Radiosurgery for Drug Resistant Invalidating Tremor

2014-08-27 04:00:53 | BioPortfolio


Stereotactic lesioning of thalamus and basal ganglia for treatment of tremor is a well-known procedure which, prior to the introduction of deep brain stimulation, or DBS, was usually achieved using stereotactic surgical procedures.

Radiosurgery of invisible targets to treat movement disorders and intractable pain are still the domain of frame-based procedures, due to the need of a solid reference system registered to the anterior commissure-posterior commissure (AC-PC) line, which allows the use of stereotactic atlases.

In this study we want to utilize a mathematical method that uses atlas-derived stereotactic coordinates to perform frameless images-guided radiosurgery of such functional targets Particularly the aim of the present study is to investigate both the efficacy and the safety of the methodology to treat upper limb and hand tremor in elderly or in patients which are not ot susceptible of surgical procedures. For these reasons a dose escalation prospective trial have been designed.

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Severe Upper Limb Tremor Refractory to Medical Therapy


Radiosurgical thalamotomy


Fondazione IRCCS Istituto Neurologico C. Besta, Unit of Radiotherapy




Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T04:00:53-0400

Clinical Trials [2010 Associated Clinical Trials listed on BioPortfolio]

RAD 1601: Edge Radiosurgery for Tremor

To determine the efficacy of frameless Virtual Cone Radiosurgical Thalamotomy for medically refractory essential tremor with the Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS) in patients ...

Evaluation of Bilateral Gamma Knife Thalamotomy in Patients Presenting With Severe Essential Tremor

Essential tremor (ET) is the most frequent movement disorder. Its prevalence is about 1/200 implying that at least 300 000 peoples are concerned in France. Its frequency increase with age ...

Evaluation the Effect of Muscle Functional Electrical Stimulation in the Upper Limb Tremor Invalidating

The main objective of this study is to identify the superficial muscle groups involved in gene-related tremor and assess the reduction in the intensity of the tremor after transient electr...

Deep Brain Frameless Radiosurgery for Drug Resistant Invalidating Tremor. Dose Escalation Pilot Study

The gamma knife radiosurgical thalamotomy to treat many movement disorders is recently becoming a new and well defined treatment paradigm. The CyberKnife if compared to the frame-based ra...

Electrophysiological Study of the Effects of Limb Cooling on Essential Tremor

To determine the effects of upper limb forearm cooling on Essential Tremor upper limb tremor using a more practical method of limb cooling through a forearm cold pack.

PubMed Articles [14989 Associated PubMed Articles listed on BioPortfolio]

Radiofrequency Thalamotomy for Drug-Refractory Essential Tremor.

The reduction in treatment efficiency at high acoustic powers during MR-guided transcranial focused ultrasound thalamotomy for Essential Tremor.

To analyze clinical data indicating a reduction in the induced energy-temperature efficiency relationship during transcranial focused ultrasound (FUS) essential tremor (ET) thalamotomy treatments at h...

MRI-guided laser interstitial thermal thalamotomy for medically intractable tremor disorders.

Medically intractable tremors are a common, difficult clinical situation. Deep brain stimulation decreases Parkinson's disease resting tremor and essential tremor, but not all patients are candidates ...

Combined Unilateral Posteroventral Pallidotomy and Ventral Intermediate Nucleus Thalamotomy in Tremor-Dominant Parkinson's Disease versus Posteroventral Pallidotomy Alone: A Prospective Comparative Study.

The optimum target in surgery for Parkinson's disease (PD) is still controversial, especially in patients with tremor-dominant PD. We aim to compare results in tremor-dominant patients undergoing pall...

Targeting the hot spot in a patient with essential tremor and Parkinson's disease: Tractography matters.

Thalamic ventralis intermedius deep brain stimulation (VIM-DBS) is generally effective in treating refractory tremor in Parkinson's disease (PD) and in essential tremor (ET), but some patients do not ...

Medical and Biotech [MESH] Definitions

A relatively common disorder characterized by a fairly specific pattern of tremors which are most prominent in the upper extremities and neck, inducing titubations of the head. The tremor is usually mild, but when severe may be disabling. An autosomal dominant pattern of inheritance may occur in some families (i.e., familial tremor). (Mov Disord 1988;13(1):5-10)

Incoordination of voluntary movements that occur as a manifestation of CEREBELLAR DISEASES. Characteristic features include a tendency for limb movements to overshoot or undershoot a target (dysmetria), a tremor that occurs during attempted movements (intention TREMOR), impaired force and rhythm of diadochokinesis (rapidly alternating movements), and GAIT ATAXIA. (From Adams et al., Principles of Neurology, 6th ed, p90)

The region of the upper limb in animals, extending from the deltoid region to the HAND, and including the ARM; AXILLA; and SHOULDER.

Distinct regions of mesenchymal outgrowth at both flanks of an embryo during the SOMITE period. Limb buds, covered by ECTODERM, give rise to forelimb, hindlimb, and eventual functional limb structures. Limb bud cultures are used to study CELL DIFFERENTIATION; ORGANOGENESIS; and MORPHOGENESIS.

The region of the upper limb between the metacarpus and the FOREARM.

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