Park Relat Disord 2025; 12: 100318
    Search in Google Scholar
  • 98 Boogers A, Billet A, Vandenberghe W. et al. Deep brain stimulation and spinal cord stimulation for orthostatic tremor: A systematic review. Parkinsonism Relat Disord 2022; 104: 115-120
    Search in Google Scholar
  • 99 Ujihara M, Kobayashi M, Hirata S, Takabatake K, Wakiya K, Fujimaki T. Deep brain stimulation leads to long-term improvement of neuropathic tremor due to chronic inflammatory demyelinating polyneuropathy: A case report. NMC Case Rep J 2024; 11: 109-112
    Search in Google Scholar
  • 100 Patel N, Ondo W, Jimenez-Shahed J. Habituation and rebound to thalamic deep brain stimulation in long-term management of tremor associated with demyelinating neuropathy. Int J Neurosci 2014; 124 (12) 919-925
    Search in Google Scholar
  • 101 Gonzalez-Latapi P, Sousa M, Lang AE. Movement disorders associated with hypogonadism. Mov Disord Clin Pract 2021; 8 (07) 997-1011
    Search in Google Scholar
  • 102 Dabboucy B, Hazrati R, Langlois M, Prudhomme M. Tremor associated with Klinefelter syndrome: Report of a case treated by deep brain stimulation and systematic review of the literature. Neuromodulation 2025; S1094-7159 (25)00137-0
    Search in Google Scholar
  • 103 Krauss JK, Lipsman N, Aziz T. et al. Technology of deep brain stimulation: current status and future directions. Nat Rev Neurol 2021; 17 (02) 75-87
    Search in Google Scholar
  • 104 Schulder M, Mishra A, Mammis A. et al. Advances in technical aspects of deep brain stimulation surgery. Stereotact Funct Neurosurg 2023; 101 (02) 112-134
    Search in Google Scholar
  • 105 Middlebrooks EH, Okromelidze L, Carter RE. et al. Directed stimulation of the dentato-rubro-thalamic tract for deep brain stimulation in essential tremor: A blinded clinical trial. Neuroradiol J 2022; 35 (02) 203-212
    Search in Google Scholar
  • 106 Malekmohammadi M, Mustakos R, Sheth S. et al. Automated optimization of deep brain stimulation parameters for modulating neuroimaging-based targets. J Neural Eng 2022 19. 04
    Search in Google Scholar
  • 107 Aslani P, Huang Y, Lucht BBC. et al. A fully electronically steerable therapeutic ultrasound phased array with MR-guidance. IEEE Trans Biomed Eng 2024; 71 (02) 574-582
    Search in Google Scholar
  • 108 McDannold N, Zhang Y, Fletcher SM. et al. Non-invasive blood-brain barrier disruption using acoustic holography with a clinical focused ultrasound system. IEEE Trans Biomed Eng 2024; 71 (10) 3046-3054
    Search in Google Scholar
  • 109 Shao MM, Liss A, Park YL. et al. Early experience with new generation deep brain stimulation leads in Parkinson's disease and essential tremor patients. Neuromodulation 2020; 23 (04) 537-542
    Search in Google Scholar
  • 110 Rammo RA, Ozinga SJ, White A. et al. Directional stimulation in Parkinson's disease and essential tremor: The Cleveland Clinic Experience. Neuromodulation 2022; 25 (06) 829-835
    Search in Google Scholar
  • 111 Jimenez-Shahed J. Device profile of the percept PC deep brain stimulation system for the treatment of Parkinson's disease and related disorders. Expert Rev Med Devices 2021; 18 (04) 319-332
    Search in Google Scholar
  • 112 Sirica D, Hewitt AL, Tarolli CG. et al. Neurophysiological biomarkers to optimize deep brain stimulation in movement disorders. Neurodegener Dis Manag 2021; 11 (04) 315-328
    Search in Google Scholar
  • 113 De Jesus S, Almeida L, Shahgholi L. et al. Square biphasic pulse deep brain stimulation for essential tremor: The BiP tremor study. Parkinsonism Relat Disord 2018; 46: 41-46
    Search in Google Scholar
  • 114 Boogers A, Peeters J, Van Bogaert T. et al. Testing of symmetric biphasic stimulation in Vim-DBS ET patients: A randomized-controlled pilot study. Front Neurol 2024; 15: 1366227
    Search in Google Scholar
  • 115 Shetty N. Essential tremor-Do we have better therapeutics? A review of recent advances and future directions. Curr Neurol Neurosci Rep 2022; 22 (03) 197-208
    Search in Google Scholar
  • 116 He S, Baig F, Mostofi A. et al. Closed-loop deep brain stimulation for essential tremor based on thalamic local field potentials. Mov Disord 2021; 36 (04) 863-873
    Search in Google Scholar
  • 117 Ferleger BI, Houston B, Thompson MC. et al. Fully implanted adaptive deep brain stimulation in freely moving essential tremor patients. J Neural Eng 2020; 17 (05) 056026
    Search in Google Scholar