Tremor Control and Patient Reported Outcomes after Bilateral Focused Ultrasound Thalamotomy for Essential Tremor

Area of Science:

• Neurology
• Neurosurgery
• Medical Imaging

Background:

• Staged bilateral magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is FDA-approved for essential tremor (ET).
• Limited data exists on patient-reported outcomes and satisfaction following bilateral MRgFUS thalamotomy.
• This study addresses the need for comprehensive outcome data in ET patients treated with bilateral MRgFUS.

Purpose of the Study:

• To evaluate tremor outcomes in patients undergoing staged bilateral MRgFUS thalamotomy.
• To assess patient-reported adverse effects and satisfaction after bilateral MRgFUS thalamotomy.
• To provide insights into the long-term efficacy and tolerability of bilateral MRgFUS for ET.

Main Methods:

• A cohort of 30 patients with essential tremor underwent staged bilateral MRgFUS thalamotomy.
• Tremor severity was assessed using the Clinical Rating Scale for Tremor Part B.
• Patients reported on adverse effects (speech, sensory, gait, etc.) and treatment satisfaction.

Main Results:

• Bilateral MRgFUS thalamotomy significantly improved tremor severity (P < 0.001).
• 87% of patients reported mild or moderate adverse effects; no severe effects occurred.
• Persistent adverse effects at 12 months included speech changes (55%), sensory changes (30%), and gait disturbance (20%).

Conclusions:

• Staged bilateral MRgFUS thalamotomy achieves significant tremor control for essential tremor.
• Higher rates of certain adverse effects were observed compared to previous reports.
• Patient satisfaction with the bilateral procedure declined over time, highlighting the need for careful counseling.