While Focused-Ultrasound thalamotomy has proven effective at reducing tremor, traditional targeting methods can be suboptimal at balancing primary tremor-reduction outcomes against undesired side-effects. The traditional “canonical” technique involves an indirect method which applies a non-individualized stereotactic coordinate atlas towards identifying the presumed approximate location of VIM thalamus, the ablation target; the canonical lesion is empirically grown in size based-on dynamic intraoperative feedback from an awake patient, until the surgeon judges that an appropriate balance of tremor-reduction and side-effect risk has been achieved. We propose optimized methods to define and monitor the ideal anatomical ablation for optimized tremor-reduction/Quality-of-Life balancing.
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