Objective: To further understand outcomes following radiofrequency (RF) thermal lesioning in the CNS, we conducted a real-world observational evaluation of patients who chose this therapy to manage motor symptoms of movement disorders.

Background: Individuals with movement disorders including essential tremor (ET), Parkinson’s disease (PD), and dystonia are often treated with deep brain stimulation (DBS) to neuromodulate targeted brain regions and alleviate motor symptoms. Nevertheless, certain patients may not be ideal candidates for device implantation or may decline this approach. Advances in imaging-guided functional neurosurgery have renewed interest in ablative therapies, with thermal RF lesioning providing a credible alternative supported by a satisfactory risk–benefit profile.

Method: This is an international, prospective, multicenter, observational outcomes study enrolling up to 200 patients with movement disorders treated with an RF thermal lesioning ablation system (Boston Scientific) in accordance with locally approved IFU. Participants must provide informed consent prior to enrollment. Patients meeting any IFU-specified contraindications or presenting with conditions that could compromise study participation are excluded. Outcome measures include UPDRS or MDS-UPDRS Part III, tremor severity changes, and both clinician and patient Global Impression of Change. Evaluations are performed at baseline and at 1-, 3-, 6-, 12-, and 24-month follow-up visits.

Results: This active, ongoing study has enrolled eight patients (mean age: 71.3 ± 5.2 years), all treated with unilateral thalamotomy. Among three patients with ET, activity of daily living scores improved by 81% (25-point reduction; 31.3 to 6.0), and performance scores improved by 64% (16-point reduction; 24.3 to 8.7) at a last follow-up of 3–6 months. In patients with PD treated with unilateral RF ablation, motor scores improved by 5 points (39.6 to 33.6) from baseline to last follow-up. Two serious adverse events (SAEs) occurred in two subjects; one case of delirium was considered possibly procedure-related. Both SAEs resolved. Data collection continues, and preliminary findings will be updated accordingly.

Conclusion: Real-world evaluation of RF ablation for movement disorder motor symptoms enables contemporary assessment of its clinical utility alongside advances in imaging and neurosurgical practice.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-effectiveness-of-radiofrequency-thermal-ablative-lesioning-for-the-management-of-motor-symptoms-in-movement-disorders-real-world-evidence/