Objective: To report a single-institution experience of MRI guided high intensity focused ultrasound (MRgFUS) unilateral ventral intermediate nucleus (VIM) thalamotomy in patients with Essential tremor (ET).
Background: ET is the most common tremor disorder which can affect daily functional activities and impairs qualify of life. There are limited medical treatment options and surgical treatment options including deep brain stimulation surgery or thalamotomy can be considered in selected patients. Unilateral MRgFUS VIM thalamotomy is an FDA approved, non-invasive surgical technique for the management of medication refractory ET.
Method: Patients with ET who underwent unilateral MRgFUS VIM thalamotomy at the University of Kansas Medical center and who completed 3 months follow-up were included in the study. Essential Tremor Rating Assessment Scale (TETRAS), Quality of Life in Essential Tremor Questionnaire (QUEST) were assessed pre-operatively and at 3 months after the procedure. Other measures including subjective clinical improvement and adverse events were also analyzed.
Results: A total of 36 patients (19 female) who underwent unilateral VIM thalamotomy were included in the analysis. The mean age at the time of surgery was 75.3 years. At 3 months the mean TETRAS total score improved from 54.8 at baseline to 25.8 (52.9 %, p<0.001) and QUEST score improved from 37.0 at baseline to 16.2 (56.2 %, p<0.001). Thirty patients reported marked (80-100%) and six patients reported moderate improvement (50-59%) in tremor. Common adverse events include gait/balance issues (23/36), weakness (13/36), speech/swallowing issues (12/36), headache (7/36) and numbness (6/36).
Conclusion: Unilateral MRgFUS thalamotomy is safe and effective treatment option for patients with medication refractory ET. Several patients experienced adverse events related to the procedure, however, in majority of patients adverse events resolved over time.
To cite this abstract in AMA style:
V. Sharma, K. Lyons, L. O'Brien, K. Au, J. Cheng, M. Kinsman, R. Pahwa. Efficacy And Safety Of Unilateral MRgFUS Thalamotomy In Patients With Essential Tremor [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/efficacy-and-safety-of-unilateral-mrgfus-thalamotomy-in-patients-with-essential-tremor/. Accessed June 14, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-and-safety-of-unilateral-mrgfus-thalamotomy-in-patients-with-essential-tremor/