scholarly journals Smartphone Apps About Crystal Methamphetamine (“Ice”): Systematic Search in App Stores and Assessment of Composition and Quality (Preprint)

2018 ◽  
Author(s):  
Cath Chapman ◽  
Katrina Elizabeth Champion ◽  
Louise Birrell ◽  
Hannah Deen ◽  
Mary-Ellen Brierley ◽  
...  
Keyword(s):  
English Language ◽  
Rating Scale ◽  
Smartphone Apps ◽  
Crystal Methamphetamine ◽  
Android Apps ◽  
Acceptable Quality ◽  
The Mean ◽  
Further Development ◽  
Google Play

BACKGROUND Amid considerable community concern about the prevalence and harms associated with the use of crystal methamphetamine (“ice”), the increased use of smartphones to access health information and a growing number of available smartphone apps related to crystal methamphetamine, no previous reviews have examined the content and quality of these apps. OBJECTIVE This study aims to systematically review existing apps in the iTunes and Google Play Stores to determine the existence, composition, and quality of educational smartphone apps about methamphetamines, including ice. METHODS The iTunes and Google Play Stores were systematically searched in April 2017 for iOS Apple and Android apps, respectively. English-language apps that provided educational content or information about methamphetamine were eligible for inclusion. Eligible apps were downloaded and independently evaluated for quality by 2 reviewers using the Mobile Application Rating Scale (MARS). RESULTS A total of 2205 apps were initially identified, of which 18 were eligible and rated using the MARS. The mean MARS quality total score for all rated apps was 3.0 (SD 0.6), indicating poor to acceptable quality. Overall, mean scores were the highest for functionality (mean 4.0, SD 0.5) and lowest for engagement (mean 2.3, SD 0.7). CONCLUSIONS This study demonstrates a shortage of high-quality educational and engaging smartphone apps specifically related to methamphetamine. The findings from this review highlight a need for further development of engaging and evidence-based apps that provide educational information about crystal methamphetamine.

scholarly journals Quality of Mobile Apps for Care Partners of People with Alzheimer’s Disease and Related Dementias: Mobile App Rating Scale Evaluation (Preprint)

2021 ◽  
Author(s):  
Nicole E Werner ◽  
Janetta C Brown ◽  
Priya Loganathar ◽  
Richard J Holden
Keyword(s):  
Rating Scale ◽  
Mobile Apps ◽  
Mobile App ◽  
Future Research ◽  
App Development ◽  
Care Partners ◽  
Acceptable Quality ◽  
The Us ◽  
Google Play

BACKGROUND The over 11 million care partners in the US who provide care to people living with Alzheimer’s disease and related dementias (ADRD) cite persistent and pervasive unmet needs related to all aspects of their caregiving role. The proliferation of mobile applications (apps) for care partners has potential to meet the care partners’ needs, but the quality of apps is unknown. OBJECTIVE The present study aimed to 1) evaluate the quality of publicly available apps for care partners of people living with ADRD and 2) identify design features of low- and high-quality apps to guide future research and app development. METHODS We searched the US Apple and Google Play app stores with the criteria that the app needed to be 1) available in US Google play or Apple app stores, 2) directly accessible to users “out of the box”, 3) primarily intended for use by an informal (family, friend) caregiver or caregivers of a person with dementia. The included apps were then evaluated using the Mobile App Rating Scale (MARS), which includes descriptive app classification and rating using 23 items across five dimensions: engagement, functionality, aesthetics, information, and subjective quality. Next, we computed descriptive statistics for each rating. To identify recommendations for future research and app development, we categorized rater comments on the score driving factors for each item and what the app could have done to improve the score for that item. RESULTS We evaluated 17 apps (41% iOS only, 12% Android only, 47% both iOS and Android). We found that on average, the apps are of minimally acceptable quality. Although we identified apps above and below minimally acceptable quality, many apps had broken features and were rated as below acceptable for engagement and information. CONCLUSIONS Minimally acceptable quality is likely insufficient to meet care partner needs. Future research should establish minimum quality standards across dimensions for mobile apps for care partners. The design features of high-quality apps we identified in this research can provide the foundation for benchmarking those standards.

