Author response: MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes
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We thank Dr. Venketasubramanian for the interest in our article,1 and for highlighting the safety concerns of focused ultrasound (FUS) as well as the need for more studies, which we agree on. Temporal bone window applies to standard brain diagnostic ultrasound whereas FUS uses over 1,000 ultrasound beams directed towards a deep target from all directions surrounding the patient's head.2 Therefore, the problem of temporal bone window does not apply to FUS. However, it is estimated that roughly 15% of FUS candidates cannot receive the treatment due to the high bone density of their skull.3
[1] A. Lozano,et al. MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes , 2017, Neurology.
[2] A. Fasano,et al. Focused Ultrasound for Essential Tremor: Review of the Evidence and Discussion of Current Hurdles , 2017, Tremor and other hyperkinetic movements.
[3] K. Hynynen,et al. MR-guided focused ultrasound thalamotomy for essential tremor: a proof-of-concept study , 2013, The Lancet Neurology.