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Magnetic resonance-guided focused ultrasound treatment for essential tremor shows sustained efficacy: a meta-analysis
Although magnetic resonance-guided focused ultrasound (MRgFUS) is a viable treatment option for essential tremor, some studies note a diminished treatment benefit over time. A PubMed search was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelin...
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| Published in: | Neurosurgical review 2022-02, Vol.45 (1), p.533-544 |
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| cites | cdi_FETCH-LOGICAL-c347t-101876270cd64a4b87d11e12f7220e3217bacdf72101de12829409576041e35a3 |
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| container_title | Neurosurgical review |
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| creator | Miller, William K. Becker, Kathryn N. Caras, Andrew J. Mansour, Tarek R. Mays, Malik T. Rashid, Mehmood Schwalb, Jason |
| description | Although magnetic resonance-guided focused ultrasound (MRgFUS) is a viable treatment option for essential tremor, some studies note a diminished treatment benefit over time. A PubMed search was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if hand tremor scores (HTS), total Clinical Rating Scale for Tremor (CRST) scores, or Quality of Life in Essential Tremor Questionnaire (QUEST) scores at regular intervals following MRgFUS treatment for essential tremor were documented. Data analyses included a random effects model of meta-analysis and mixed-effects model of meta-regression. Twenty-one articles reporting HTS for 395 patients were included. Mean pre-operative HTS was 19.2 ± 5.0. Mean HTS at 3 months post-treatment was 7.4 ± 5.0 (61.5% improvement,
p
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| doi_str_mv | 10.1007/s10143-021-01562-w |
| format | article |
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p
< 0.001). Treatment effect was mildly decreased at 36 months at 9.1 ± 5.4 (8.8% reduction). Meta-regression of time since treatment as a modifier of HTS revealed a downward trend in effect size, though this was not statistically significant (
p
= 0.208). Only 4 studies included follow-up ≥ 24 months. Thirteen included articles reported total CRST scores with standardized follow-up for 250 patients. Mean pre-operative total CRST score decreased by 46.2% at 3 months post-treatment (
p
< 0.001). Additionally, mean QUEST scores at 3 months post-treatment significantly improved compared to baseline (
p
< 0.001). HTS is significantly improved from baseline ≥ 24 months post-treatment and possibly ≥ 48 months post-treatment. There is a current paucity of long-term CRST and QUEST score reporting in the literature.</description><identifier>ISSN: 0344-5607</identifier><identifier>EISSN: 1437-2320</identifier><identifier>DOI: 10.1007/s10143-021-01562-w</identifier><identifier>PMID: 33978922</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Essential Tremor - surgery ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Medicine ; Medicine & Public Health ; Neurosurgery ; Original Article ; Quality of Life ; Treatment Outcome ; Ultrasonography, Interventional</subject><ispartof>Neurosurgical review, 2022-02, Vol.45 (1), p.533-544</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-101876270cd64a4b87d11e12f7220e3217bacdf72101de12829409576041e35a3</citedby><cites>FETCH-LOGICAL-c347t-101876270cd64a4b87d11e12f7220e3217bacdf72101de12829409576041e35a3</cites><orcidid>0000-0003-4533-6993</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33978922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miller, William K.</creatorcontrib><creatorcontrib>Becker, Kathryn N.</creatorcontrib><creatorcontrib>Caras, Andrew J.</creatorcontrib><creatorcontrib>Mansour, Tarek R.</creatorcontrib><creatorcontrib>Mays, Malik T.</creatorcontrib><creatorcontrib>Rashid, Mehmood</creatorcontrib><creatorcontrib>Schwalb, Jason</creatorcontrib><title>Magnetic resonance-guided focused ultrasound treatment for essential tremor shows sustained efficacy: a meta-analysis</title><title>Neurosurgical review</title><addtitle>Neurosurg Rev</addtitle><addtitle>Neurosurg Rev</addtitle><description>Although magnetic resonance-guided focused ultrasound (MRgFUS) is a viable treatment option for essential tremor, some studies note a diminished treatment benefit over time. A PubMed search was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if hand tremor scores (HTS), total Clinical Rating Scale for Tremor (CRST) scores, or Quality of Life in Essential Tremor Questionnaire (QUEST) scores at regular intervals following MRgFUS treatment for essential tremor were documented. Data analyses included a random effects model of meta-analysis and mixed-effects model of meta-regression. Twenty-one articles reporting HTS for 395 patients were included. Mean pre-operative HTS was 19.2 ± 5.0. Mean HTS at 3 months post-treatment was 7.4 ± 5.0 (61.5% improvement,
p
< 0.001). Treatment effect was mildly decreased at 36 months at 9.1 ± 5.4 (8.8% reduction). Meta-regression of time since treatment as a modifier of HTS revealed a downward trend in effect size, though this was not statistically significant (
p
= 0.208). Only 4 studies included follow-up ≥ 24 months. Thirteen included articles reported total CRST scores with standardized follow-up for 250 patients. Mean pre-operative total CRST score decreased by 46.2% at 3 months post-treatment (
p
