Magnetic resonance-guided focused ultrasound unilateral thalamotomy for medically refractory essential tremor: 3-year follow-up data

Autor: Stefano Tamburin, Fabio Paio, Tommaso Bovi, Giorgia Bulgarelli, Michele Longhi, Roberto Foroni, Elisa Mantovani, Paolo Maria Polloniato, Micaela Tagliamonte, Emanuele Zivelonghi, Chiara Zucchella, Carlo Cavedon, Antonio Nicolato, Benedetto Petralia, Francesco Sala, Bruno Bonetti, Michele Tinazzi, Stefania Montemezzi, Giuseppe Kenneth Ricciardi
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Frontiers in Neurology, Vol 15 (2024)
Druh dokumentu: article
ISSN: 1664-2295
DOI: 10.3389/fneur.2024.1360035
Popis: IntroductionMagnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy of the ventralis intermediate (Vim) nucleus is an “incisionless” treatment for medically refractory essential tremor (ET). We present data on 49 consecutive cases of MRgFUS Vim thalamotomy followed-up for 3 years and review the literature on studies with longer follow-up data.MethodsA retrospective chart review of patients who underwent MRgFUS thalamotomy (January 2018–December 2020) at our institution was performed. Clinical Rating Scale for Tremor (CRST) and Quality of Life in Essential Tremor (QUEST) scores were obtained pre-operatively and at each follow-up with an assessment of side effects. Patients had post-operative magnetic resonance imaging within 24 h and at 1 month to figure out lesion location, size, and extent. The results of studies with follow-up ≥3 years were summarized through a literature review.ResultsThe CRST total (baseline: 58.6 ± 17.1, 3-year: 40.8 ± 18.0) and subscale scores (A + B, baseline: 23.5 ± 6.3, 3-year: 12.8 ± 7.9; C, baseline: 12.7 ± 4.3, 3-year: 5.8 ± 3.9) and the QUEST score (baseline: 38.0 ± 14.8, 3-year: 18.7 ± 13.3) showed significant improvement that was stable during the 3-year follow-up. Three patients reported tremor recurrence and two were satisfactorily retreated. Side effects were reported by 44% of patients (severe: 4%, mild and transient: 40%). The improvement in tremor and quality of life in our cohort was consistent with the literature.ConclusionWe confirmed the effectiveness and safety of MRgFUS Vim thalamotomy in medically refractory ET up to 3 years.
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