Magnetic Resonance‐Guided Focused Ultrasound (MRgFUS)‐Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes
Background Factors predicting clinical outcomes after MR‐guided focused ultrasound (MRgFUS)‐thalamotomy in patients with essential tremor (ET) are not well known. Objective To examine the clinical outcomes and their relationship with patients' baseline demographic and clinical features and lesi...
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| Veröffentlicht in: | Movement disorders 2024-06, Vol.39 (6), p.1015-1025 |
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| creator | Arcadi, Alana Aviles‐Olmos, Iciar Gonzalez‐Quarante, Lain Hermes Gorospe, Arantza Jiménez‐Huete, Adolfo Corte, Marta Macías Parras, Olga Martin‐Bastida, Antonio Riverol, Mario Villino, Rafael Guridi, Jorge Rodríguez‐Oroz, Maria C. |
| description | Background
Factors predicting clinical outcomes after MR‐guided focused ultrasound (MRgFUS)‐thalamotomy in patients with essential tremor (ET) are not well known.
Objective
To examine the clinical outcomes and their relationship with patients' baseline demographic and clinical features and lesion characteristics at 6‐month follow‐up in ET patients.
Methods
A total of 127 patients were prospectively evaluated at 1 (n = 122), 3 (n = 102), and 6 months (n = 78) after MRgFUS‐thalamotomy. Magnetic resonance imaging (MRI) was obtained at 6 months (n = 60). Primary outcomes included: (1) change in the Clinical Rating Scale of Tremor (CRST)‐A+B score in the treated hand and (2) frequency and severity of adverse events (AEs) at 6 months. Secondary outcomes included changes in all subitems of the CRST scale in the treated hand, CRST‐C, axial tremor (face, head, voice, tongue), AEs, and correlation of primary outcomes at 6 months with lesion characteristics. Statistical analysis included linear mixed, standard, and logistic regression models.
Results
Scores for CRST‐A+B, CRST‐A, CRST‐B in the treated hand, CRST‐C, and axial tremor were improved at each evaluation (P |
| doi_str_mv | 10.1002/mds.29801 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3039235046</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3072210778</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3481-4c6ed21f9ba1d15f94716d22d4fb5fabc77e4794e442a92eb9c809b27a289e5e3</originalsourceid><addsrcrecordid>eNp10U9rFDEYx_Egil2rB9-ADHhpD9Pm7yTxJmu3CrsU2t3zkEmeqSkzSU1mkL3pO_A1-kpM3epB8PTk8OFL4IfQa4LPCMb0fHT5jGqFyRO0IIKRWlEhn6IFVkrUjChxhF7kfIcxIYI0z9ERUw1pGOUL9H1jbgNM3lbXkGMwwcLPbz8uZ-_AVato51zubpiSyXEOrjrZXN-udjenBW0_m8GMcYrjvupjqi5yhjB5M1TbBGNM76o1ZB9DtY7WTA8PUwLLwQdvC7qaJxtHyC_Rs94MGV493mO0W11slx_r9dXlp-X7dW0ZV6TmtgFHSa87QxwRveaSNI5Sx_tO9KazUgKXmgPn1GgKnbYK645KQ5UGAewYnRy69yl-mSFP7eizhWEwAeKcW4aZpkxg3hT69h96F-cUyu-KkpQSLKUq6vSgbIo5J-jb--RHk_Ytwe3DLm3Zpf29S7FvHotzN4L7K_8MUcD5AXz1A-z_X2o3H24OyV8Kuply</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3072210778</pqid></control><display><type>article</type><title>Magnetic Resonance‐Guided Focused Ultrasound (MRgFUS)‐Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Arcadi, Alana ; Aviles‐Olmos, Iciar ; Gonzalez‐Quarante, Lain Hermes ; Gorospe, Arantza ; Jiménez‐Huete, Adolfo ; Corte, Marta Macías ; Parras, Olga ; Martin‐Bastida, Antonio ; Riverol, Mario ; Villino, Rafael ; Guridi, Jorge ; Rodríguez‐Oroz, Maria C.</creator><creatorcontrib>Arcadi, Alana ; Aviles‐Olmos, Iciar ; Gonzalez‐Quarante, Lain Hermes ; Gorospe, Arantza ; Jiménez‐Huete, Adolfo ; Corte, Marta Macías ; Parras, Olga ; Martin‐Bastida, Antonio ; Riverol, Mario ; Villino, Rafael ; Guridi, Jorge ; Rodríguez‐Oroz, Maria C.</creatorcontrib><description>Background
Factors predicting clinical outcomes after MR‐guided focused ultrasound (MRgFUS)‐thalamotomy in patients with essential tremor (ET) are not well known.