Mobile Applications in Otolaryngology: A Systematic Review of the Literature, Apple App Store and the Google Play Store

2020 ◽  
Vol 130 (1) ◽  
pp. 78-91
Author(s):  
Eleonora M. C. Trecca ◽  
Antonio Lonigro ◽  
Matteo Gelardi ◽  
Brandon Kim ◽  
Michele Cassano
Keyword(s):  
Rating Scale ◽  
Case Reports ◽  
Mobile App ◽  
App Store ◽  
Literature Reviews ◽  
Scientific Associations ◽  
Conference Papers ◽  
Further Development ◽  
Google Play

Objectives: Although the last few years have seen an increased number of smartphone applications (apps) disseminated in the field of Otolaryngology (ORL), these apps vary widely in quality. The aim of this paper, therefore, is to systematically review ORL apps directed towards patients in mobile app stores and the current literature. Methods: The Google Play Store, Apple App Store and PubMed were searched for ORL apps for patients using various keywords pertaining to different ORL subspecialties. Apps not relevant to the scope of this research and/or duplicates, educational apps, apps promoting a business, apps requiring specific separate hardware, and apps in non-English were excluded. In PubMed, keywords pertaining to the subspecialties were combined with “mobile app” in a search query; literature reviews, editorials, case reports, conference papers, duplicate articles, and articles irrelevant to ORL apps were excluded. The quality of apps with the highest number of reviews was assessed using the “Mobile App Rating Scale” (MARS), while the quality of the articles was rated using “The Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) Statement. Results: After searching the app stores, 1074 apps were included and grouped according to their ORL subspecialties. The overall MARS score of the ten most popular apps in each category was 3.65 out of 5. A total of 636 articles were identified in the literature, and 193 were included. The mean adherence percentage of the articles to the STROBE checklist was of 84.37%. Conclusions: Although the apps currently available need further development, their application in ORL appears promising. Further dialogue between physicians and patients, as well as formal support from professional and scientific associations, should be encouraged.

scholarly journals Evaluation of M-Health Applications Use in Epilepsy: A Systematic Review

2021 ◽  
Author(s):  
Niloofar MOHAMMADZADEH ◽  
Sahar KHENARINEZHAD ◽  
Ehsan GHAZANFARISAVADKOOHI ◽  
Mohammad Saleh SAFARI ◽  
Shahrbanoo PAHLEVANYNEJAD
Keyword(s):  
English Language ◽  
Rating Scale ◽  
Rapid Evolution ◽  
Self Management ◽  
Application Development ◽  
Clinical Value ◽  
Keywords Epilepsy ◽  
Google Play ◽  
Health Applications

Background: Epilepsy is a neurological disorder characterized by seizures and recurrent attacks. Selfmanagement leads to seizure control and maximizes the quality of life in epileptic patients. The purpose of this study was to evaluate the quality of applications available in the epileptic google play store based on the rating features of MARS (Mobile Applications Rating Scale). Methods: The search was conducted systematically using the keywords "epilepsy", "seizure", "mobile health" at the Android google play store. Data were extracted and analyzed from Feb 2018 to Apr 2019. Results: Accordingly, 45 apps were identified potentially relevant of which 20 met inclusion criteria. Twentyfive apps were excluded because they were unrelated to epilepsy self-management, or not Development for people with epilepsy, not in English language or were not free and available. The total mean MARS score was 3.21 out of 5, and more than half of apps (17, 85%) had a minimum acceptability score of 3.0. The mean of apps’ items were 3.27 in Engagement, 3.96 in function, 3.30 in Aesthetics, 2.96 in Information and 2.73 in subjective quality items. Conclusion: Few apps meet prespecified criteria for quality, content, and functionality for epilepsy selfmanagement. Despite the rapid evolution of self-management apps, lack of validation studies is a significant concern that limits the clinical value of these apps. Moreover, having a guideline and benchmarking in the field of mobile application development, in epilepsy management, can help analyze the content of established applications.

