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Functional Lesional Neurosurgery for Tremor: A Systematic Review and Meta-Analysis

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dc.contributor.author장진우-
dc.date.accessioned2020-06-04T08:42:43Z-
dc.date.available2020-06-04T08:42:43Z-
dc.date.issued2018-04-
dc.identifier.issn0022-3050-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/175854-
dc.description.abstractBackground: This work evaluates the consistency, effect size and incidence of persistent side effects of lesional neurosurgical interventions in the treatment of tremor due to Parkinson's disease (PD), essential tremor (ET), multiple sclerosis (MS) and midbrain lesions. Methods: Systematic review and meta-analysis according to PRISMA-P guidelines. Random effects meta-analysis of standardised mean difference based on a peer-reviewed protocol (PROSPERO no. CRD42016048049). Results: From 1249 abstracts screened, 86 peer-reviewed studies reporting 102 cohorts homogeneous for tremor aetiology, surgical target and technique were included.Effect on PD tremor was better when targeted at the ventral intermediate nucleus (V.im.) by radiofrequency ablation (RF) (Hedge's g: -4.15;) over V.im. by Gamma Knife (GK) (-2.2), subthalamic nucleus (STN) by RF (-1.12) and globus pallidus internus (GPi) by RF (-0.89). For ET MRI-guided focused ultrasound (MRIgFUS) ablation of the cerebellothalamic tract (CTT) (-2.35) and V.im. (-2.08) showed similar mean tremor reductions to V.im. ablation by RF (-2.42) or GK (-2.13). In MS V.im. ablation by GK (-1.96) and RF (-1.63) were similarly effective.Mean rates of persistent side effects after unilateral lesions in PD were 12.8% (RF V.im.), 13.6% (RF STN), 9.2% (RF GPi), 0.7% (GK V.im.) and 7.0% (MRIgFUS V.im.). For ET, rates were 9.3% (RF V.im.), 1.8% (GK V.im.), 18.7% (MRIgFUS V.im.) and 0.0% (MRIgFUS CTT), for MS 37.7% (RF V.im.) and for rubral tremor 30.3% (RF V.im.). Conclusion: This meta-analysis quantifies safety, consistency and efficacy of lesional neurosurgical interventions for tremor by target, technique and aetiology.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherBMJ Publishing Group-
dc.relation.isPartOfJOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHBrain Neoplasms / complications-
dc.subject.MESHBrain Neoplasms / surgery*-
dc.subject.MESHEssential Tremor-
dc.subject.MESHHumans-
dc.subject.MESHMultiple Sclerosis / complications-
dc.subject.MESHMultiple Sclerosis / surgery*-
dc.subject.MESHNeurosurgical Procedures*-
dc.subject.MESHParkinson Disease / complications-
dc.subject.MESHParkinson Disease / surgery*-
dc.subject.MESHTremor / etiology-
dc.subject.MESHTremor / surgery*-
dc.titleFunctional Lesional Neurosurgery for Tremor: A Systematic Review and Meta-Analysis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Neurosurgery (신경외과학교실)-
dc.contributor.googleauthorSebastian R Schreglmann-
dc.contributor.googleauthorJoachim K Krauss-
dc.contributor.googleauthorJin Woo Chang-
dc.contributor.googleauthorKailash P Bhatia-
dc.contributor.googleauthorGeorg Kägi-
dc.identifier.doi10.1136/jnnp-2017-316302-
dc.contributor.localIdA03484-
dc.relation.journalcodeJ01628-
dc.identifier.eissn1468-330X-
dc.identifier.pmid29326290-
dc.identifier.urlhttps://jnnp.bmj.com/content/89/7/717.long-
dc.subject.keywordmeta-analysis-
dc.subject.keywordneurosurgery-
dc.subject.keywordparkinson’s disease-
dc.subject.keywordsystematic reviews-
dc.subject.keywordtremor-
dc.contributor.alternativeNameChang, Jin Woo-
dc.contributor.affiliatedAuthor장진우-
dc.citation.volume89-
dc.citation.number7-
dc.citation.startPage717-
dc.citation.endPage726-
dc.identifier.bibliographicCitationJOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, Vol.89(7) : 717-726, 2018-04-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers

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