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Updated: Aug 11, 2026
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MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
Staged Bilateral Magnetic Resonance-Guided Focused Ultrasound for Treating Essential Tremor: Systematic Review and
Nima Norbu Sherpa1,2, Andrea Gonzalez Lezana3, Gabriela Prilip4
1Brain Research and Imaging Centre, University of Plymouth, Plymouth, United Kingdom.
Movement Disorders Clinical Practice
|August 10, 2026
Summary
Staged bilateral magnetic resonance guided focused ultrasound (MRgFUS) thalamotomy significantly reduces essential tremor. While adverse events were mostly mild at 3 months, the very low certainty of evidence necessitates further controlled studies.
Area of Science:
- Neurology
- Neurosurgery
- Medical Imaging
Background:
- Essential tremor (ET) is a neurological disorder causing debilitating tremors.
- Unilateral MR-guided focused ultrasound (MRgFUS) thalamotomy offers tremor relief but often leaves contralateral disability.
- The efficacy and safety of staged bilateral MRgFUS thalamotomy for ET are not well-established.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of staged bilateral MRgFUS thalamotomy for essential tremor.
- To assess tremor severity reduction and adverse events following the procedure.
Main Methods:
- A systematic search of multiple databases (MEDLINE, EMBASE, etc.) was conducted up to April 12, 2026.
- Seven cohorts (n=149) from nine included studies were meta-analyzed for tremor severity reduction (SMD) and 3-month adverse event proportions.
- Risk of bias and certainty of evidence were assessed using established methodologies.
Main Results:
- A consistent, large-magnitude tremor reduction (SMD = -1.91) was observed across studies.
- Common 3-month adverse events included sensory changes (28.8%), gait disturbance (27.5%), and dysarthria (22.0%).
- All included studies were non-randomized with moderate to serious risk of bias, leading to very low certainty of evidence.
Conclusions:
- Staged bilateral MRgFUS thalamotomy appears to provide clinically meaningful tremor reduction in essential tremor patients.
- Adverse events were predominantly mild at the 3-month follow-up.
- The very low certainty of evidence highlights the need for high-quality, controlled studies with blinded assessments and longer follow-up periods.