Frailty and Tremor Recurrence after Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) Thalamotomy for Essential Tremor: An Age-Driven Association

Mazurek M.H.; Limbania D.; Pacheco-Barrios N.; Chua M.M.J.; Glaser A.C.; McDannold N.J.; Cosgrove G.R.; Rolston J.D. · Movement Disorders (2026) · DOI: 10.1002/mds.70435

Resumen

Background: Frailty has been associated with adverse outcomes after neurosurgical procedures, but its impact on magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for essential tremor (ET) is unknown. Methods: This single-center cohort included 481 consecutive ET patients undergoing unilateral MRgFUS thalamotomy (March 2016–March 2025). Frailty was quantified using the International Classification of Diseases, Tenth Revision (ICD-10)-derived Risk Analysis Index (RAI). Outcomes included 3-month Fahn–Tolosa–Marin (FTM) tremor score, side effects, satisfaction, and tremor recurrence over 3 years. Results: Frailty and age did not predict 3-month FTM score (RAI: β = 0.011, P = 0.134; age: β = 0.016, P = 0.065) or side effects (RAI: odds ratio [OR] = 1.003, P = 0.792; age: OR = 1.021, P = 0.116). RAI and age predicted recurrence with similar effect sizes (RAI hazard ratio [HR] = 1.040, P = 0.008; age HR = 1.063, P = 0.005); RAI subcomponent analysis indicated age was the primary driver. Lesion volumes did not differ by RAI or age. Conclusions: Short-term tremor control after MRgFUS is excellent regardless of RAI-measured frailty or age though recurrence rose with age, which accounted for the frailty association.

Instituciones: Universidad Científica del Sur