Thalamic Deep Brain Stimulation Versus Magnetic Resonance-Guided Focused Ultrasound in Tremor Patients: A Retrospective Single-Surgeon Comparison.

Background: Bilateral deep brain stimulation (DBS) and unilateral magnetic resonance-guided focused ultrasound (MRgFUS), with potential future second-side treatment targeting the thalamic ventral intermediate nucleus (VIM), are currently the two best-established interventions for pharmaco-resistant tremors, but treatment selection is hampered by the lack of comparative evidence.

Objective: To provide the first direct within-center and within-surgeon comparison between bilateral VIM-DBS and unilateral VIM-MRgFUS, applying consistently timed and elaborated efficacy and safety assessements.

Methods: In this retrospective study, we included patients having received bilateral VIM-DBS (n = 30) or unilateral VIM-MRgFUS (n = 52) performed by one single neurosurgeon between 2014 and 2022.