To review the evolution of surgical management for tremor syndromes, focusing on deep brain stimulation and incisionless lesioning techniques.
Key Findings:
Deep brain stimulation (DBS) remains a central treatment for tremor syndromes.
Incisionless lesioning techniques, such as magnetic resonance-guided focused ultrasound, are expanding options for selected patients.
DBS is preferred in Parkinson’s disease tremor for broader motor benefits, while both DBS and focused ultrasound show strong efficacy in essential tremor.
Treatment selection depends on tremor type, symptom severity, comorbidities, and patient preferences.
Interpretation:
Surgical management of tremor syndromes is evolving, with a need for individualized treatment strategies based on patient characteristics and preferences.
Limitations:
Treatment effects and supporting evidence vary by tremor syndrome.
Focused ultrasound approaches are generally reserved for select cases and not widely recommended outside clinical trials.
Conclusion:
As surgical technologies develop, clinicians should consider a broader range of options for managing medication-refractory tremor.
Meta-analysis links higher activity, less sitting, and 7 to 8 hours of sleep with lower incident dementia risk, though findings vary widely across studies.
