Abstract
Deep brain stimulation (DBS) has been widely accepted as a powerful tool capable of
suppressing tremor by modulating the neuronal circuitry, with long-term adaptability
and a profile of low adverse effects. It has been the primary treatment for refractory
tremor for decades, with sustained long-term efficacy. Recently, magnetic resonance-guided
high-frequency focused ultrasound (HIFU) has emerged as an alternative, prompting
comparisons between these approaches. Deep brain stimulation offers long-lasting tremor
control in Parkinson's disease (PD) and essential tremor (ET). In addition, it enables
us to advance our understanding of brain circuits by integrating neuroimaging, electrophysiology,
and connectomics data to map the best stimulation spots. Technologies such as adaptive
and directional DBS enable real-time adjustments and greater precision, optimizing
results and minimizing adverse effects. Although HIFU shows promising results, it
remains an ablative and non-adjustable therapy, contrasting with DBS's dynamic and
customizable advances.
Keywords
Tremor - Deep Brain Stimulation - High-Intensity Focused Ultrasound Ablation - Movement
Disorders
Bibliographical Record
Flávia de Paiva Santos Rolim, Denise Maria Menezes Cury Portela. High-intensity focused
ultrasound (HIFU) versus deep brain stimulation (DBS) for refractory tremor: team
DBS. Arq Neuropsiquiatr 2025; 83: s00451808087.
DOI: 10.1055/s-0045-1808087
