Schreglmann, Sebastian R; Bauer, Ronald; Hägele-Link, Stefan; Bhatia, Kailash P; Natchev, Parashkev; Wegener, Nikolas; Lebeda, Anita; Werner, Beat; Martin, Ernst; Kägi, Georg (2017). Unilateral cerebellothalamic tract ablation in essential tremor by MRI-guided focused ultrasound. Neurology, 88(14), pp. 1329-1333. Lippincott Williams & Wilkins 10.1212/WNL.0000000000003795
Full text not available from this repository. (Request a copy)OBJECTIVE
To report results of a prospective trial of unilateral transcranial MRI-guided focused ultrasound (MRIgFUS) ablation of the cerebellothalamic tract in essential tremor (ET).
METHODS
This was a prospective, uncontrolled, single-center interventional study. Patients with ET fulfilling criteria for interventional therapy received unilateral ablation of the cerebellothalamic tract (CTT) by MRIgFUS. Motor symptoms, manual dexterity, cognition, and quality of life were assessed before intervention and at 48 hours and 1, 3, and 6 months after intervention. Rating of standardized video recordings was blinded for evaluation time points. Primary outcome was the change in unilateral hand tremor score of the treated hand.
RESULTS
Six patients received MRIgFUS ablation of the CTT contralateral to the treated hand. Repeated-measures comparison determined a statistically significant 83% reduction (before vs 6 months after intervention mean ± SD; absolute reduction; 95% confidence interval) in the unilateral treated hand subscore (14.3 ± 4.9 vs 2.5 ± 2.6; 11.8; 8.4-15.2; p < 0.001), while quality of life improved by 52% (50.5 ± 19.4 vs 24.8 ± 11.4; 25.7; 3.5-47.28; p = 0.046). Measures for manual dexterity, attention and coordination, and overall cognition were unchanged. Transient side effects (n = 3) were ipsilateral hand clumsiness and mild gait instability for up to 3 months.
CONCLUSIONS
Unilateral MRIgFUS lesioning of the CTT was highly efficacious in reducing contralateral hand tremor in ET without affecting fine motor function and dexterity over 6 months of follow-up. Adverse effects were mild and transient.
CLASSIFICATION OF EVIDENCE
This study provides Class IV evidence that for patients with ET, transcranial MRIgFUS ablation of the cerebellothalamic tract improves tremor.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Kägi, Georg Heinrich |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0028-3878 |
Publisher: |
Lippincott Williams & Wilkins |
Language: |
English |
Submitter: |
Stefanie Hetzenecker |
Date Deposited: |
23 Oct 2017 10:28 |
Last Modified: |
02 Mar 2023 23:29 |
Publisher DOI: |
10.1212/WNL.0000000000003795 |
PubMed ID: |
28275083 |
URI: |
https://boris.unibe.ch/id/eprint/102133 |
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