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Abstract Details

Clinical Characteristics of Patients who Develop Gait Instability after Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) Thalamotomy
Movement Disorders
Movement Disorders Posters (7:00 AM-5:00 PM)
121
To determine whether pre-existing conditions are correlated with gait instability after MRgFUS thalamotomy.
MRgFUS thalamotomy is an incisionless procedure which can effectively treat patients with essential tremor, although the procedure can result in adverse side effects including gait instability (generally due to ataxia).  By determining whether certain pre-existing conditions predispose patients to developing gait instability, we will be able to better counsel our patients prior to determining whether or not MRgFUS thalamotomy is the safest intervention available.  

All patients diagnosed with essential tremor who underwent thalamotomy at Mayo Clinic, Rochester between December 2017 and October 2020 were retrospectively reviewed. Patient demographics were assessed and gait symptoms from follow-up (1-6 months post-procedure) were compared. 

Out of 44 patients who underwent MRgFUS, 31 met criteria and were included in the study . Those that were excluded did not have available clinical follow-up or consent for research. The median age of the patient population was 77.6 years (IQR 72.1-83.2). 11 out of 31 (35%) patients had worsened gait stability after the procedure. Older age was not correlated with gait decline (p=0.2118). 11 out of 31 (35%) patients had neuropathy on a baseline examination prior to the procedure; of these patients 3 required a gait aid prior to the procedure. Patients with a history of neuropathy were more likely to have gait decline after MRgFUS thalamotomy than those without neuropathy (p=0.0012). A history of arthritis or joint replacement, regardless of its effect on pre-procedure gait, was not associated with post-procedure gait decline (p=0.3255 and p=.0746). Patients with pre-existing gait aids were not more likely to develop worsening gait instability after the procedure (p=.0827).
Patients who undergo MRgFUS thalamotomy have an increased risk of experiencing gait decline when there a pre-procedure history of peripheral neuropathy. Older age is not associated with worsened gait outcomes.
Authors/Disclosures
Lauren Jackson, MD (Mayo Clinic)
PRESENTER 		Dr. Jackson has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Bryan T. Klassen, MD (Mayo Clinic) The institution of Dr. Klassen has received research support from Insightec.