{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:29:10Z","timestamp":1786343350206,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unilateral magnetic resonance guided focused ultrasound (MRgFUS) thalamotomy reduces tremor in essential tremor, yet disability often persists on the untreated side. The added benefit and safety of a staged contralateral lesion remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to evaluate the efficacy and safety of staged bilateral MRgFUS thalamotomy for essential tremor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL, Scopus,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      , and World Health Organization International Clinical Trials Registry Platform from inception to April 12, 2026 (PROSPERO CRD420251027624). Eligible studies were staged bilateral MRgFUS with Clinical Rating Scale for Tremor outcomes and adverse events, and at least 3 months of follow up. Two reviewers extracted data per Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses. The primary outcome was the standardized mean difference (SMD) in tremor severity from pre\u2010 to post\u2010second procedure. Safety outcomes were pooled 3\u2010month adverse event proportions using random effects. Risk of bias was assessed with Newcastle\u2010Ottawa Scale and Risk of Bias in Non\u2010randomized Studies of Interventions; certainty was graded with Grading of Recommendations Assessment, Development, and Evaluation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies were included in the systematic review, of which seven cohorts (n\u2009=\u2009149) were included in the meta\u2010analysis. The pooled SMD was \u22121.91 (95% confidence intervals, \u22122.19 to \u22121.63;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), indicating consistent, large\u2010magnitude tremor reduction across all seven cohorts. Three\u2010month adverse events included sensory changes (28.8%), gait disturbance (27.5%), dysarthria (22.0%), taste changes (21.7%), dysphagia (18.4%), and ataxia (11.3%). All studies were single\u2010arm and non\u2010randomized with moderate to serious risk of bias, and certainty was very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Staged bilateral MRgFUS yielded clinically meaningful tremor reduction with predominantly mild adverse events at 3 months. Given very low certainty, findings are hypothesis\u2010generating and support\u2010controlled studies with blinded assessment and longer follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70748","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:49:02Z","timestamp":1786340942000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Staged Bilateral Magnetic Resonance\u2010Guided Focused Ultrasound for Treating Essential Tremor: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5037-7792","authenticated-orcid":false,"given":"Nima Norbu","family":"Sherpa","sequence":"first","affiliation":[{"name":"Brain Research and Imaging Centre University of Plymouth  Plymouth United Kingdom"},{"name":"Institute of Psychiatry, Psychology, and Neuroscience King's College London  London United 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