Four‐year follow‐up results of magnetic resonance‐guided focused ultrasound thalamotomy for essential tremor

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Abstract

Background

Following the emergence of magnetic resonance‐guided focused ultrasound as a promising tool for movement disorder surgery, thalamotomy for essential tremor using this technique has become a useful tool based on its efficacy and lack of adverse effects. Here, we summarize the 4‐year results of previous reports focusing on the durability of effectiveness of magnetic resonance‐guided focused ultrasound thalamotomy for essential tremor.

Methods

From October 2013 to August 2014, 15 patients with intractable essential tremor were enrolled. Twelve of them completed clinical assessment through 4 years of postoperative follow‐up. Tremor severity, task performance, and disability were measured using the Clinical Rating Scale of Tremor.

Results

The mean age of the 12 patients was 61.7 ± 8.1 years. Maximally delivered energy was 15,552.4 ± 6574.1 joules. The mean number of sonications was 17.3 ± 1.6. The mean postoperative lesion volume was 82.6 ± 29.023 mm3 and in 1 year was a mean of 9.667 ± 8.573 mm3. Four years postoperatively, improvement of the hand tremor score was 56%, that of the disability score was 63%, that of the postural score was 70%, and that of the action score was 63% compared with baseline; all improvements were significant and sustained over the 4‐year period after thalamotomy. There was no permanent adverse effect throughout the 4‐year follow‐up period.

Conclusions

Magnetic resonance‐guided focused ultrasound thalamotomy exhibits sustained clinical efficacy 4 years after the treatment of intractable essential tremor. Adverse events are generally transient. A large cohort of patients who have undergone magnetic resonance‐guided focused ultrasound thalamotomy with longer follow‐up is needed to confirm our findings. © 2019 International Parkinson and Movement Disorder Society

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