Journal of the neurological sciences · 2025
Changes in tremor, anxiety and depression after magnetic resonance-guided focused ultrasound for essential tremor: A one-year prospective study and analysis of predictive factors.
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Shiramba Alyssa, Lane Steven, Andrews Luke, Patel Vishal, Shepherd Hilary, Damodaran Dinesh, Srinivasaiah Rajesha, Radon Mark, Panicker Jay, Osman-Farah Jibril, Macerollo Antonella
Аннотация
BACKGROUND: Medication-refractory essential tremor can be managed with Magnetic Resonance-Guided Focused Ultrasound thalamotomy. Although this procedure has demonstrated benefit in reducing tremor symptoms, factors contributing to patient response are unclear. This study describes the outcomes in our cohort, patient-related and treatment-related factors, and their impact on treatment outcomes.
METHODS: Prospectively collected clinical data of 92 patients with essential tremor who have undergone the procedure at The Walton Centre from April 2022 to July 2024 were collected up to 12 months follow-up post-operatively. Assessments included the Clinical Rating Scale for Essential Tremor scale, EQ-5D scale, and the Hospital Anxiety and Depression Scale. Improvements were calculated across follow-ups, and relationships between variables and treatment outcomes investigated through correlation and regression analysis.
RESULTS: Our cohort demonstrated treatment benefit regarding tremor reduction, reduced disability scores, quality of life, anxiety and depression; tremor recurrence was reported in a minority of the cohort. Most side effects occurred in the immediate post-operative period, and were largely transient. Baseline scores were associated with scores at subsequent follow-up assessments including, notably, depression scores. Patient and treatment related factors did not have a substantial impact on outcomes.
CONCLUSIONS: Treatment benefit and safety was demonstrated in our cohort, and factors contributing to treatment response varied with follow-up timepoints and outcomes measured. Further study is required to provide clarity to the impact of variables on treatment response, and patient mental health should be considered more widely for its influence on outcomes.
METHODS: Prospectively collected clinical data of 92 patients with essential tremor who have undergone the procedure at The Walton Centre from April 2022 to July 2024 were collected up to 12 months follow-up post-operatively. Assessments included the Clinical Rating Scale for Essential Tremor scale, EQ-5D scale, and the Hospital Anxiety and Depression Scale. Improvements were calculated across follow-ups, and relationships between variables and treatment outcomes investigated through correlation and regression analysis.
RESULTS: Our cohort demonstrated treatment benefit regarding tremor reduction, reduced disability scores, quality of life, anxiety and depression; tremor recurrence was reported in a minority of the cohort. Most side effects occurred in the immediate post-operative period, and were largely transient. Baseline scores were associated with scores at subsequent follow-up assessments including, notably, depression scores. Patient and treatment related factors did not have a substantial impact on outcomes.
CONCLUSIONS: Treatment benefit and safety was demonstrated in our cohort, and factors contributing to treatment response varied with follow-up timepoints and outcomes measured. Further study is required to provide clarity to the impact of variables on treatment response, and patient mental health should be considered more widely for its influence on outcomes.