AUTHOR=Agrawal Mohit , Garg Kanwaljeet , Samala Raghu , Rajan Roopa , Naik Vikas , Singh Manmohan 

TITLE=Outcome and Complications of MR Guided Focused Ultrasound for Essential Tremor: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.654711

DOI=10.3389/fneur.2021.654711

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Magnetic resonance guided focused ultrasound (MRgFUS) is a relatively novel technique to treat essential tremor (ET). The objective of this review was to analyze the efficacy and the safety profile of MRgFUS for ET.</p><p><bold>Methods:</bold> A systematic literature review was done. The post procedure changes in the Clinical Rating Scale for Tremor (CRST) score, hand score, disability and quality of life scores were analyzed.</p><p><bold>Results:</bold> We found 29 studies evaluating 617 patients. DTI based targeting was utilized in six cohorts. A significant difference was observed in the pooled standard mean difference between the pre and postoperative total CRST score (<italic>p</italic>-value &lt; 0.001 and 0.0002), hand score (<italic>p</italic>-value 0.03 and 0.02); and the disability at 12 months (<italic>p</italic>-value 0.01). Head pain and dizziness were the most in procedure complications. The immediate pooled proportion of ataxia was 50%, while it was 20% for sensory complications, which, respectively, declined to 31 and 13% on long term follow up. A significant reduction (<italic>p</italic> = 0.03) in immediate ataxia related complications was seen with DTI targeting.</p><p><bold>Conclusion:</bold> MRgFUS for ET seems to be an effective procedure for relieving unilateral tremor. Use of DTI based targeting revealed a significant reduction in post procedure ataxia related complications as compared to traditional targeting techniques. Analysis of other complications further revealed a decreasing trend on follow up.</p>