Objective: To assess the 9-year outcome of unilateral MRI guided focused ultrasound (MRgFUS) ventral intermediate nucleus thalamotomy in Essential Tremor (ET) patients, with medication resistant tremor.

Background: MRI Guided Focused Ultrasound is a technology that enables non-invasive intracranial focal thermal ablation. Thalamotomy using this technology has been effective in ameliorating tremor in medication resistant patients immediately following the procedure. Long-term data on the effects of Focused ultrasound thalamotomy for tremor in medication resistant ET patients beyond 5 years has not been reported.

Method: Five ET patients who completed 9 years follow-up were included. Tremor was assessed with Clinical Rating Scale for Tremor (CRST) and in the treated hemibody (hemi-CRST).

Results: Median age before MRgFUS was 70 years (range 67-75 years). Median disease duration of 13 years (range 4-30). Tremor was significantly improved immediately following MRgFUS in all patients. At 9-years following MRgFUS, Median hemi-CRST score was significantly improved as compared with baseline (baseline median score 20, range 15-35 vs. median score at 9 years 10, range 5-19, p=0.001). At 9-years following MRgFUS, Median total CRST score was improved as compared with baseline (baseline median score 55, range 40-73 vs. median score at 9 years 35, range 30-60) but this did not reach statistical significance. Adverse events following the procedure were mild and transient.

Conclusion: This study found that improvement in tremor following unilateral MRgFUS thalamotomy in ET was sustained at 9 years with no long standing adverse effects.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nine-year-outcome-of-mri-guided-focused-ultrasound-thalamotomy-in-essential-tremor-patients/