Non-motor outcomes following focused ultrasound thalamotomy for tremor

Essential tremor (ET) is marked by action tremor primarily affecting the upper limbs. Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is a relatively novel, minimally invasive treatment for medication-refractory tremor. Although unilateral MRgFUS thalamotomy effectively reduces tremor, its impact on non-motor outcomes remains unclear. This study examined non-motor outcomes following unilateral MRgFUS thalamotomy in patients with refractory ET.

Patients with refractory ET completed a series of questionnaires before and approximately four months after MRgFUS thalamotomy. Questionnaires assessed tremor-related embarrassment, subjective cognition, depressive and anxiety symptoms, sleep quality, sense of purpose in life, outlook on the future, functional abilities, and quality of life. Changes from baseline to follow-up were tested using paired-sample t-tests or Wilcoxon tests, as appropriate.

A total of 53 patients with ET were included. Participants had a median (IQR) age of 72 (11) and 60% were male. As expected, there was a significant reduction in tremor severity following MRgFUS. In terms of non-motor outcomes, significant improvements were observed in tremor-related embarrassment, subjective cognition, functional abilities, and quality of life. Additionally, among individuals with elevated baseline depressive and anxiety symptoms, symptoms decreased. No significant changes were found in sleep quality, sense of purpose in life, or outlook on the future.

Unilateral MRgFUS thalamotomy not only reduces tremor severity but also improves aspects of psychosocial wellbeing, highlighting its broader therapeutic potential for individuals with refractory ET.