Evaluation of Persian language epilepsy-related mobile apps: A systematic review and quality assessment with a focus on content (Preprint)

2020 ◽  
Author(s):  
Mina Zibaei ◽  
Reza Khajouei
Keyword(s):  
Information Quality ◽  
Mobile Apps ◽  
Self Care ◽  
Keywords Epilepsy ◽  
Limited Health Literacy ◽  
Persian Language ◽  
The Mean ◽  
Limited Health ◽  
Google Play

BACKGROUND In Iran, around 0.05 of population suffer from epilepsy. Poorer health outcomes stem from limited health literacy. The use of mHealth, especially for educating patients in terms of self-care can be very effective. But the important thing is the content that is presented by apps, especially when unreliable or biased information can negatively affect the patient-doctor relationship, causing anxiety or stress. Also, usability of mHealth apps and their impact on behavior change are the other important issues that should be considered. OBJECTIVE The purpose of this study was to assess the quality of Persian language epilepsy-related mobile applications in terms of functionality and quality with a focus on content. METHODS The Persian equivalent of the keywords 'epilepsy' and 'seizure' were searched in the Google Play, Cafe Bazaar and IranApps app stores and the Persian language applications about epilepsy were extracted. These apps were evaluated by two trained reviewers independently using the uMARS scale and DISCERN instrument. Also apps’ prices and the number of installations were assessed. RESULTS A total of 659 applications were retrieved, 78 of which were epilepsy-related. After exclusion of non-Persian language and duplicate apps, there remained 11 relevant apps. The overall mean uMARS score was 2.8 out of 5 while six out of 11 apps (54%) scored higher than 3. The mean figures for the section-specific scores were as follows: engagement 2.2, functionality 4.0, aesthetics 3.3, and information 2.3. The overall DISCERN scores ranged from 26 to 40 out of 80, while the mean score was 34.5. The mean score of reliability was 18.5. CONCLUSIONS This study showed that the overall information quality of the epilepsy apps is poor. The most important missing characteristics of these apps include lack of functionalities for self-care, missing entry date, lack of details about additional sources and inexistence of the risks/benefits of each treatment. The findings suggest that more efforts should be made to develop evidence-based epilepsy-related apps to cover broader domains of self-care and behavioral change techniques.

scholarly journals Comprehensively addressing postpartum maternal health: a content and image review of commercially available mobile health apps

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Tucker ◽  
Alan Cuevas Villagomez ◽  
Tamar Krishnamurti
Keyword(s):  
Maternal Health ◽  
Health Information ◽  
Mobile Health ◽  
Rating Scale ◽  
The United States ◽  
People Of Color ◽  
Evidence Based ◽  
Or Education ◽  
Google Play

Abstract Background The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health (mHealth) apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated the quality of existing mHealth tools targeted to this time period in terms of sufficiency of maternal health information, inclusivity of people of color, and app usability. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were evaluated for extent and quality of maternal health information and inclusivity of people of color using an a priori coding scheme. App usability was evaluated using the Mobile Application Rating Scale (MARS) score. Results Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The coverage of maternal health information and inclusivity of people of color in app imagery both correlated positively with the MARS usability score of the app. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between MARS usability score and number of app users, as estimated by number of ratings for the app available on the app store. In addition, apps with evidence-based maternal health information had greater MARS engagement, information, and aesthetics scores. However, presence of evidence-based information did not correlate with greater numbers of app users. Conclusions Current commercially available peripartum apps range widely in quality. Overall current app offerings generally do not provide adequate maternal health information and are not optimally accessible to the target users in terms of inclusivity of women of color or app usability. Apps delivering evidence-based information and more usable design are more likely to meet these standards but are not more likely to be downloaded by users.

An Analysis of Apps with a Medication List Functionality for Older People with Heart Failure: Evaluation using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics Functionality Score (Preprint)

2021 ◽  
Author(s):  
Yohanca Maria Diaz-Skeete ◽  
David McQuaid ◽  
Adewale Samuel Akinosun ◽  
Idongesit Ekerete ◽  
Natacha Carragher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mobile Application ◽  
Rating Scale ◽  
Scientific Evidence ◽  
Medication List ◽  
Healthcare Informatics ◽  
Medication History ◽  
Clinic Efficiency ◽  
Google Play

