BackgroundFactors predicting clinical outcomes after MR‐guided focused ultrasound (MRgFUS)‐thalamotomy in patients with essential tremor (ET) are not well known.ObjectiveTo 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.MethodsA 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.ResultsScores 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.ConclusionsMRgFUS‐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.

中文翻译：

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磁共振引导聚焦超声（MRgFUS）-丘脑切除术治疗特发性震颤：病变位置和临床结果

背景预测特发性震颤 (ET) 患者 MR 引导聚焦超声 (MRgFUS) 丘脑切除术后临床结果的因素尚不清楚。目的检查临床结果及其与患者基线人口统计学、临床特征以及 6 岁时病变特征的关系。对 ET 患者进行一个月的随访。方法共有 127 名患者在 1（n= 122), 3 (n= 102), 和 6 个月 (n= 78) MRgFUS 丘脑切除术后。 6 个月时获得磁共振成像 (MRI)（n= 60）。主要结局包括：(1) 治疗手的震颤临床评定量表 (CRST)-A+B 评分的变化，以及 (2) 6 个月时不良事件 (AE) 的频率和严重程度。次要结局包括治疗手 CRST 量表所有子项目的变化、CRST-C、轴性震颤（面部、头部、声音、舌头）、AE 以及 6 个月时主要结局与病变特征的相关性。统计分析包括线性混合模型、标准回归模型和逻辑回归模型。结果每次评估时，治疗手的 CRST-A+B、CRST-A、CRST-B、CRST-C 和轴性震颤的得分均有所提高（磷< 0.001）。 5 名患者在 1 个月时出现严重 AE，但在随访过程中逐渐变得轻微。 1、3 和 6 个月时，轻度 AE 分别发生在 71%、45% 和 34% 的患者中。病变体积与 CRST-A 的减少相关（磷= 0.003）及其与腹侧中间核（Vim）的重叠，CRST-A+B 的减少（磷= 0.02) 和 CRST-B (磷= 0.008) 在 6 个月时。结论 MRgFUS 丘脑切除术改善了 ET 患者的手部和轴性震颤。短暂和轻微的 AE 很常见。病变体积和位置与震颤减少相关。 © 2024 作者。运动障碍由 Wiley periodicals LLC 代表国际帕金森和运动障碍协会出版。