{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:18:46Z","timestamp":1790900326244,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Staged bilateral Magnetic Resonance\u2013guided Focused Ultrasound (MRgFUS) thalamotomy is an incisionless option for medication\u2010refractory essential tremor (ET). While the efficacy and safety of unilateral MRgFUS are established, evidence for bilateral treatment remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of staged bilateral MRgFUS in a prospective single\u2010centre observational cohort and to perform a systematic review and meta\u2010analysis of the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive ET patients undergoing second\u2010side MRgFUS were prospectively assessed. The primary efficacy endpoint was the longitudinal change in Clinical Rating Scale for Tremor (CRST) A\u2009+\u2009B scores for the treated hand after FUS2, while safety was evaluated by collecting and grading adverse events (AEs). A systematic review identified published bilateral MRgFUS series; efficacy data were meta\u2010analysed, while AEs were reported descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen patients (60% men; mean age 74.1\u2009\u00b1\u20098.9\u2009years) underwent FUS2 28.9\u2009\u00b1\u200922.5\u2009months after first\u2010side treatment. At the 12\u2010month evaluation, CRST A\u2009+\u2009B decreased from 21.0 to 8.8 (\u221258%), CRST C from 7.3 to 1.9 (\u221274.2%), and QUEST from 30.5 to 9.5 (\u221268.7%). Head and voice tremor were reduced by 73.8% and 40.3%, respectively. AEs were predominantly mild (95.2%) and transient (88%). Cognition at 1\u2009year was globally preserved, with a selective decline in verbal episodic memory. Meta\u2010analysis confirmed significant improvement in tremor severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Staged bilateral MRgFUS thalamotomy was associated with sustained tremor reduction, including midline tremor, functional improvement and acceptability, with a manageable safety profile. Overall, consistent with literature, these findings support its potential role as a therapeutic option in selected ET patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70535","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T12:11:57Z","timestamp":1774959117000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Staged Bilateral Magnetic Resonance\u2010Guided Focused Ultrasound Thalamotomy for Essential Tremor: Prospective Single\u2010Centre Cohort and Systematic Review With Meta\u2010Analysis"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6534-9911","authenticated-orcid":false,"given":"F.","family":"Paio","sequence":"first","affiliation":[{"name":"Neurology Section, Department of Neurosciences, Biomedicine, and Movement Sciences University of Verona  Verona Italy"},{"name":"Neurology Unit, Department of Neurosciences Azienda Ospedaliera Universitaria Integrata  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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M.","family":"Polloniato","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, Department of Pathology and Diagnostics Azienda Ospedaliera Universitaria Integrata  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Zivelonghi","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, Department of Pathology and Diagnostics Azienda Ospedaliera Universitaria Integrata  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Cavedon","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, Department of Pathology and Diagnostics Azienda Ospedaliera Universitaria Integrata  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Montemezzi","sequence":"additional","affiliation":[{"name":"Radiology Unit, Department of Pathology and Diagnostics Azienda Ospedaliera Universitaria Integrata  Verona 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