Four-tract tractography: multiparametric direct targeting of the dentatorubrothalamic tract.

This video article presents a case study of a 70-year-old male with medically refractory essential tremor treated with magnetic resonance-guided focused ultrasound (MRgFUS). Following an initial successful ablation of the right thalamus, the patient underwent left-sided thalamotomy. After two tractography-guided sonications, the authors observed a significant reduction in his right-hand tremor with no immediate side effects. Postprocedure evaluation revealed sustained tremor reduction with minimal side effects, showcasing bilateral MRgFUS as an effective, noninvasive option for essential tremor management. The video can be found here: https://stream.cadmore.media/r10.3171/2024.7.FOCVID2483.