Table 6:
Improvement in Tremor Severity Observed in Cohort Studies of MRgFUS Neurosurgery
| Author, Year | N | CRST Scale(s) Assessed | Baseline Score, Mean (SD) | Follow-Up | Post-treatment Score, Mean (SD) | Improvement | P Value |
|---|---|---|---|---|---|---|---|
| Ventral Intermediate Nucleus Thalamotomy | |||||||
| Zaaroor et al, 201745 | 18a | Total | 40.7 (11.6) | 1 mo 6 mo |
9.3 (7.1) 8.2 (5.0) |
77% 80% |
< .001 < .001 |
| Chang et al, 201536 | 11b | Part A Part B Part C |
5.1 13.0 13.5 |
6 mo 6 mo 6 mo |
1.4 2.6 2.8 |
73% 80% 79% |
NR NR NR |
| Elias et al, 201337,43,44 | 15 | Part A Total |
20.4 (5.2) 54.9 (14.4) |
3 mo 12 mo 12 mo |
4.3 (3.5) 5.2 (4.8) 24.3 (14.8) |
79% 75% 56% |
NR .001 .001 |
| Lipsman et al, 201341 | 4 | Part A Part B Part C Total Part A Part B Part C Total |
21.5 (11.2) 28.5 (6.5) 20.8 (4.5) 70.8 (19.7) |
1 mo 1 mo 1 mo 1 mo 3 mo 3 mo 3 mo 3 mo |
7.3 (2.2) 16 (7.6) 8 (4.2) 31.3 (15.0) 7.8 (4.6) 17.3 (6.6) 10.3 (3.3) 35.3 (11.0) |
66% 45.5% 62% 56% 65% 39.6% 50% 50% |
NR NR NR NR NR NR NR NR |
| Cerebellothalamic Tractotomy | |||||||
| Schreglmann et al, 201742 | 6 | Total CRST Unilateral (treated side) Speaking and working Drawing and pouring |
43.8 (9.8) 14.3 (4.9) 13.8 (3.4) 8.7 (2.7) |
6 mo 6 mo 6 mo 6 mo |
19.8 (6.8) 2.5 (2.6) 2.5 (0.8) 2.3 (2.3) |
−24 points (95% CI: −18.1 to −29.9) −11.8 points (95% CI: −8.4 to −15.2) −11.3 (95% CI: −8.8 to −13.9) −6.3 (95% CI: −3.8 to −8.9) |
< .001 < .001 < .001 < .001 |
| Gallay et al, 201639 | 21c | Total | 57.6 (13.2) | 12 mo | 25.8 (17.6) | 55% | NR |
| Hand function, targeted hand only | 12.4 (1.3) | 3 mo 12 mo |
NR NR |
74% 78% |
NR NR |
||
| Subgroup 1 (Severe) | 7 | Hand function, targeted hand only | 15.3 (1.3) |
3 mo 12 mo |
NR NR |
41% 40% |
NR NR |
| Subgroup 2 | 14 | Hand function, targeted hand only | 11.0 (3.3) |
3 mo 12 mo |
NR NR |
92% 90% |
NR NR |
Abbreviations: CI, confident interval; MRgFUS, magnetic resonance-guided focused ultrasound; NR, not reported; SD, standard deviation.
Note: Essential tremor severity was assessed via the Clinical Rating Scale for Tremor (CRST).
a
There were 30 study participants, of whom 18 had essential tremor and 12 had either Parkinson's disease or tremor-dominant Parkinson's disease. The characteristics described reflect means, ranges, and proportions for the subset of participants with essential tremor.45
b
There were outcome data for 8 of 11 participants at follow-up.
c
There were outcome data for 10 of 21 participants at the 12-month follow-up.