Outcome and Complications of MR Guided Focused Ultrasound for Essential Tremor: A Systematic Review and Meta-Analysis
Background: Magnetic resonance guided focused ultrasound (MRgFUS) is a relatively novel technique to treat essential tremor (ET). The objective of this review was to analyze the efficacy and the safety profile of MRgFUS for ET. Methods: A systematic literature review was done. The post procedure cha...
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Published in | Frontiers in neurology Vol. 12; p. 654711 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Frontiers Media S.A
07.05.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Background:
Magnetic resonance guided focused ultrasound (MRgFUS) is a relatively novel technique to treat essential tremor (ET). The objective of this review was to analyze the efficacy and the safety profile of MRgFUS for ET.
Methods:
A systematic literature review was done. The post procedure changes in the Clinical Rating Scale for Tremor (CRST) score, hand score, disability and quality of life scores were analyzed.
Results:
We found 29 studies evaluating 617 patients. DTI based targeting was utilized in six cohorts. A significant difference was observed in the pooled standard mean difference between the pre and postoperative total CRST score (
p
-value < 0.001 and 0.0002), hand score (
p
-value 0.03 and 0.02); and the disability at 12 months (
p
-value 0.01). Head pain and dizziness were the most in procedure complications. The immediate pooled proportion of ataxia was 50%, while it was 20% for sensory complications, which, respectively, declined to 31 and 13% on long term follow up. A significant reduction (
p
= 0.03) in immediate ataxia related complications was seen with DTI targeting.
Conclusion:
MRgFUS for ET seems to be an effective procedure for relieving unilateral tremor. Use of DTI based targeting revealed a significant reduction in post procedure ataxia related complications as compared to traditional targeting techniques. Analysis of other complications further revealed a decreasing trend on follow up. |
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Bibliography: | content type line 23 SourceType-Scholarly Journals-1 This article was submitted to Experimental Therapeutics, a section of the journal Frontiers in Neurology Reviewed by: Bhavya Shah, University of Texas Southwestern Medical Center, United States; Jin Woo Chang, Yonsei University Health System, South Korea; Dheeraj Gandhi, University of Maryland, United States These authors have contributed equally to this work Edited by: Vibhor Krishna, The Ohio State University, United States |
ISSN: | 1664-2295 1664-2295 |
DOI: | 10.3389/fneur.2021.654711 |