Radiosurgery for Drug Resistant Invalidating Tremor
Radiosurgery for Drug Resistant Invalidating Tremor
Stereotactic lesioning of thalamus and basal ganglia for treatment of tremor is a well-known
 procedure which, prior to the introduction of deep brain stimulation, or DBS, was usually
 achieved using stereotactic surgical procedures.

 Radiosurgery of invisible targets to treat movement disorders and intractable pain are still
 the domain of frame-based procedures, due to the need of a solid reference system registered
 to the anterior commissure-posterior commissure (AC-PC) line, which allows the use of
 stereotactic atlases.

 In this study we want to utilize a mathematical method that uses atlas-derived stereotactic
 coordinates to perform frameless images-guided radiosurgery of such functional targets
 Particularly the aim of the present study is to investigate both the efficacy and the safety
 of the methodology to treat upper limb and hand tremor in elderly or in patients which are
 not ot susceptible of surgical procedures. For these reasons a dose escalation prospective
 trial have been designed.
Inclusion Criteria:

 -  patients affected by severe upper limb tremor refractory to medical therapy and who
 are candidate for a deep brain stimulation (DBS) procedure.

 -  Age: ≥ 18 years old

 -  Refusal of DBS procedure

 -  Written consent

 Exclusion Criteria:

 -  Pregnancy

 -  Allergy to contrast medium

 -  DBS procedure susceptibility, if not refused