Article Figures & Data
Figures
- FIGURE
Four-tract tractography. Axial FGATIR MR image through the level of the thalamus shows the relative position of the 4 tracts: corticospinal tract (red), ML (blue), dDRTT (yellow), dDRTT (green).
Tables
Comparison of DBS versus MRgHIFU thalamotomy
DBS MRgHIFU Infection risk ∼2%−4% None Intracranial hemorrhage risk ∼2%−3% Very low, <1%, no reports Imbalance/risk of gait ataxia Not seen initially but can develop with time with stimulation; stimulation-related ataxia can occur in up to ∼30% of patients with ET48 Initial transient imbalance is not infrequent and can gradually resolve during 3−4 weeks; higher risk of permanent worsening of balance in patients with pre-existing balance issues, joint replacement, or neuropathies Risk of aspiration Not seen Possibly due to the head being fixed in supine position and occasional induced nausea Tremor relief efficacy 80%–100% 70%–90% relief more typical, with known return of some tremor Risk of thalamic pain syndrome None Possible, but not reported Reversible Yes No Anticoagulation Must be held Currently held; some evidence supporting not holding anticoagulation in the literature34 Possible “honeymoon” effect Yes Yes Battery maintenance Yes No
