{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:42:49Z","timestamp":1784544169870,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T00:00:00Z","timestamp":1489968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:bold>Background<\/jats:bold>: Essential Tremor (ET) is a common movement disorder that can be disabling. Initial treatment is in the form of medical therapies. Patients with medically refractory ET seek surgical intervention which include radiofrequency thalamotomy, deep brain stimulation, and radiosurgical thalamotomy. Radiosurgical thalamotomy is a minimally invasive surgical option which is especially valuable for elderly and high surgical risk patients.<\/jats:p><jats:p><jats:bold>Objective<\/jats:bold>: The purpose of this study was to retrospectively analyze the outcomes of stereotactic radiosurgery for patients suffering from medically refractory essential tremor.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: During a 19\u2010year period (1996\u20132015), 73 patients underwent gamma knife thalamotomy for intractable essential tremor. A median central dose of 140 Gy (range, 130\u2013150) was delivered to the nucleus ventralis intermedius through a single 4\u2010mm isocenter. We used the Fahn\u2010Tolosa\u2010Marin clinical tremor rating scale to score tremor, handwriting, drawing, and ability to drink fluids. The median time to last follow\u2010up was 28 months (range, 6\u2013152).<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: After gamma knife thalamotomy, 93.2% improved in tremor. Forty\u2010four patients (60.3%) experienced tremor arrest or barely perceptible tremor. Eighteen patients (24.7%) noted tremor arrest and complete restoration of motor function. Tremor improvement was sustained at last follow\u2010up in 96% of patients who experience tremor relief. Mean tremor score improved from 3.19 before to 1.27 after gamma knife thalamotomy (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Mean handwriting score improved from 2.97 to 1.25 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Mean drawing score improved from 3.16 to 1.26 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Mean drinking score improved from 3.14 to 1.56 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Imaging follow\u2010up showed three types of lesions: enhancing lesion, streaking along internal capsule on fluid\u2010attenuated inversion recovery, and significant reactive changes. Three patients (4%) experienced temporary adverse radiation effects.<\/jats:p><jats:p><jats:bold>Conclusion<\/jats:bold>: Radiosurgery is a safe and valuable treatment option for medically refractory essential tremor, especially for the elderly or those with high surgical risk for DBS or radiofrequency thalamotomy. \u00a9 2017 International Parkinson and Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.26925","type":"journal-article","created":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T10:07:01Z","timestamp":1490004421000},"page":"769-777","source":"Crossref","is-referenced-by-count":70,"title":["Stereotactic radiosurgery for essential tremor: Retrospective analysis of a 19\u2010year experience"],"prefix":"10.1002","volume":"32","author":[{"given":"Ajay","family":"Niranjan","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudesh S.","family":"Raju","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Kooshkabadi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Edward","family":"Monaco","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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