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For essential tremor (ET), results of magnetic resonance-guided focused ultrasound (MRgFUS) varied by treatment or target location. Overall, there was insufficient evidence to examine comparative results for adverse events. Only 1 comparative study was identified for Parkinson's disease (PD), with insufficient evidence to make any conclusions. For other movement disorders, only single group studies were identified. These studies showed improvements in several outcomes of interest, but overall, there was insufficient evidence to make any conclusions about the comparative effectiveness of MRgFUS with dystonia conditions.
MRgFUS has been shown to be effective for treating a variety of health issues including pain, certain cancers, fibroids, and movement disorders. However, there is limited evidence for the comparative effectiveness of this treatment for movement disorders including ET and PD. The purpose of this review was to examine the comparative effectiveness of MRgFUS versus other treatments or anatomic targets for the treatment of ET and PD, and to examine the benefits and harms of MRgFUS for the treatment of other movement disorders.
When comparing treatments for ET, bilateral DBS compared to unilateral MRgFUS may provide better improvement of tremor-related outcomes and quality of life (low confidence). There was insufficient evidence to assess adverse events or other outcomes for studies that compared treatments (no conclusions), and no studies reported on functional outcomes. For target locations for ET, MRgFUS targeting the posterior subthalamic area (PSA) or targets with PSA compared to ventral intermedius alone may provide better improvement of tremor-related outcomes (low confidence). There is insufficient evidence for adverse events between target locations (no conclusion). When comparing unilateral and bilateral treatment for ET, bilateral treatment compared to unilateral treatment may provide better improvement of tremor related outcomes (moderate confidence). There were no differences in functional outcomes between unilateral and bilateral treatments (low confidence). There is insufficient evidence for quality of life, adverse events, and other outcomes (no conclusions). Evidence was insufficient to make any conclusions about the effect of treatment side on tremor-related outcomes for ET (no conclusion). Additionally, for PD and dystonia conditions, there was insufficient evidence to make any conclusions about the comparative effectiveness of MRgFUS in these patients.
Comparative Effectiveness of Focused Ultrasound Therapy for Movement Disorders (Management Brief)
