Health Problem: Movement disorders, such as Parkinson disease (PD) and essential tremor (ET), are neurological conditions that can cause tremor that cannot be controlled with medication in some patients. ET is the most common movement disorder, affecting an estimated 7 million Americans and approximately 1% to 6% of the adult population > 40 years of age. Estimates suggest that 1.5 million Americans are affected by PD and approximately 60,000 new cases of this disorder are diagnosed annually.

Technology Description: Stereotactic radiosurgery (SRS) is a therapeutic technique that focuses high dosages of radiation onto small, precisely defined targets in the brain, such as a segment of the thalamus or globus pallidus. In SRS, a head frame with trackable markers is securely attached to the head of the patient who then undergoes high-resolution magnetic resonance imaging and/or computed tomography scans. Information from imaging is used to identify the target for intensive radiation treatment and the head frame is used to guide targeting of radiation to the site of treatment.

Controversy: Despite use of high-resolution imaging and target tracking, errors can occur in target identification and focusing of radiation beams during SRS, causing complications that may be irreversible.

Key Questions:

  • Is SRS an effective treatment for movement disorders?

  • Is SRS safe for the treatment of movement disorders?

  • Have definitive patient selection criteria been established for SRS treatment for movement disorders?

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