Stereotactic and Functional Neurosurgery

Moosa S.a· Craver A.a· Asuzu D.a· Eames M.b,c· Wang T.R.d· Elias W.J.a

Author affiliations

aDepartment of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA
bFocused Ultrasound Foundation, Charlottesville, VA, USA
cDepartment of Radiology, University of Virginia Health System, Charlottesville, VA, USA
dDepartment of Neurological Surgery, Swedish Neuroscience Institute, Seattle, WA, USA

Stereotact Funct Neurosurg

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Article / Publication Details

First-Page Preview

Received: August 26, 2021
Accepted: June 22, 2022
Published online: August 26, 2022

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Abstract

Introduction: The objectives of this study were to determine long-term patient-reported outcomes with magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for medication-refractory essential tremor (ET) and to identify risk factors for a poor clinical outcome. Methods: We administered a telephone or mail-in survey to patients who consecutively underwent unilateral MRgFUS thalamotomy for ET at our institution over an 8-year period. Patients were asked to self-report measures of hand tremor improvement, degree of overall postprocedure improvement, activities of daily life, side effects, and willingness to undergo the procedure again. Specific patient characteristics, ultrasound treatment parameters, and postoperative radiological findings from magnetic resonance imaging performed 1 day after the procedure were analyzed, and multivariable linear regression was used to determine if these factors could serve as predictors of clinical outcome. Results: A total of 85 patients were included in this study with a mean follow-up time of 3.0 years (range 2 months to 1 8.4 years). The mean patient-reported improvement in hand tremor at last follow-up was 66%, and 73% of patients reported meaningful change in their overall condition after the procedure. The percentages of patients reporting normal or only minimal limitations with feeding, drinking, and writing ability at last follow-up were 60%, 71%, and 48%, respectively. In the position of their former selves, 89% of patients would again choose to undergo the procedure. Larger lesions were correlated with a higher risk of adverse events. Discussion/Conclusion: While subjective hand tremor improvement declines with time, willingness to undergo the procedure again following MRgFUS thalamotomy for ET remains very high even several years after the procedure.

© 2022 S. Karger AG, Basel

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First-Page Preview

Received: August 26, 2021
Accepted: June 22, 2022
Published online: August 26, 2022

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

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