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Background: Factors predicting clinical outcomes after MR-guided focused ultrasound (MRgFUS)-thalamotomy in patients with essential tremor (ET) are not well known.

Objective: To examine the clinical outcomes and their relationship with patients' baseline demographic and clinical features and lesion characteristics at 6-month follow-up in ET patients.

Methods: A total of 127 patients were prospectively evaluated at 1 (n = 122), 3 (n = 102), and 6 months (n = 78) after MRgFUS-thalamotomy. Magnetic resonance imaging (MRI) was obtained at 6 months (n = 60). Primary outcomes included: (1) change in the Clinical Rating Scale of Tremor (CRST)-A+B score in the treated hand and (2) frequency and severity of adverse events (AEs) at 6 months. Secondary outcomes included changes in all subitems of the CRST scale in the treated hand, CRST-C, axial tremor (face, head, voice, tongue), AEs, and correlation of primary outcomes at 6 months with lesion characteristics. Statistical analysis included linear mixed, standard, and logistic regression models.

Results: Scores for CRST-A+B, CRST-A, CRST-B in the treated hand, CRST-C, and axial tremor were improved at each evaluation (P < 0.001). Five patients had severe AEs at 1 month that became mild throughout the follow-up. Mild AEs occurred in 71%, 45%, and 34% of patients at 1, 3, and 6 months, respectively. Lesion volume was associated with the reduction in the CRST-A (P = 0.003) and its overlapping with the ventralis intermedius nucleus (Vim) nucleus with the reduction in CRST-A+B (P = 0.02) and CRST-B (P = 0.008) at 6 months.

Conclusions: MRgFUS-thalamotomy improves hand and axial tremor in ET patients. Transient and mild AEs are frequent. Lesion volume and location are associated with tremor reduction. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Titel:	Magnetic Resonance-Guided Focused Ultrasound (MRgFUS)-Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes.
Autor/in / Beteiligte Person:	Arcadi, A ; Aviles-Olmos, I ; Gonzalez-Quarante, LH ; Gorospe, A ; Jiménez-Huete, A ; de la Corte MM ; Parras, O ; Martin-Bastida, A ; Riverol, M ; Villino, R ; Guridi, J ; Rodríguez-Oroz, MC
Zeitschrift:	Movement disorders : official journal of the Movement Disorder Society, Jg. 39 (2024-06-01), Heft 6, S. 1015-1025
Veröffentlichung:	<2001->: New York, NY : Wiley-Liss ; <i>Original Publication</i>: [New York, N.Y.] : Raven Press, [c1986-, 2024
Medientyp:	academicJournal
ISSN:	1531-8257 (electronic)
DOI:	10.1002/mds.29801
Schlagwort:	Humans Female Male Aged Middle Aged Treatment Outcome Thalamus diagnostic imaging Thalamus surgery Prospective Studies Essential Tremor surgery Essential Tremor diagnostic imaging Magnetic Resonance Imaging methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Mov Disord] 2024 Jun; Vol. 39 (6), pp. 1015-1025. <i>Date of Electronic Publication: </i>2024 Apr 14. MeSH Terms: Essential Tremor* / surgery ; Essential Tremor* / diagnostic imaging ; Magnetic Resonance Imaging* / methods ; Humans ; Female ; Male ; Aged ; Middle Aged ; Treatment Outcome ; Thalamus / diagnostic imaging ; Thalamus / surgery ; Prospective Studies References: Miller WK, Becker KN, Caras AJ, Mansour TR, Mays MT, Rashid M, Schwalb J. Magnetic resonance‐guided focused ultrasound treatment for essential tremor shows sustained efficacy: a meta‐analysis. Neurosurg Rev 2022;45(1):533–544. ; Lipsman N, Schwartz ML, Huang Y, et al. MR‐guided focused ultrasound thalamotomy for essential tremor: a proof‐of‐concept study. Lancet Neurol 2013;12(5):462–468. ; Elias WJHDVT, Huss D, Voss T, et al. A pilot study of focused ultrasound thalamotomy for essential tremor. 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Magnetic Resonance-Guided Focused Ultrasound (MRgFUS)-Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes.