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Four-year Follow-Up Results of Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Essential Tremor

 Yong-Sook Park  ;  Na Young Jung  ;  Young Cheol Na  ;  Jin Woo Chang 
 MOVEMENT DISORDERS, Vol.34(5) : 727-734, 2019-05 
Journal Title
Issue Date
Aged ; Essential Tremor / surgery* ; Female ; Follow-Up Studies ; High-Intensity Focused Ultrasound Ablation / methods* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurosurgical Procedures ; Surgery, Computer-Assisted / methods* ; Thalamus / surgery* ; Treatment Outcome
essential tremor ; high-intensity focused ultrasound ; thalamotomy
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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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Na Young(정나영)
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