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MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
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Bilateral Focused Ultrasound Thalamotomy for Essential Tremor (BEST-FUS Phase 2 Trial)
Christian Iorio-Morin1,2, Kazuaki Yamamoto2, Can Sarica2
1Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, Québec, Canada.
Summary
Bilateral focused ultrasound thalamotomy offers significant quality of life and tremor improvement for essential tremor patients. Most patients would undergo the staged bilateral procedure again, reporting an acceptable safety profile.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Essential tremor is a neurological condition often treated with unilateral procedures.
- Unilateral thalamotomy improves contralateral tremor but does not address symptoms on the same side of the body.
Purpose of the Study:
- To evaluate the safety and efficacy of bilateral thalamotomies using magnetic resonance-guided focused ultrasound.
- To determine if the benefits of bilateral treatment outweigh potential adverse effects.
Main Methods:
- A prospective, single-arm, single-blinded phase 2 trial was conducted.
- Ten patients with essential tremor underwent second-side focused ultrasound thalamotomy.
- Outcomes included quality of life, patient satisfaction, tremor severity, and adverse events over a 3-month follow-up.
Main Results:
- The procedure significantly improved quality of life (mean difference 19.7, P=0.004).
- All patients reported willingness to undergo the second-side treatment again.
- Tremor improved in all participants, with mild adverse effects reported in seven patients.
Conclusions:
- Staged bilateral focused ultrasound thalamotomy is a safe and effective treatment for essential tremor.
- The procedure demonstrates a favorable safety profile comparable to unilateral treatment.
- Further phase 3 trials are needed for long-term validation.
