{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:48:39Z","timestamp":1791229719584,"version":"4.1.0"},"reference-count":67,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The efficacy and adverse events (AEs) of bilateral magnetic resonance\u2010guided focused ultrasound (MRgFUS) thalamotomies for essential tremor (ET) have not been compared to those of deep brain stimulation (DBS). Furthermore, it is uncertain whether second\u2010side thalamotomies can be positioned differently from the first without compromising effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to indirectly compare bilateral MRgFUS and DBS, while identifying optimal lesion\/stimulation locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively examined 41 ET patients who received either bilateral thalamic DBS (n\u2009=\u200922) or MRgFUS (n\u2009=\u200919) surgery. The primary outcome was the comparison of modalities for change in Clinical Rating Scale for Tremor (CRST) from baseline to post second surgery. We characterized AEs, generated probabilistic maps, and tracked streamlines intersecting lesions. First\u2010side lesions were always intentionally placed ventrally (\n                      <jats:italic>z<\/jats:italic>\n                      \u2009=\u20090\/+2\u2009mm above the intercommissural plane [ICP]), and second\u2010side lesions were placed dorsally (\n                      <jats:italic>z<\/jats:italic>\n                      \u2009=\u2009+3\u2009mm above ICP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Tremor scores improved significantly after second surgeries (MRgFUS: 56.3\u2009\u00b1\u20097.1 to 24.2\u2009\u00b1\u200910.4,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; DBS: 58.8\u2009\u00b1\u200911.6 to 25.0\u2009\u00b1\u200913,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05, mean follow\u2010up: 23\/26\u2009months), with no differences between modalities. Following first surgeries, scores were MRgFUS: 37.9\u2009\u00b1\u20097.9 and DBS: 35.2\u2009\u00b1\u200913.6, with significant improvement from baseline (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, mean follow\u2010up: 40\/73\u2009months). All AEs were grade 1\u20132, with AE\u2010free rates of 41% for DBS and 32% for MRgFUS. First\u2010side lesions exhibited maximal efficacy in the ventral Vim, extending to posterior subthalamic area (PSA), whereas second\u2010side lesions demonstrated maximal efficacy in the dorsomedial Vim\u2010Vop border. DBS maps corroborated this finding and confined to Vim\u2010Vop border. Lesions intersecting with networks interconnected with the supplementary motor area, in addition to M1, were associated with improved outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The efficacies of bilateral MRgFUS and DBS appear comparable. MRgFUS probabilistic maps vary with different targeting methods, revealing two distinct sweet spots: dorsal Vim\u2010Vop border and ventral Vim\/PSA. \u00a9 2025 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.30221","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T11:46:06Z","timestamp":1746186366000},"page":"1265-1278","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Bilateral Focused Ultrasound Thalamotomy for Essential Tremor: Clinical Outcomes Compared to Bilateral\n                    <scp>Deep Brain Stimulation<\/scp>\n                    and Probabilistic Lesion Mapping"],"prefix":"10.1002","volume":"40","author":[{"given":"Can","family":"Sarica","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Krembil Research Institute, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Center, Shonan Fujisawa Tokushukai Hospital  Fujisawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2995-7255","authenticated-orcid":false,"given":"Christian","family":"Iorio\u2010Morin","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery Universit\u00e9 de Sherbrooke  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-8226","authenticated-orcid":false,"given":"Jurgen","family":"Germann","sequence":"additional","affiliation":[{"name":"Krembil Research Institute, University Health Network  Toronto Ontario Canada"},{"name":"Center for Advancing Neurotechnological Innovation to Application (CRANIA)  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Z.","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1782-4527","authenticated-orcid":false,"given":"Brendan","family":"Santyr","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Krembil Research Institute, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Colditz","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4487-432X","authenticated-orcid":false,"given":"Artur","family":"Vetkas","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Department of Neurosurgery Tartu University Hospital  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Fomenko","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Davidson","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3126-8002","authenticated-orcid":false,"given":"Talyta","family":"Grippe","sequence":"additional","affiliation":[{"name":"Edmond J. 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