{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:19:54Z","timestamp":1788542394773,"version":"build-2803163510"},"reference-count":54,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Stereotact Funct Neurosurg"],"published-print":{"date-parts":[[2024]]},"abstract":"<b><i>Introduction:<\/i><\/b> MRI-guided focused ultrasound (FUS) is an incisionless thermo-ablative procedure that may be used to treat medication-refractory movement disorders, with a growing number of potential anatomic targets and clinical applications. As of this article\u2019s publication, the only US Food and Drug Administration (FDA)-approved uses of FUS for movement disorders are thalamotomy for essential tremor (ET) and tremor-dominant Parkinson\u2019s Disease (PD), and pallidotomy for other cardinal symptoms of PD. We present a state-of-the-art review on all non-FDA approved indications of FUS for movement disorders, beyond the most well-described indications of ET and PD. Our objective was to summarize the safety and efficacy of FUS in this setting and provide a roadmap for future directions of FUS for movement disorders. <b><i>Methods:<\/i><\/b> A state-of-the-art review was conducted on use of FUS for non-FDA approved movement disorders. All movement disorders excluding FDA-approved uses for ET and PD were included. <b><i>Results:<\/i><\/b> A total of 25 studies on 172 patients were included. In patients with tremor plus dystonia syndromes (<i>n<\/i> = 6), ventralis intermediate nucleus of the thalamus (VIM)-FUS gave &gt;50% tremor reduction, with no improvement in dystonia and worsened dystonia in 2\/6 patients. Ventral-oralis complex (VO)-FUS gave &gt;50% improvement for focal hand dystonia (<i>n<\/i> = 6) and 100% return to musical performance in musician\u2019s dystonia (<i>n<\/i> = 6). In patients with multiple sclerosis (MS) and tremor (<i>n<\/i> = 3), improvement in tremor was seen in 2 patients with a favorable skull density ratio; no MS disease change was noted after VIM-FUS. In patients with tremor and comorbid ataxia syndromes (<i>n<\/i> = 3), none were found to have worsened ataxia after VIM-FUS; all had clinically significant tremor improvement. Subthalamic nucleus (STN)-FUS for PD (<i>n<\/i> = 49) gave approximately 50% improvement in PD motor symptoms, with dystonia and mild dyskinesias as possible adverse effects. Cerebellothalamic tract (CTT-FUS) for ET (<i>n<\/i> = 42) gave 55\u201390% tremor improvement, with gait dysfunction as a rare persistent adverse effect. Pallidothalamic tract (PTT-FUS) for PD (<i>n<\/i> = 50) gave approximately 50% improvement in motor symptoms, with mild speech dysfunction as a possible adverse effect. <b><i>Conclusion:<\/i><\/b> VIM-FUS appeared safe and effective for heterogenous tremor etiologies, and VO-FUS appeared most effective for isolated segmental dystonia. STN-FUS was effective for PD symptom reduction; postoperative dystonia and mild on-medication dyskinesias required medical management. Tractography-based targeting with CTT-FUS for ET and PTT-FUS for PD demonstrated promising early results. Larger prospective trials with long-term follow-up are needed to the evaluate the safety and efficacy non-FDA approved indications for FUS. <\/jats:p>","DOI":"10.1159\/000535621","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T22:00:30Z","timestamp":1708380030000},"page":"93-108","source":"Crossref","is-referenced-by-count":15,"title":["Focused Ultrasound for Treatment of Movement Disorders: A Review of Non-Food and Drug Administration Approved Indications"],"prefix":"10.1159","volume":"102","author":[{"given":"Daniel D.","family":"Cummins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Bernabei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris 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