Gautam Diwas, Venkatraman Vishal, Horns Joshua, Yang Lexie Zidanyue, Lee Hui-Jie, Kassavetis Panagiotis, Alshaikh Jumana, Moretti Paolo, Shofty Ben, Rahimpour Shervin
University of Utah Health, Salt Lake City, Utah, USA.
Duke University School of Medicine, Durham, North Carolina, USA.
BMJ Neurol Open. 2024 Apr 10;6(1):e000582. doi: 10.1136/bmjno-2023-000582. eCollection 2024.
Essential tremor (ET) is a movement disorder that affects 4%-5% of adults >65 years. For patients with medically refractory ET, neurosurgical interventions such as deep brain stimulation (DBS) and unilateral MR-guided focused ultrasound thalamotomy (MRgFUS) are available. In this retrospective cohort study, we examined the demographics of patients with ET who have received MRgFUS and evaluated trends in DBS usage in the USA after the introduction of MRgFUS in 2016.
We used multiple databases to examine the demographics of patients who received DBS and MRgFUS, and trends in DBS. To assess the demographics, we queried the TriNetX database from 2003 to 2022 to identify patients diagnosed with ET and stratify them by DBS or MRgFUS treatment by using Current Procedural Terminology codes. Patient demographics were reported as frequencies and percentages. To examine the trends in DBS for ET, the yearly frequency of DBS procedures done for ET between 2012 and 2019 was extracted from the National Inpatient Sample (NIS) database, and breakpoint analysis was performed. Additionally, the yearly frequency of MRgFUS procedures for ET was obtained from Insightec Exlabate.
Most of the patients (88.69%) in the cohort extracted from TriNetX database self-identified as white, followed by black or African American (2.40%) and Asian (0.52%). A higher percentage of black patients received MRgFUS treatment than DBS (4.10% vs 1.88%). According to the NIS database, from 2012 to 2020, 13 525 patients received DBS for ET.
This study provides an overview of the characteristics of patients who undergo DBS or MRgFUS. We found notable differences in sex and race among patients who underwent each treatment type. Additionally, until at least the beginning of 2020, the number of DBS procedures for ET was not negatively affected after the introduction of MRgFUS.
特发性震颤（ET）是一种运动障碍，影响4% - 5%的65岁以上成年人。对于药物难治性ET患者，可采用神经外科干预措施，如深部脑刺激（DBS）和单侧磁共振引导聚焦超声丘脑切开术（MRgFUS）。在这项回顾性队列研究中，我们调查了接受MRgFUS的ET患者的人口统计学特征，并评估了2016年引入MRgFUS后美国DBS使用情况的趋势。
我们使用多个数据库来调查接受DBS和MRgFUS的患者的人口统计学特征以及DBS的趋势。为了评估人口统计学特征，我们查询了2003年至2022年的TriNetX数据库，以识别诊断为ET的患者，并使用当前程序术语代码按DBS或MRgFUS治疗对他们进行分层。患者人口统计学特征以频率和百分比报告。为了研究ET的DBS趋势，从国家住院样本（NIS）数据库中提取2012年至2019年期间为ET进行DBS手术的年度频率，并进行断点分析。此外，ET的MRgFUS手术年度频率来自Insightec Exlabate。
从TriNetX数据库中提取的队列中的大多数患者（88.69%）自我认定为白人，其次是黑人或非裔美国人（2.40%）和亚洲人（0.52%）。接受MRgFUS治疗的黑人患者比例高于接受DBS治疗的黑人患者（4.10%对1.88%）。根据NIS数据库，2012年至2020年期间，有13525名患者因ET接受了DBS治疗。
本研究概述了接受DBS或MRgFUS治疗的患者的特征。我们发现接受每种治疗类型的患者在性别和种族方面存在显著差异。此外，至少到2020年初，引入MRgFUS后ET的DBS手术数量并未受到负面影响。
