{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:50:21Z","timestamp":1787889021433,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bilateral deep brain stimulation (DBS) and unilateral magnetic resonance\u2013guided focused ultrasound (MRgFUS), with potential future second\u2010side treatment targeting the thalamic ventral intermediate nucleus (VIM), are currently the two best\u2010established interventions for pharmaco\u2010resistant tremors, but treatment selection is hampered by the lack of comparative evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide the first direct within\u2010center and within\u2010surgeon comparison between bilateral VIM\u2010DBS and unilateral VIM\u2010MRgFUS, applying consistently timed and elaborated efficacy and safety assessements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, we included patients having received bilateral VIM\u2010DBS (n\u2009=\u200930) or unilateral VIM\u2010MRgFUS (n\u2009=\u200952) performed by one single neurosurgeon between 2014 and 2022. Efficacy was primarily measured by the improvement of the Washington Heights\u2010Inwood Genetic Study of Essential Tremor scale in the more affected hand at 6\u2009months. Regarding safety, we compared treatment\u2010, procedure\u2010, and hardware\u2010related adverse events (AEs), graded by impact on activities of daily living (ADLs), and serious AEs (SAEs), retrospectively defined based on prolonged\/repeated hospitalizations or persistent symptoms affecting ADLs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found equivalent tremor reduction in the more affected hand (DBS: 62.4% [41.3\u201387.9] vs. MRgFUS: 69.4% [42.4\u201377.7]; <jats:italic>P<\/jats:italic>\u2009=\u20090.958), but contralateral and axial tremors improved only with bilateral DBS. DBS was associated with a higher rate of procedure\u2010 and hardware\u2010related AEs (17% vs. 2%; <jats:italic>P<\/jats:italic>\u2009=\u20090.023) but a nonsignificantly lower rate of persistent treatment\u2010related AEs affecting ADLs at 6\u2009months (7% vs. 13%; <jats:italic>P<\/jats:italic>\u2009=\u20090.343). Overall, the rates of SAEs (23.3% vs. 19.2%; <jats:italic>P<\/jats:italic>\u2009=\u20090.779) and persistent deficits affecting ADLs at 6\u2009months (10% vs. 13%; <jats:italic>P<\/jats:italic>\u2009=\u20090.82) were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite distinct safety profiles, both interventions produced a similar burden of AEs. Tremor control was equivalent on the more affected side, whereas contralateral and axial tremors improved only after bilateral DBS. \u00a9 2025 International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.30153","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T10:53:53Z","timestamp":1741690433000},"page":"834-843","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Thalamic Deep Brain Stimulation Versus Magnetic Resonance\u2013Guided Focused Ultrasound in Tremor Patients: A Retrospective Single\u2010Surgeon Comparison"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3417-1978","authenticated-orcid":false,"given":"Christian Rainer","family":"Baumann","sequence":"first","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Fleisch","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujitha","family":"Mahendran","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mechtild","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carola","family":"Freudinger","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evdokia","family":"Efthymiou","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus Florian","family":"Oertel","sequence":"additional","affiliation":[{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"},{"name":"Department of Neurosurgery University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3744-5105","authenticated-orcid":false,"given":"Lennart Henning","family":"Stieglitz","sequence":"additional","affiliation":[{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"},{"name":"Department of Neurosurgery University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7091-1676","authenticated-orcid":false,"given":"Fabian","family":"B\u00fcchele","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Zurich  Zurich Switzerland"},{"name":"Clinical Neuroscience Centre University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22838"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2011.03.012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318236f0fd"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010316"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2022.120193"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-013-0378-8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-318240"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3098"},{"key":"e_1_2_8_10_1","unstructured":"EliasWJ LipsmanN OndoWG et al.A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor;2016. 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