Title

Three-year follow-up of prospective trial of focused ultrasound thalamotomy for essential tremor.

Document Type

Article

Publication Date

12-10-2019

Publication Title

Neurology

Keywords

Aged; Aged, 80 and over; Cohort Studies; Cross-Over Studies; Essential Tremor; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Psychosurgery; Single-Blind Method; Surveys and Questionnaires; Thalamus; Time Factors; Ultrasonic Therapy

Abstract

OBJECTIVE: To test the hypothesis that transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) thalamotomy is effective, durable, and safe for patients with medication-refractory essential tremor (ET), we assessed clinical outcomes at 3-year follow-up of a controlled multicenter prospective trial.

METHODS: Outcomes were based on the Clinical Rating Scale for Tremor, including hand combined tremor-motor (scale of 0-32), functional disability (scale of 0-32), and postural tremor (scale of 0-4) scores, and total scores from the Quality of Life in Essential Tremor Questionnaire (scale of 0-100). Scores at 36 months were compared with baseline and at 6 months after treatment to assess for efficacy and durability. Adverse events were also reported.

RESULTS: Measured scores remained improved from baseline to 36 months (all

CONCLUSIONS: Results at 3 years after unilateral tcMRgFUS thalamotomy for ET show continued benefit, and no progressive or delayed complications. Patients may experience mild degradation in some treatment metrics by 3 years, though improvement from baseline remains significant.

CLINICALTRIALSGOV IDENTIFIER: NCT01827904.

CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with severe ET, unilateral tcMRgFUS thalamotomy provides durable benefit after 3 years.

Clinical Institute

Neurosciences (Brain & Spine)

Department

Neurosciences

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