학술논문
A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor.
Document Type
Academic Journal
Author
Elias WJ; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Lipsman N; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Ondo WG; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Ghanouni P; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Kim YG; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Lee W; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Schwartz M; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Hynynen K; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Lozano AM; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Shah BB; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Huss D; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Dallapiazza RF; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Gwinn R; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Witt J; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Ro S; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Eisenberg HM; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Fishman PS; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Gandhi D; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Halpern CH; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Chuang R; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Butts Pauly K; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Tierney TS; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Hayes MT; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Cosgrove GR; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Yamaguchi T; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Abe K; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Taira T; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.; Chang JW; From the University of Virginia Health Sciences Center, Charlottesville (W.J.E., B.B.S., D.H., R.F.D.); Toronto Western Hospital (N.L., A.M.L.) and Sunnybrook Health Sciences Centre (M.S., K.H.), Toronto; Methodist Neurological Institute, Houston (W.G.O.); Stanford University School of Medicine, Stanford, CA (P.G., C.H.H., K.B.P.); Yonsei University College of Medicine, Seoul, South Korea (Y.G.K., W.L., J.W.C.); Swedish Neuroscience Institute, Seattle (R.G., J.W., S.R., R.C.); University of Maryland School of Medicine, Baltimore (H.M.E., P.S.F., D.G.); University of Miami School of Medicine, Nicklaus Children's Hospital, Miami (T.S.T.); Brigham and Women's Hospital, Boston (M.T.H., G.R.C.); and Shin-yurigaoka General Hospital, Kawasaki (T.Y.), and Tokyo Women's Medical University, Tokyo (K.A., T.T.) - both in Japan.
Source
Publisher: Massachusetts Medical Society Country of Publication: United States NLM ID: 0255562 Publication Model: Print Cited Medium: Internet ISSN: 1533-4406 (Electronic) Linking ISSN: 00284793 NLM ISO Abbreviation: N Engl J Med Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Uncontrolled pilot studies have suggested the efficacy of focused ultrasound thalamotomy with magnetic resonance imaging (MRI) guidance for the treatment of essential tremor.
Methods: We enrolled patients with moderate-to-severe essential tremor that had not responded to at least two trials of medical therapy and randomly assigned them in a 3:1 ratio to undergo unilateral focused ultrasound thalamotomy or a sham procedure. The Clinical Rating Scale for Tremor and the Quality of Life in Essential Tremor Questionnaire were administered at baseline and at 1, 3, 6, and 12 months. Tremor assessments were videotaped and rated by an independent group of neurologists who were unaware of the treatment assignments. The primary outcome was the between-group difference in the change from baseline to 3 months in hand tremor, rated on a 32-point scale (with higher scores indicating more severe tremor). After 3 months, patients in the sham-procedure group could cross over to active treatment (the open-label extension cohort).
Results: Seventy-six patients were included in the analysis. Hand-tremor scores improved more after focused ultrasound thalamotomy (from 18.1 points at baseline to 9.6 at 3 months) than after the sham procedure (from 16.0 to 15.8 points); the between-group difference in the mean change was 8.3 points (95% confidence interval [CI], 5.9 to 10.7; P<0.001). The improvement in the thalamotomy group was maintained at 12 months (change from baseline, 7.2 points; 95% CI, 6.1 to 8.3). Secondary outcome measures assessing disability and quality of life also improved with active treatment (the blinded thalamotomy cohort)as compared with the sham procedure (P<0.001 for both comparisons). Adverse events in the thalamotomy group included gait disturbance in 36% of patients and paresthesias or numbness in 38%; these adverse events persisted at 12 months in 9% and 14% of patients, respectively.
Conclusions: MRI-guided focused ultrasound thalamotomy reduced hand tremor in patients with essential tremor. Side effects included sensory and gait disturbances. (Funded by InSightec and others; ClinicalTrials.gov number, NCT01827904.).
Methods: We enrolled patients with moderate-to-severe essential tremor that had not responded to at least two trials of medical therapy and randomly assigned them in a 3:1 ratio to undergo unilateral focused ultrasound thalamotomy or a sham procedure. The Clinical Rating Scale for Tremor and the Quality of Life in Essential Tremor Questionnaire were administered at baseline and at 1, 3, 6, and 12 months. Tremor assessments were videotaped and rated by an independent group of neurologists who were unaware of the treatment assignments. The primary outcome was the between-group difference in the change from baseline to 3 months in hand tremor, rated on a 32-point scale (with higher scores indicating more severe tremor). After 3 months, patients in the sham-procedure group could cross over to active treatment (the open-label extension cohort).
Results: Seventy-six patients were included in the analysis. Hand-tremor scores improved more after focused ultrasound thalamotomy (from 18.1 points at baseline to 9.6 at 3 months) than after the sham procedure (from 16.0 to 15.8 points); the between-group difference in the mean change was 8.3 points (95% confidence interval [CI], 5.9 to 10.7; P<0.001). The improvement in the thalamotomy group was maintained at 12 months (change from baseline, 7.2 points; 95% CI, 6.1 to 8.3). Secondary outcome measures assessing disability and quality of life also improved with active treatment (the blinded thalamotomy cohort)as compared with the sham procedure (P<0.001 for both comparisons). Adverse events in the thalamotomy group included gait disturbance in 36% of patients and paresthesias or numbness in 38%; these adverse events persisted at 12 months in 9% and 14% of patients, respectively.
Conclusions: MRI-guided focused ultrasound thalamotomy reduced hand tremor in patients with essential tremor. Side effects included sensory and gait disturbances. (Funded by InSightec and others; ClinicalTrials.gov number, NCT01827904.).