Stereotactic Radiosurgery Useful in Eliminating Parkinson's Disease Tremors

Stereotactic radiosurgery (SRS) offers a less invasive, and just as effective, option to eliminate tremors caused by Parkinson's disease and essential tremor than deep brain stimulation (DBS) and radiofrequency (RF) treatments.

Researchers at the Joe Arrington Cancer Center (Lubbock, TX, USA) and Texas Tech University (Lubbock, TX, USA) followed 183 patients who underwent SRS thalamotomy between 1991 and 2007, for hard-to-treat tremors caused by Parkinson's disease and essential tremors. With a median follow-up of seven years, 84% of the patients had significant or complete resolution of tremors. In patients with Parkinson's disease, 83% had near or complete tremor resolution, while those with essential tremor had 87% of this degree of tremor resolution. The study was presented at the 51st annual meeting of the American Society for Radiation Oncology (ASTRO), held during November 2009 in Chicago (IL, USA).

"The study shows that radiosurgery is an effective and safe method of getting rid of tremors caused by Parkinson's disease and essential tremor, with outcomes that favorably compare to both DBS and RF in tremor relief and risk of complications at seven years after treatment,” said study coauthor radiation oncologist Rufus Mark, M.D. "In view of these long-term results, this noninvasive procedure should be considered a primary treatment option for tremors that are hard to treat.”

Thalamotomy is an invasive procedure, primarily effective for tremors such as those associated with Parkinson's disease (PD), where a selected portion of the thalamus, the Ventralis Inter-Medius nucleus, is surgically destroyed or ablated. Neurosurgeons use specialized equipment to precisely locate an area of the thalamus, usually choosing to work on only one side (the side opposite that of the worst tremors). Bilateral procedures are poorly tolerated because of increased complication and risk, including vision and speech problems. The positive effects on tremor are immediate. Other less destructive procedures, such as subthalamic DBS, are sometimes preferred, since this procedure can also improve other symptoms of PD.


Related Links:
Joe Arrington Cancer Center

Texas Tech University