Objective
To examine the clinical outcomes and their relationship with patients' baseline demographic and clinical features and lesion characteristics at 6‐month follow‐up in ET patients.
Methods
A total of 127 patients were prospectively evaluated at 1 (n = 122), 3 (n = 102), and 6 months (n = 78) after MRgFUS‐thalamotomy. Magnetic resonance imaging (MRI) was obtained at 6 months (n = 60). Primary outcomes included: (1) change in the Clinical Rating Scale of Tremor (CRST)‐A+B score in the treated hand and (2) frequency and severity of adverse events (AEs) at 6 months. Secondary outcomes included changes in all subitems of the CRST scale in the treated hand, CRST‐C, axial tremor (face, head, voice, tongue), AEs, and correlation of primary outcomes at 6 months with lesion characteristics. Statistical analysis included linear mixed, standard, and logistic regression models.
Results
Scores for CRST‐A+B, CRST‐A, CRST‐B in the treated hand, CRST‐C, and axial tremor were improved at each evaluation (P < 0.001). Five patients had severe AEs at 1 month that became mild throughout the follow‐up. Mild AEs occurred in 71%, 45%, and 34% of patients at 1, 3, and 6 months, respectively. Lesion volume was associated with the reduction in the CRST‐A (P = 0.003) and its overlapping with the ventralis intermedius nucleus (Vim) nucleus with the reduction in CRST‐A+B (P = 0.02) and CRST‐B (P = 0.008) at 6 months.
Conclusions
MRgFUS‐thalamotomy improves hand and axial tremor in ET patients. Transient and mild AEs are frequent. Lesion volume and location are associated with tremor reduction. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</description><identifier>ISSN: 0885-3185</identifier><identifier>ISSN: 1531-8257</identifier><identifier>EISSN: 1531-8257</identifier><identifier>DOI: 10.1002/mds.29801</identifier><identifier>PMID: 38616324</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Clinical outcomes ; essential tremor ; Lesions ; Magnetic resonance imaging ; Movement disorders ; MRgFUS ; MRI ; Regression analysis ; Statistical analysis ; Statistical models ; thalamotomy ; Tremor ; Tremor (Muscular contraction) ; Ultrasonic imaging ; Ultrasound</subject><ispartof>Movement disorders, 2024-06, Vol.39 (6), p.1015-1025</ispartof><rights>2024 The Authors. published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</rights><rights>2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3481-4c6ed21f9ba1d15f94716d22d4fb5fabc77e4794e442a92eb9c809b27a289e5e3</cites><orcidid>0000-0001-6676-7034 ; 0000-0002-8480-7009 ; 0000-0001-5962-772X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmds.29801$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmds.29801$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38616324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arcadi, Alana</creatorcontrib><creatorcontrib>Aviles‐Olmos, Iciar</creatorcontrib><creatorcontrib>Gonzalez‐Quarante, Lain Hermes</creatorcontrib><creatorcontrib>Gorospe, Arantza</creatorcontrib><creatorcontrib>Jiménez‐Huete, Adolfo</creatorcontrib><creatorcontrib>Corte, Marta Macías</creatorcontrib><creatorcontrib>Parras, Olga</creatorcontrib><creatorcontrib>Martin‐Bastida, Antonio</creatorcontrib><creatorcontrib>Riverol, Mario</creatorcontrib><creatorcontrib>Villino, Rafael</creatorcontrib><creatorcontrib>Guridi, Jorge</creatorcontrib><creatorcontrib>Rodríguez‐Oroz, Maria C.</creatorcontrib><title>Magnetic Resonance‐Guided Focused Ultrasound (MRgFUS)‐Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes</title><title>Movement disorders</title><addtitle>Mov Disord</addtitle><description>Background
Factors predicting clinical outcomes after MR‐guided focused ultrasound (MRgFUS)‐thalamotomy in patients with essential tremor (ET) are not well known.
Objective
To examine the clinical outcomes and their relationship with patients' baseline demographic and clinical features and lesion characteristics at 6‐month follow‐up in ET patients.
