2026/07/22 by Mercy H. Mazurek, Daniela Limbania, Niels Pacheco‐Barrios +5 · 1 voice
Medicine · #Botulinum Toxin and Related Neurological Disorders #Neurological disorders and treatments #Parkinson's Disease Mechanisms and Treatments
paper · doi:10.1002/mds.70435
openalex publication_date 2026/07/22 · openalex created_date 2026/07/24 · openalex updated_date 2026/07/24
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. © 2026 International Parkinson and Movement Disorder Society.