Safety and efficacy of bilateral staged focused ultrasound thalamotomy in refractory essential tremor
Bibliographic record
Abstract
Essential Tremor is a common movement disorder characterized by postural and kinetic tremor, primarily affecting the upper limbs, head and voice. For patients who fail medical therapy, neurosurgical interventions such as thalamotomy have been explored. This study evaluates the efficacy and safety of bilateral staged Magnetic Resonance Imaging-guided High-Intensity Focused Ultrasound thalamotomy for the treatment of medication-refractory Essential Tremor. From January 2022 to January 2024, 20 patients who had previously undergone successful unilateral focused ultrasound thalamotomy were enrolled. The primary outcome was the change in tremor severity, using the Clinical Rating Scale for Tremor at 6 months post-second side thalamotomy. Secondary outcomes included functional disability, quality of life and adverse events, particularly balance and gait impairments. Results demonstrated significant tremor reduction, with a 59.98% decrease in Clinical Rating Scale for Tremor A + B score from baseline to 6 months after the second thalamotomy. Quality of life also improved markedly, with an 84.91% reduction in disability and significant enhancement in physical and psychosocial aspects of quality of life. Adverse events were predominantly mild; with subjective gait instability and paresthaesia being the most common. Notably, no cases of severe ataxia or cognitive impairment were observed. Bilateral staged Magnetic Resonance Imaging-guided High-Intensity Focused Ultrasound thalamotomy is an effective and safe treatment for medication-refractory Essential Tremor, providing substantial tremor relief and improved quality of life with manageable side effects. These findings support its use as an alternative to more invasive neurosurgical procedures, especially in carefully selected patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".