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Magnetic resonance–guided focused ultrasound thalamotomy for treatment of essential tremor: A 2‐year outcome study
Author(s) -
Meng Ying,
Solomon Benjamin,
Boutet Alexandre,
Llinas Maheleth,
Scantlebury Nadia,
Huang Yuexi,
Hynynen Kullervo,
Hamani Clement,
Fasano Alfonso,
Lozano Andres M.,
Lipsman Nir,
Schwartz Michael L.
Publication year - 2018
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.99
Subject(s) - thalamotomy , magnetic resonance imaging , essential tremor , medicine , refractory (planetary science) , confidence interval , ultrasound , clinical trial , focused ultrasound , radiology , surgery , physical medicine and rehabilitation , deep brain stimulation , parkinson's disease , disease , physics , astrobiology
Background Magnetic resonance–guided focused ultrasound is an emerging, minimally invasive thermoablation technique for medically refractory essential tremor. Beyond the initial year, data regarding efficacy and potential predictors of efficacy are still preliminary. Objectives The objective of this study was to assess the outcome at 2 years and the association between lesion volume and outcome 1 year after treatment. Methods We reviewed data from 37 patients who underwent unilateral magnetic resonance–guided focused ultrasound thalamotomy, with primary outcome being dominant tremor subscore of the Clinical Rating Scale for Tremor. We used multivariable linear regression to model initial lesion volume with 1‐year outcome, adjusting for other clinically relevant variables. Results Although we detected a trend in loss of clinical benefit within the first year, the dominant tremor score at 2 years continued to be significantly improved (43.4%, 95% confidence interval 27.8%‐59.0%) from baseline. Secondarily, initial lesion volume is significantly associated with 1‐year outcome. Conclusion Our findings show that magnetic resonance–guided focused ultrasound thalamotomy results in sustained tremor reduction for medically refractory essential tremor even in the long term, and we highlight areas for improvement.