Table 5.

Aspects which might be considered for the treatment choice during the shared decision-making between patient and physician

	Deep brain stimulation	Focused ultrasound thalamotomy	Gamma-knife thalamotomy	Radiofrequency thalamotomy
Availability	Many centers worldwide	Few centers to-date but rapidly increasing	Extremely rare	Rare
Experience	Vast experience	Limited experience	Only few centers offer this treatment	Only few centers offer this treatment
Bilateral treatment necessary	Established option	Only within clinical studies	Almost no data	Not recommended because of side effects
Exclusion criteria due to patient’s risk profile	Multimorbidity as for other brain surgeries, frailty	Frailty often tolerated	unknown	Multimorbidity as for other brain surgeries, age (?)
Patients perception of procedural risks	Open brain surgery	Incision-free but invasive	Incision-free but invasive	Open brain surgery
Procedure under general anesthesia possible	For rare cases, but carries special risks	Not established	Not established	Not established
Risk of infections/bleedings	Possible, but rare	Fewer than DBS, limited experience	No reported with limited experience	More frequent than for DBS
Need to shave the head	partial	Complete	no	partial
Single-stage treatment	Yes, can be done within one surgery or staggered	Yes	Yes	Yes
Exclusion because of skull density	no	20-30% of the patients	no	no
Experienced center for follow-up needed	needed	Not regularly needed	Not regularly needed	Not regularly needed