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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Outcome after thalamotomy for treatment of essential tremor using MR-guided focused ultrasound (MRgFUS) – results from a newly initiated MRgFUS treatment centre

Outcome nach Thalamotomie mittels MR-gesteuertem fokussierten Ultraschall in der Behandlung des essentiellen Tremors – Ergebnisse aus einem neu initiierten MRgFUS-Behandlungszentrum

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  • presenting/speaker Valeri Borger - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Veronika Purrer - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurologie, Bonn, Deutschland
  • Vera C. Keil - Universitätsklinikum Bonn, Neuroradiologie, Bonn, Deutschland
  • Christine Kindler - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurologie, Bonn, Deutschland
  • Claus C. Pieper - Universitätsklinikum Bonn, Neuroradiologie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Ullrich Wüllner - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurologie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV140

doi: 10.3205/20dgnc141, urn:nbn:de:0183-20dgnc1419

Published: June 26, 2020

© 2020 Borger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Magnetic resonance-guided focused ultrasound (MRgFUS) offers an effective approach for treatment of drug-resistant essential tremor (ET) using incisionless thalamotomy. Being a recently clinically approved option to treat movement disorders, this technology is increasingly gaining interest. Dozens of specialized centers around the world offer MRgFUS thalamotomy for treatment of tremor symptoms in essential tremor (ET) and Parkinson’s disease (PD). The authors report their experience in treating patients with ET using MRgFUS at a newly initiated treatment center.

Methods: From May 2018 to August 2019, from a total of 35 eligible patients 30 were treated with unilateral thalamotomy using MRgFUS. The effects on tremor were assessed using the Clinical Rating Scale for Tremor (CRST) at baseline, directly post-interventional (T1), at 1 month (T2), and at 6 months (T3). Furthermore, treatment associated side effects were analyzed at 1 month and 6 months follow-up (FU) visits.

Results: From 30 patients, 2 patients were excluded from the analysis (1 PD patient, 1 patient lost for FU). In the remaining 28 patients with ET, the mean age was 69±12.45 years (y), the mean duration of symptoms was 29±17.3 y. The mean total CRST score at baseline was 59.75±15.15. Compared to baseline, the mean total CRST score was significantly decreased at each FU (p<0.0001 at T1; p<0.0001 at T2; p<0.001 at T3). The most often occurring side effects were gait disturbances (36% at T1; 29% at T2; 30% at T3), followed by paresthesia (22% at T1; 14% at T2; 30% at T3). None of the side effects were disabeling.

Conclusion: MRgFUS thalamotomy in treating ET is effective and safe. In regard to reduce the occurrence of side effects and to maximize the treatment effect, more effort should be made to optimize the lesioning due to individualization of targeting for each individual patient.