< 0.001). Additionally, mean QUEST scores at 3 months post-treatment significantly improved compared to baseline (
p
< 0.001). HTS is significantly improved from baseline ≥ 24 months post-treatment and possibly ≥ 48 months post-treatment. There is a current paucity of long-term CRST and QUEST score reporting in the literature.</description><subject>Essential Tremor - surgery</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Magnetic Resonance Spectroscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Quality of Life</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional</subject><issn>0344-5607</issn><issn>1437-2320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kE9P3DAQxS3UChbaL9BDlSMXw9hO4g23CvUPEohLOVuzzmQblDjgsbXab4_pUo49jf3mvSfNT4gvCi4UgL1kBao2ErSSoJpWy92RWBXFSm00fBArMHUtmxbsiThlfgRQtgN1LE6M6ey603ol8h1uA6XRV5F4CRg8yW0ee-qrYfGZy8xTishLDn2VImGaKaSyjBUxl-eI06s-F4H_LDuuOHPCMZQkDcPo0e-vKqxmSigx4LTnkT-JjwNOTJ_f5pl4-PH99_UveXv_8-b62630prZJlvvWttUWfN_WWG_WtleKlB6s1kBGK7tB35dfMfZFX-uuhq6xLdSKTIPmTJwfep_i8pyJk5tH9jRNGGjJ7HSjW2VKvitWfbD6uDBHGtxTHGeMe6fAveJ2B9yu4HZ_cbtdCX1968-bmfr3yD--xWAOBi6rsKXoHpccCwX-X-0LuLCMnQ</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Miller, William K.</creator><creator>Becker, Kathryn N.</creator><creator>Caras, Andrew J.</creator><creator>Mansour, Tarek R.</creator><creator>Mays, Malik T.</creator><creator>Rashid, Mehmood</creator><creator>Schwalb, Jason</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4533-6993</orcidid></search><sort><creationdate>20220201</creationdate><title>Magnetic resonance-guided focused ultrasound treatment for essential tremor shows sustained efficacy: a meta-analysis</title><author>Miller, William K. ; Becker, Kathryn N. ; Caras, Andrew J. ; Mansour, Tarek R. ; Mays, Malik T. ; Rashid, Mehmood ; Schwalb, Jason</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-101876270cd64a4b87d11e12f7220e3217bacdf72101de12829409576041e35a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Essential Tremor - surgery</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Magnetic Resonance Spectroscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Quality of Life</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miller, William K.</creatorcontrib><creatorcontrib>Becker, Kathryn N.</creatorcontrib><creatorcontrib>Caras, Andrew J.</creatorcontrib><creatorcontrib>Mansour, Tarek R.</creatorcontrib><creatorcontrib>Mays, Malik T.</creatorcontrib><creatorcontrib>Rashid, Mehmood</creatorcontrib><creatorcontrib>Schwalb, Jason</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgical review</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miller, William K.</au><au>Becker, Kathryn N.</au><au>Caras, Andrew J.</au><au>Mansour, Tarek R.</au><au>Mays, Malik T.</au><au>Rashid, Mehmood</au><au>Schwalb, Jason</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic resonance-guided focused ultrasound treatment for essential tremor shows sustained efficacy: a meta-analysis</atitle><jtitle>Neurosurgical review</jtitle><stitle>Neurosurg Rev</stitle><addtitle>Neurosurg Rev</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>45</volume><issue>1</issue><spage>533</spage><epage>544</epage><pages>533-544</pages><issn>0344-5607</issn><eissn>1437-2320</eissn><abstract>Although magnetic resonance-guided focused ultrasound (MRgFUS) is a viable treatment option for essential tremor, some studies note a diminished treatment benefit over time. A PubMed search was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if hand tremor scores (HTS), total Clinical Rating Scale for Tremor (CRST) scores, or Quality of Life in Essential Tremor Questionnaire (QUEST) scores at regular intervals following MRgFUS treatment for essential tremor were documented. Data analyses included a random effects model of meta-analysis and mixed-effects model of meta-regression. Twenty-one articles reporting HTS for 395 patients were included. Mean pre-operative HTS was 19.2 ± 5.0. Mean HTS at 3 months post-treatment was 7.4 ± 5.0 (61.5% improvement,
p
< 0.001). Treatment effect was mildly decreased at 36 months at 9.1 ± 5.4 (8.8% reduction). Meta-regression of time since treatment as a modifier of HTS revealed a downward trend in effect size, though this was not statistically significant (
p
= 0.208). Only 4 studies included follow-up ≥ 24 months. Thirteen included articles reported total CRST scores with standardized follow-up for 250 patients. Mean pre-operative total CRST score decreased by 46.2% at 3 months post-treatment (
p
< 0.001). Additionally, mean QUEST scores at 3 months post-treatment significantly improved compared to baseline (
p
< 0.001). HTS is significantly improved from baseline ≥ 24 months post-treatment and possibly ≥ 48 months post-treatment. There is a current paucity of long-term CRST and QUEST score reporting in the literature.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33978922</pmid><doi>10.1007/s10143-021-01562-w</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4533-6993</orcidid></addata></record> |
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| subjects | Essential Tremor - surgery Humans Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Medicine Medicine & Public Health Neurosurgery Original Article Quality of Life Treatment Outcome Ultrasonography, Interventional |
| title | Magnetic resonance-guided focused ultrasound treatment for essential tremor shows sustained efficacy: a meta-analysis |
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