BACKGROUND Managing the care of older patients with heart failure (HF) largely centres on medication management. Due to their frequent medication or dosing changes, an app supporting them to keep an up-to-date list of medication could be advantageous. During COVID-19 times, HF outpatients’ consultations are taking place virtually or by phone. An app with the capability to share the medication list with healthcare professionals before consultation could support the clinic efficiency, for example, reducing consultation time. However, the influence of apps on maintaining an up to date medication history for older adults with HF in Ireland remains largely unexplored. OBJECTIVE The objectives of this review are twofold: to review apps with a medication list functionality and to evaluate the quality of the apps included in the review using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. METHODS A systematic search of apps was conducted in June 2019 using the Google Play StoreTM and iTunes App StoreTM. The MARS was used independently by four researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. RESULTS Google play and iOS app stores searches identified 483 potential apps (292 from Android stores and 191 from Apple stores). Six apps met the inclusion criteria. Medisafe app had the highest overall MARS score (4/5) and the medication list & medical records app had the lowest overall score (2.5/5). Five out of the six apps achieved an acceptable quality MARS score (>3.0). Two apps scored the maximum number of features (n=11) according to the IMS Institute for Healthcare Informatics functionality score and two scored the lowest (n=5). The apps had on average 8 functions based on the IMS functionality criteria (range 5 to 11). CONCLUSIONS The quality of current apps with a medication list functionality varies regarding their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality. However, the subjective quality or satisfaction with the apps was poor. Only three apps are based on scientific evidence and have been previously tested. Two apps featured all the IMS Institute for Healthcare Informatics functionalities and half do not provide clear instructions on how to enter medication data, do not display vital parameters data in an easy to understand format and do not guide users on how or when to take their medication. CLINICALTRIAL N/A

scholarly journals Smartphone Apps Targeting Physical Activity in People With Rheumatoid Arthritis: Systematic Quality Appraisal and Content Analysis

10.2196/18495 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e18495 ◽  
Author(s):  
Lindsay M Bearne ◽  
Mandeep Sekhon ◽  
Rebecca Grainger ◽  
Anthony La ◽  
Mehrdad Shamali ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Rating Scale ◽  
Mobile App ◽  
Information Support ◽  
World Health ◽  
Smartphone Apps ◽  
High Quality ◽  
App Store ◽  
Google Play

Background Rheumatoid arthritis (RA) is a disabling, inflammatory joint condition affecting 0.5%-1% of the global population. Physical activity (PA) and exercise are recommended for people with RA, but uptake and adherence tend to be low. Smartphone apps could assist people with RA to achieve PA recommendations. However, it is not known whether high quality, evidence-informed PA apps that include behavior change techniques (BCTs) previously identified as effective for PA adherence are available for people with RA. Objective This study aims to systematically identify apps that include goals to facilitate PA for adults with RA and assess app quality and content for the inclusion of relevant BCTs against recommendations for cardiorespiratory, resistance, flexibility, and neuromotor PA and exercise. Methods A systematic search of the Apple App Store and Google Play Store in the United Kingdom was conducted to identify English language apps that promote PA for adults with RA. Two researchers independently assessed app quality (mobile app rating scale [MARS]; range 0-5) and content (BCT Taxonomy version 1, World Health Organization, the American College of Sports Medicine, and the European League against Rheumatism recommendations for PA). The completeness of reporting of PA prescription was evaluated using a modified version of the Consensus on Exercise Reporting Template (CERT; range 0-14). Results A total of 14,047 apps were identified. Following deduplication, 2737 apps were screened for eligibility; 6 apps were downloaded (2 on the Apple App Store and 4 on the Google Play Store), yielding 4 unique apps. App quality varied (MARS score 2.25-4.17). Only 1 app was congruent with all aspects of the PA recommendations. All apps completely or partially recommended flexibility and resistance exercises, 3 apps completely or partially advised some form of neuromotor exercise, but only 2 offered full or partial guidance on cardiorespiratory exercise. Completeness of exercise reporting was mixed (CERT scores 7-14 points) and 3-7 BCTs were identified. Two BCTs were common to all apps (information about health consequences and instruction on how to perform behavior). Higher quality apps included a greater number of BCTs and were more closely aligned to PA guidance. No published trials evaluating the effect of the included apps were identified. Conclusions This review identifies 4 PA apps of mixed quality and content for use by people with RA. Higher quality apps were more closely aligned to PA guidance and included a greater number of BCTs. One high-quality app (Rheumatoid Arthritis Information Support and Education) included 7 BCTs and was fully aligned with PA and exercise guidance. The effect of apps on PA adherence should be established before implementation.

