Objective: To describe the impact on quality of life (QoL) and nonmotor symptoms of unilateral magnetic resonance-guided focused ultrasounds (FUS) thalamotomy in patients with refractory essential tremor (ET).

Background: Refractory tremor has an important impact on QoL of patients with ET. These patients also present several nonmotor symptoms which also have a negative impact on their daily living activities.

Method: Patients with ET who underwent unilateral FUS thalamotomy between February/2022 and August/2023 were included, and were assessed pre-procedure, at 3 and 6 months. The QoL in essential tremor questionnaire (QUEST) and the EuroQoL-5D visual analogue scale (EQ-5D) were used. Symptoms of depression and anxiety were evaluated by means of the Geriatric Depression Scale (GDS-15) and Geriatric Anxiety Index (GAI), respectively.  The patient global impression of severity (PGI-S) and Patient global Impression of improvement (PGI-I) were also applied.

Results: 155 patients were included (103 had available data at 3-months, and 72 at 6-months). Age at procedure was 72.10±8.68 years. The QUEST summary index improved overall a 48.38% at 6-months (44.44±15.65 vs 21.50±4.95). However, the subjective overall health status and the EQ-5D visual analogue scale were similar before and 6-months after the procedure (62.80±15.58 vs 68.03±16.22 and 63.49±18.27 vs 68.28±16.13, respectively). Symptoms of depression significantly improved after the FUS thalamotomy (GDS-15 before the procedure 4.34±3.33, at 3months 2.87±3.06). The percentage of patients with a score suggestive of depression decreased from 23.5% to 4.2% at 6-months. 54 (34.8%) patients had a generalized anxiety disorder before the treatment, but only 9 (5.4%) at 6-months. 79.1% of patients reported that their symptoms were moderately severe or severe. At 6-months, 68 (90.7%) of patients reported that their symptoms were, at most, moderate. 75% of patients considered that their symptoms were much better or very much better than before the procedure at 3 and 6 months.

Conclusion: QoL of patients with refractory ET improves after unilateral FUS thalamotomy, measured by means of the specific QUEST tool. Symptoms of depression and anxiety improved after the treatment in these cohort of patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-on-quality-of-life-and-nonmotor-symptoms-of-unilateral-magnetic-resonance-guided-focused-ultrasounds-fus-thalamotomy-in-patients-with-essential-tremor/