Magnetic Resonance-Guided Focused Ultrasound without Anesthesiologist Support

Area of Science:

• Neurosurgery
• Neurology
• Medical Technology

Background:

• Magnetic resonance-guided focused ultrasound (MRgFUS) is an established treatment for essential tremor (ET) and tremor-dominant Parkinson's disease (TDPD).
• Current MRgFUS procedures often involve sedation or anesthesiologist support to ensure patient comfort and minimize risks.
• The safety and efficacy of performing MRgFUS without anesthesiologist involvement require further investigation.

Purpose of the Study:

• To evaluate the safety, feasibility, and tolerability of MRgFUS performed without an anesthesiologist.
• To compare outcomes and adverse events with historical MRgFUS procedures that included anesthesia support.

Main Methods:

• A retrospective review of 180 ET and TDPD patients undergoing MRgFUS without anesthesiologist support was conducted.
• Data collected included patient demographics, procedural parameters, adverse events, and 3-month tremor scores (CRST-B).
• Outcomes were compared to existing literature on MRgFUS with varying anesthesia levels.

Main Results:

• No anesthesia-related adverse events or treatment failures occurred.
• Patient-reported side effects included facial/tongue paresthesia (26.3%) and nausea (22.3%).
• A significant reduction in tremor scores (83.1%) was observed at 3 months post-procedure, with 94.6% of patients willing to repeat the procedure.

Conclusions:

• MRgFUS can be safely and effectively performed without intra-procedural anesthesiologist support.
• This approach is feasible and well-tolerated by patients with ET and TDPD.
• The procedure demonstrates a favorable safety profile and significant tremor reduction, comparable to procedures with anesthesia.