Decision analysis of treatment options for vestibular schwannoma

2011 ◽  
Vol 114 (2) ◽  
pp. 400-413 ◽  
Author(s):  
Robert G. Whitmore ◽  
Christopher Urban ◽  
Ephraim Church ◽  
Michael Ruckenstein ◽  
Sherman C. Stein ◽  
...  
Keyword(s):  
English Language ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Complication Rates ◽  
Online Databases ◽  
Decision Analytical Model ◽  
The Mean ◽  
Meta Regression

Object Widespread use of MR imaging has contributed to the more frequent diagnosis of vestibular schwannomas (VSs). These tumors represent 10% of primary adult intracranial neoplasms, and if they are symptomatic, they usually present with hearing loss and tinnitus. Currently, there are 3 treatment options for quality of life (QOL): wait and scan, microsurgery, and radiosurgery. In this paper, the authors' purpose is to determine which treatment modality yields the highest QOL at 5- and 10-year follow-up, considering the likelihood of recurrence and various complications. Methods The MEDLINE, Embase, and Cochrane online databases were searched for English-language articles published between 1990 and June 2008, containing key words relating to VS. Data were pooled to calculate the prevalence of treatment complications, tumor recurrence, and QOL with various complications. For parameters in which incidence varied with time of follow-up, the authors used meta-regression to determine the mean prevalence rates at a specified length of follow-up. A decision-analytical model was constructed to compare 5- and 10-year outcomes for a patient with a unilateral tumor and partially intact hearing. The 3 treatment options, wait and scan, microsurgery, and radiosurgery, were compared. Results After screening more than 2500 abstracts, the authors ultimately included 113 articles in this analysis. Recurrence, complication rates, and onset of complication varied with the treatment chosen. The relative QOL at the 5-year follow-up was 0.898 of normal for wait and scan, 0.953 for microsurgery, and 0.97 for radiosurgery. These differences are significant (p < 0.0052). Data were too scarce at the 10-year follow-up to calculate significant differences between the microsurgery and radiosurgery strategies. Conclusions At 5 years, patients treated with radiosurgery have an overall better QOL than those treated with either microsurgery or those investigated further with serial imaging. The authors found that the complications associated with wait-and-scan and microsurgery treatment strategies negatively impacted patient lives more than the complications from radiosurgery. One limitation of this study is that the 10-year follow-up data were too limited to analyze, and more studies are needed to determine if the authors' results are still consistent at 10 years.

scholarly journals Depressive Symptoms, Pain, and Quality of Life among Patients with Nonalcohol-Related Chronic Pancreatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Wendy E. Balliet ◽  
Shenelle Edwards-Hampton ◽  
Jeffery J. Borckardt ◽  
Katherine Morgan ◽  
David Adams ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Depression Scale ◽  
Self Report ◽  
Cross Sectional ◽  
Depressive Symptomology ◽  
The Mean

Objective. The present study was conducted to determine if depressive symptoms were associated with variability in pain perception and quality of life among patients with nonalcohol-related chronic pancreatitis. Methods. The research design was cross-sectional, and self-report data was collected from 692 patients with nonalcohol-related, intractable pancreatitis. The mean age of the sample was 52.6 (); 41% of the sample were male. Participants completed the MOS SF12 Quality of Life Measure, the Center for Epidemiological Studies 10-item Depression Scale (CESD), and a numeric rating scale measure of “pain on average” from the Brief Pain Inventory. Results. Depressive symptoms were significantly related to participants’ reports of increased pain and decreased quality of life. The mean CESD score of the sample was 10.6 () and 52% of the sample scored above the clinical cutoff for the presence of significant depressive symptomology. Patients scoring above the clinical cutoff on the depression screening measure rated their pain as significantly higher than those below the cutoff () and had significantly lower physical quality of life () and lower mental quality of life (). Conclusion. Although causality cannot be determined based on cross-sectional, correlational data, findings suggest that among patients with nonalcoholic pancreatitis, the presence of depressive symptoms is common and may be a risk factor associated with increased pain and decreased quality of life. Thus, routine screening for depressive symptomology among patients with nonalcoholic pancreatitis may be warranted.

