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Updated: Aug 6, 2026
MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
Frailty and Tremor Recurrence after Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) Thalamotomy for Essential
Mercy H Mazurek1, Daniela Limbania1, Niels Pacheco-Barrios2,3
1Harvard Medical School, Boston, Massachusetts, USA.
Background:
Frailty has been associated with adverse outcomes after neurosurgical procedures, but its impact on magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for essential tremor (ET) is unknown.
Methods:
This single-center cohort included 481 consecutive ET patients undergoing unilateral MRgFUS thalamotomy (March 2016-March 2025). Frailty was quantified using the International Classification of Diseases, Tenth Revision (ICD-10)-derived Risk Analysis Index (RAI). Outcomes included 3-month Fahn-Tolosa-Marin (FTM) tremor score, side effects, satisfaction, and tremor recurrence over 3 years.
Results:
Frailty and age did not predict 3-month FTM score (RAI: β = 0.011, P = 0.134; age: β = 0.016, P = 0.065) or side effects (RAI: odds ratio [OR] = 1.003, P = 0.792; age: OR = 1.021, P = 0.116). RAI and age predicted recurrence with similar effect sizes (RAI hazard ratio [HR] = 1.040, P = 0.008; age HR = 1.063, P = 0.005); RAI subcomponent analysis indicated age was the primary driver. Lesion volumes did not differ by RAI or age.
Conclusions:
Short-term tremor control after MRgFUS is excellent regardless of RAI-measured frailty or age though recurrence rose with age, which accounted for the frailty association. © 2026 International Parkinson and Movement Disorder Society.
