Focused ultrasound thalamotomy for essential tremor: clinical outcomes from two years of treatments in Scotland

<h3>Objective</h3> To report the two-year clinical experience in Scotland in the treatment of essential tremor (ET) with Magnetic Resonance-guided Focused Ultrasound (MRgFUS). <h3>Background</h3> MRgFUS is a recently established, non-incisional treatment for ET, utilising high-intensity focused ultrasound waves to precisely target specific thalamic nuclei in order to suppress tremor symptoms. <h3>Methods</h3> Thirty-three medication-refractory ET patients (5 female, 28 male; mean age 71.4 ± 6.79) underwent MRgFUS. We employed the Clinical Rating Scale for Tremor (CRST) and Quality of Life in Essential Tremor Questionnaire (QUEST) to assess tremor severity and quality of life, respectively, at baseline and 12 months post-treatment. All adverse events were recorded. <h3>Results</h3> At 12 months, CRST scores showed a mean reduction of 52.0% from baseline (37.5 ± 7.5 to 18 ± 16), reflecting significant tremor control. Similarly, QUEST scores improved by 65.4% (52 ± 16 to 18 ± 17). Transient side effects included gait difficulties (66%), while permanent side effects were rare, occurring in one patient (3%). <h3>Conclusion</h3> MRgFUS thalamotomy demonstrates sustained tremor reduction and substantial improvement in quality of life for ET patients. This two-year Scottish study reinforces the effectiveness and safety of MRgFUS as a viable treatment for medication-resistant ET.