Magnetic resonance–guided focused ultrasound thalamotomy for tremor: a report of 30 Parkinson's disease and essential tremor cases

2018 ◽  
Vol 128 (1) ◽  
pp. 202-210 ◽  
Author(s):  
Menashe Zaaroor ◽  
Alon Sinai ◽  
Dorith Goldsher ◽  
Ayelet Eran ◽  
Maria Nassar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Events ◽  
Essential Tremor ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Innovative Technology ◽  
The Mean

OBJECTIVEThalamotomy of the ventral intermediate nucleus (VIM) is effective in alleviating medication-resistant tremor in patients with essential tremor (ET) and Parkinson's disease (PD). MR-guided focused ultrasound (MRgFUS) is an innovative technology that enables noninvasive thalamotomy via thermal ablation.METHODSPatients with severe medication-resistant tremor underwent unilateral VIM thalamotomy using MRgFUS. Effects on tremor were evaluated using the Clinical Rating Scale for Tremor (CRST) in patients with ET and by the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS) in patients with PD and ET-PD (defined as patients with ET who developed PD many years later). Quality of life in ET was measured by the Quality of Life in Essential Tremor (QUEST) questionnaire and in PD by the PD Questionnaire (PDQ-39).RESULTSThirty patients underwent MRgFUS, including 18 with ET, 9 with PD, and 3 with ET-PD. The mean age of the study population was 68.9 ± 8.3 years (range 46–87 years) with a mean disease duration of 12.1 ± 8.9 years (range 2–30 years). MRgFUS created a lesion at the planned target in all patients, resulting in cessation of tremor in the treated hand immediately following treatment. At 1 month posttreatment, the mean CRST score of the patients with ET decreased from 40.7 ± 11.6 to 9.3 ± 7.1 (p < 0.001) and was 8.2 ± 5.0 six months after treatment (p < 0.001, compared with baseline). Average QUEST scores decreased from 44.8 ± 12.9 to 13.1 ± 13.2 (p < 0.001) and was 12.3 ± 7.2 six months after treatment (p < 0.001). In patients with PD, the mean score of the motor part of the UPDRS decreased from 24.9 ± 8.0 to 16.4 ± 11.1 (p = 0.042) at 1 month and was 13.4 ± 9.2 six months after treatment (p = 0.009, compared with baseline). The mean PDQ-39 score decreased from 38.6 ± 16.8 to 26.1 ± 7.2 (p = 0.036) and was 20.6 ± 8.8 six months after treatment (p = 0.008). During follow-up of 6–24 months (mean 11.5 ± 7.2 months, median 12.0 months), tremor reappeared in 6 of the patients (2 with ET, 2 with PD, and 2 with ET-PD), to a lesser degree than before the procedure in 5. Adverse events that transiently occurred during sonication included headache (n = 11), short-lasting vertigo (n = 14) and dizziness (n = 4), nausea (n = 3), burning scalp sensation (n = 3), vomiting (n = 2) and lip paresthesia (n = 2). Adverse events that lasted after the procedure included gait ataxia (n = 5), unsteady feeling (n = 4), taste disturbances (n = 4), asthenia (n = 4), and hand ataxia (n = 3). No adverse event lasted beyond 3 months. Patients underwent on average 21.0 ± 6.9 sonications (range 14–45 sonications) with an average maximal sonication time of 16.0 ± 3.0 seconds (range 13–24 seconds). The mean maximal energy reached was 12,500 ± 4274 J (range 5850–23,040 J) with a mean maximal temperature of 56.5° ± 2.2°C (range 55°–60°C).CONCLUSIONSMRgFUS VIM thalamotomy to relieve medication-resistant tremor was safe and effective in patients with ET, PD, and ET-PD. Current results emphasize the superior adverse events profile of MRgFUS over other surgical approaches for treating tremor with similar efficacy. Large randomized studies are needed to assess prolonged efficacy and safety.

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