Details

Autor(en) / Beteiligte

• Halpern, Casey H
• Santini, Veronica
• Lipsman, Nir
• Lozano, Andres M
• Schwartz, Michael L
• Shah, Binit B
• Elias, W Jeff
• Cosgrove, Garth R
• Hayes, Michael T
• McDannold, Nathan
• Aldrich, Christina
• Eisenberg, Howard M
• Gandhi, Dheeraj
• Taira, Takaomi
• Gwinn, Ryder
• Ro, Susie
• Witt, Jennifer
• Jung, Na Young
• Chang, Jin Woo
• Rosenberg, Jarrett
• Ghanouni, Pejman

Titel

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

Ist Teil von

• Neurology, 2019-12, Vol.93 (24), p.e2284

Ort / Verlag

United States

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. 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. Measured scores remained improved from baseline to 36 months (all < 0.0001). Range of improvement from baseline was 38%-50% in hand tremor, 43%-56% in disability, 50%-75% in postural tremor, and 27%-42% in quality of life. When compared to scores at 6 months, median scores increased for hand tremor (95% confidence interval [CI] 0-2, = 0.0098) and disability (95% CI 1-4, = 0.0001). During the third follow-up year, all previously noted adverse events remained mild or moderate, none worsened, 2 resolved, and no new adverse events occurred. 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. NCT01827904. This study provides Class IV evidence that for patients with severe ET, unilateral tcMRgFUS thalamotomy provides durable benefit after 3 years.