Objective: To examine the clinical outcomes and their relationship with lesion characteristics at 6-month follow-up in TDPD patients

Background: Clinical outcomes and lesion features after MR-guided focused ultrasound (MRgFUS)-thalamotomy in patients with tremor-predominant Parkinson´s disease (TDPD) are not well known

Method: 74 patients were prospectively evaluated at 1 (n =60), 3 (n = 42), and 6 months (n = 45) after MRgFUS-thalamotomy. MRI was obtained at 6 months (n=36). Primary outcomes included: 1) Change in the Unified Parkinson´s disease rate scale (UPDRS) tremor scores in the treated hand. 2) Frequency and severity of adverse events (AEs) at 6 months. Secondary outcomes included changes in all subitems of tremor (rest, postural, action) in the UPDRS III scale in the treated hand). Statistical analysis included linear mixed, standard and logistic regression models

Results: Scores for UPDRS III total tremor,postural, rest and action tremor in the treated hand were improved at each evaluation (p<0.001). At 6 months follow-up, the improvement was above 70% for all types of tremor. Most of AE were mild and transient, with a significant reduction in their proportion at 3 and 6 months Three patients had severe AEs at 1 month that became mild throughout the follow-up. The total number of mild AE were 77, 28 and 18 at 1, 3 and 6 months respectively. The overlapping of the lesion with the dentatorubric thalamic tract (DTTT) correlated with the reduction in the UPDRS III resting tremor scores in the upper treated limb at 6 months follow-up

Conclusion: MRgFUS-thalamotomy improves hand tremor in TDPD patients. Transient and mild AEs are frequent. Lesion volume encroaching the DRTT is associated with tremor reduction

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mrgfus-thalamotomy-for-tremor-predominant-parkinsons-disease-a-single-center-prospective-study/