Methods
A total of 127 patients were prospectively evaluated at 1 (n = 122), 3 (n = 102), and 6 months (n = 78) after MRgFUS‐thalamotomy. Magnetic resonance imaging (MRI) was obtained at 6 months (n = 60). Primary outcomes included: (1) change in the Clinical Rating Scale of Tremor (CRST)‐A+B score in the treated hand and (2) frequency and severity of adverse events (AEs) at 6 months. Secondary outcomes included changes in all subitems of the CRST scale in the treated hand, CRST‐C, axial tremor (face, head, voice, tongue), AEs, and correlation of primary outcomes at 6 months with lesion characteristics. Statistical analysis included linear mixed, standard, and logistic regression models.
Results
Scores for CRST‐A+B, CRST‐A, CRST‐B in the treated hand, CRST‐C, and axial tremor were improved at each evaluation (P < 0.001). Five patients had severe AEs at 1 month that became mild throughout the follow‐up. Mild AEs occurred in 71%, 45%, and 34% of patients at 1, 3, and 6 months, respectively. Lesion volume was associated with the reduction in the CRST‐A (P = 0.003) and its overlapping with the ventralis intermedius nucleus (Vim) nucleus with the reduction in CRST‐A+B (P = 0.02) and CRST‐B (P = 0.008) at 6 months.
Conclusions
MRgFUS‐thalamotomy improves hand and axial tremor in ET patients. Transient and mild AEs are frequent. Lesion volume and location are associated with tremor reduction. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</description><subject>Clinical outcomes</subject><subject>essential tremor</subject><subject>Lesions</subject><subject>Magnetic resonance imaging</subject><subject>Movement disorders</subject><subject>MRgFUS</subject><subject>MRI</subject><subject>Regression analysis</subject><subject>Statistical analysis</subject><subject>Statistical models</subject><subject>thalamotomy</subject><subject>Tremor</subject><subject>Tremor (Muscular contraction)</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>0885-3185</issn><issn>1531-8257</issn><issn>1531-8257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp10U9rFDEYx_Egil2rB9-ADHhpD9Pm7yTxJmu3CrsU2t3zkEmeqSkzSU1mkL3pO_A1-kpM3epB8PTk8OFL4IfQa4LPCMb0fHT5jGqFyRO0IIKRWlEhn6IFVkrUjChxhF7kfIcxIYI0z9ERUw1pGOUL9H1jbgNM3lbXkGMwwcLPbz8uZ-_AVato51zubpiSyXEOrjrZXN-udjenBW0_m8GMcYrjvupjqi5yhjB5M1TbBGNM76o1ZB9DtY7WTA8PUwLLwQdvC7qaJxtHyC_Rs94MGV493mO0W11slx_r9dXlp-X7dW0ZV6TmtgFHSa87QxwRveaSNI5Sx_tO9KazUgKXmgPn1GgKnbYK645KQ5UGAewYnRy69yl-mSFP7eizhWEwAeKcW4aZpkxg3hT69h96F-cUyu-KkpQSLKUq6vSgbIo5J-jb--RHk_Ytwe3DLm3Zpf29S7FvHotzN4L7K_8MUcD5AXz1A-z_X2o3H24OyV8Kuply</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Arcadi, Alana</creator><creator>Aviles‐Olmos, Iciar</creator><creator>Gonzalez‐Quarante, Lain Hermes</creator><creator>Gorospe, Arantza</creator><creator>Jiménez‐Huete, Adolfo</creator><creator>Corte, Marta Macías</creator><creator>Parras, Olga</creator><creator>Martin‐Bastida, Antonio</creator><creator>Riverol, Mario</creator><creator>Villino, Rafael</creator><creator>Guridi, Jorge</creator><creator>Rodríguez‐Oroz, Maria C.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6676-7034</orcidid><orcidid>https://orcid.org/0000-0002-8480-7009</orcidid><orcidid>https://orcid.org/0000-0001-5962-772X</orcidid></search><sort><creationdate>202406</creationdate><title>Magnetic Resonance‐Guided Focused Ultrasound (MRgFUS)‐Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes</title><author>Arcadi, Alana ; Aviles‐Olmos, Iciar ; Gonzalez‐Quarante, Lain Hermes ; Gorospe, Arantza ; Jiménez‐Huete, Adolfo ; Corte, Marta Macías ; Parras, Olga ; Martin‐Bastida, Antonio ; Riverol, Mario ; Villino, Rafael ; Guridi, Jorge ; Rodríguez‐Oroz, Maria C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3481-4c6ed21f9ba1d15f94716d22d4fb5fabc77e4794e442a92eb9c809b27a289e5e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Clinical outcomes</topic><topic>essential tremor</topic><topic>Lesions</topic><topic>Magnetic resonance imaging</topic><topic>Movement disorders</topic><topic>MRgFUS</topic><topic>MRI</topic><topic>Regression analysis</topic><topic>Statistical analysis</topic><topic>Statistical models</topic><topic>thalamotomy</topic><topic>Tremor</topic><topic>Tremor (Muscular contraction)</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arcadi, Alana</creatorcontrib><creatorcontrib>Aviles‐Olmos, Iciar</creatorcontrib><creatorcontrib>Gonzalez‐Quarante, Lain Hermes</creatorcontrib><creatorcontrib>Gorospe, Arantza</creatorcontrib><creatorcontrib>Jiménez‐Huete, Adolfo</creatorcontrib><creatorcontrib>Corte, Marta Macías</creatorcontrib><creatorcontrib>Parras, Olga</creatorcontrib><creatorcontrib>Martin‐Bastida, Antonio</creatorcontrib><creatorcontrib>Riverol, Mario</creatorcontrib><creatorcontrib>Villino, Rafael</creatorcontrib><creatorcontrib>Guridi, Jorge</creatorcontrib><creatorcontrib>Rodríguez‐Oroz, Maria C.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Movement disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arcadi, Alana</au><au>Aviles‐Olmos, Iciar</au><au>Gonzalez‐Quarante, Lain Hermes</au><au>Gorospe, Arantza</au><au>Jiménez‐Huete, Adolfo</au><au>Corte, Marta Macías</au><au>Parras, Olga</au><au>Martin‐Bastida, Antonio</au><au>Riverol, Mario</au><au>Villino, Rafael</au><au>Guridi, Jorge</au><au>Rodríguez‐Oroz, Maria C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic Resonance‐Guided Focused Ultrasound (MRgFUS)‐Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes</atitle><jtitle>Movement disorders</jtitle><addtitle>Mov Disord</addtitle><date>2024-06</date><risdate>2024</risdate><volume>39</volume><issue>6</issue><spage>1015</spage><epage>1025</epage><pages>1015-1025</pages><issn>0885-3185</issn><issn>1531-8257</issn><eissn>1531-8257</eissn><abstract>Background
Factors predicting clinical outcomes after MR‐guided focused ultrasound (MRgFUS)‐thalamotomy in patients with essential tremor (ET) are not well known.
Objective
To examine the clinical outcomes and their relationship with patients' baseline demographic and clinical features and lesion characteristics at 6‐month follow‐up in ET patients.
Methods
A total of 127 patients were prospectively evaluated at 1 (n = 122), 3 (n = 102), and 6 months (n = 78) after MRgFUS‐thalamotomy. Magnetic resonance imaging (MRI) was obtained at 6 months (n = 60). Primary outcomes included: (1) change in the Clinical Rating Scale of Tremor (CRST)‐A+B score in the treated hand and (2) frequency and severity of adverse events (AEs) at 6 months. Secondary outcomes included changes in all subitems of the CRST scale in the treated hand, CRST‐C, axial tremor (face, head, voice, tongue), AEs, and correlation of primary outcomes at 6 months with lesion characteristics. Statistical analysis included linear mixed, standard, and logistic regression models.
Results
Scores for CRST‐A+B, CRST‐A, CRST‐B in the treated hand, CRST‐C, and axial tremor were improved at each evaluation (P < 0.001). Five patients had severe AEs at 1 month that became mild throughout the follow‐up. Mild AEs occurred in 71%, 45%, and 34% of patients at 1, 3, and 6 months, respectively. Lesion volume was associated with the reduction in the CRST‐A (P = 0.003) and its overlapping with the ventralis intermedius nucleus (Vim) nucleus with the reduction in CRST‐A+B (P = 0.02) and CRST‐B (P = 0.008) at 6 months.
Conclusions
MRgFUS‐thalamotomy improves hand and axial tremor in ET patients. Transient and mild AEs are frequent. Lesion volume and location are associated with tremor reduction. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>38616324</pmid><doi>10.1002/mds.29801</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6676-7034</orcidid><orcidid>https://orcid.org/0000-0002-8480-7009</orcidid><orcidid>https://orcid.org/0000-0001-5962-772X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Movement disorders, 2024-06, Vol.39 (6), p.1015-1025 |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Clinical outcomes essential tremor Lesions Magnetic resonance imaging Movement disorders MRgFUS MRI Regression analysis Statistical analysis Statistical models thalamotomy Tremor Tremor (Muscular contraction) Ultrasonic imaging Ultrasound |
| title | Magnetic Resonance‐Guided Focused Ultrasound (MRgFUS)‐Thalamotomy for Essential Tremor: Lesion Location and Clinical Outcomes |
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