Erratum. A meta-analysis of outcomes and complications of magnetic resonance–guided focused ultrasound in the treatment of essential tremor

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TO THE READERSHIP: We appreciate the publication of our article in the February issue of Neurosurgical Focus (Mohammed N, Patra D, Nanda A: A meta-analysis of outcomes and complications of magnetic resonance–guided focused ultrasound in the treatment of essential tremor. Neurosurg Focus 44(2):E4, 2018). Unfortunately, some errors were made. We want to report the following corrections to the article.

In our Results, we have corrected the mean age in the study by Schreglmann et al.2 to be 70.7 ± 8.5 years instead of 71 ± 8.3 years and we have also corrected the pooled estimate of in-procedure dizziness in our study to be 43.4% rather than 45.5%. The correct percentage has been placed in the Abstract and Fig. 3A as well.

FIG. 3.
FIG. 3.

Pooled estimate of in-procedure complications, and complications at 3 and 12 months postprocedure. A: Pooled estimate of in-procedure dizziness. B: Pooled estimate of in-procedure nausea and vomiting. C: Pooled estimate of paresthesias occurring in patients at 3 months postprocedure. D: Pooled estimate of ataxia occurring in patients at 3 months postprocedure. E: Pooled estimate of paresthesias occurring in patients at 12 months postprocedure. F: Pooled estimate of ataxia occurring in patients at 12 months postprocedure.

In Table 1, the study by Schreglmann et al. is now listed as prospective instead of retrospective. The mean age of patients in that study is now listed as 70.7 ± 8.5 years.

TABLE 1.

Details of studies included in a meta-analysis of MRgFUS in treatment of ET

Authors & YearNo. of PtsAge in Yrs (range)Sex (M/F)Duration of Sx in Yrs (range)Site of LesionType of StudySonicationsMax Energy (Joules)Peak Temp (°C)
Zaaroor et al., 20181868.9 ± 8.3NS12.1 ± 8.9VimRetro21.0 ± 6.912,500 ± 4,27456.5 ± 2.2
Schreglmann et al., 2017670.7 ± 8.5NS24.5 ± 22.5CTTPros11 ± 3.212,008 ± 4,44162.0 ± 2.5
Elias et al., 20131566.6 ± 811/432 ± 21.3VimUncontrolled, pros study17.9 ± 4.610,320 ± 4,53758.5 ± 2.5
Lipsman et al., 2013470.8 (58–77)4/017.8 ± 8.18VimPros, uncontrolled22.5 ± 7.59NS59 ± 2.87
Huss et al., 20151567.2 (28–82)10/5NSVimRetroNSNSNS
Kim et al., 20172364.7 (47–77)20/320.5 (5–54)VimRetroNSNS55.62
Chang et al., 2015865.72 (53–78)9/230.6 ± 16.12VimRetroNSNS53 ± 3.3
Wintermark et al., 20141567 ± 810/5NSVimRetroNSNSNS
Elias et al., 20165671 ± 8.337/1916.8 ± 12.3VimRCT18.5 ± 5.214,497 ± 6,69555.6 ± 2.3

NS = not specified; pros = prospective; pts = patients; retro = retrospective; Sx = symptoms; temp = temperature.

Unless otherwise stated, values are presented as the mean ± SD.

In Table 3, the in-procedure complication of “dizzy feeling” for the study of Schreglmann et al. has been changed to 4 patients instead of 5.

The title of Table 4 has been changed to “Complications occurring between 0 and 3 months (resolved and persisting).”

In Figure 3, we have revised the forest plot shown in panel A and we have updated the titles for panels C–F.

In References, we originally listed a study by Chang et al. published in 2016 (Reference 4). That was incorrect. We have replaced this reference with the following:

  • 4. Chang WS, Jung HH, Kweon EJ, Zadicario E, Rachmilevitch I, Chang JW: Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes. J Neurol Neurosurg Psychiatry 86:257–264, 2015

In addition, we have corrected all references to Chang et al. in Tables 15 in our paper to show the correct year of the replacement publication.1

TABLE 2.

Baseline CRST Total, Part A, Part C, and QUEST scores, and percentage improvement at 3, 6, or 12 months

Authors & YearCRST Total Score at Baseline (mean ± SD)CRST Total Score at 3 or 6 Mos (mean ± SD)CRST Total Score at 12 Mos (mean ± SD)CRST Total Score, % Improvement
CRST Total
 Zaaroor et al., 201840.7 ± 11.68.2 ± 5.0 (6 mos)NS79.85
 Schreglmann et al., 201743.8 ± 9.819.8 ± 6.8 (6 mos)NS54.79
 Elias et al., 201354.9 ± 14.4NS24.3 ± 14.856
 Lipsman et al., 201370.75 ± 19.635.25 ± 10.9 (3 mos)NS50.17
 Huss et al., 201554.9NS17.767.75
 Kim et al., 2017NSNSNS78.3% improved at 12 mos
 Chang et al., 201546.72 ± 10.516.25 ± 7.16 (6 mos)NS80.43
 Wintermark et al., 201419.8 ± 5*4.6 ± 3 (3 mos)NS76.5
 Elias et al., 201650.1 ± 14.029.6 ± 13 (3 mos)32.4 ± 14.535
CRST Part ACRST Part A score at baseline (mean ± SD)CRST Part A score at 3 or 6 mos (mean ± SD)CRST Part A score at 12 mos (mean ± SD)CRST Part A score, % improvement
 Schreglmann et al., 201714.3 ± 4.92.5 ± 2.1 (6 mos)NS82.51
 Elias et al., 201320.4 ± 5.24.3 ± 3.5 (3 mos)5.2 ± 4.874.50
 Lipsman et al., 20137.25 ± 2.21.25 ± 0.95 (3 mos)NS82.75
 Huss et al., 201513.4NS8.735.07
 Chang et al., 201512.09 ± 2.91.4 ± 1.59 (6 mos)NS88.42
 Elias et al., 201618.1 ± 4.89.6 ± 5.1 (3 mos)10.9 ± 4.540
QUEST & CRST Part CQUEST score, % improvementCRST Part C score at baseline (mean ± SD)CRST Part C score at 6 or 12 mos (mean ± SD)CRST Part C score, % improvement
 Zaaroor et al., 201894%NSNSNS
 Elias et al., 201337%NSNSNS
 Lipsman et al., 2013NS20.75 ± 4.510.25 ± 3.3 (12 mos)50.60
 Huss et al., 201537.5%18.22.8 (12 mos)84.61
 Chang et al., 2015NS12.81 ± 3.622.75 ± 3.49 (6 mos)78.51
 Elias et al., 201646%16.5 ± 4.66.3 ± 5.6 (12 mos)62

Unless otherwise stated, values are presented as the mean ± SD.

The score denotes Part A and Part B subsections only.

TABLE 3.

In-procedure complications

Authors & YearHeadacheDizzy FeelingNausea & VomitingSensation of Heat, Warmth, or FlushingScalp TinglingParesthesiasFrame Related & Others
Zaaroor et al., 20180145032Scalp numbness (5), subcutaneous hematoma (3)
Schreglmann et al., 20170400000
Elias et al., 20139584000
Lipsman et al., 20130000020
Huss et al., 20159118400MRI pin site burn (2)
Kim et al., 2017NSNSNSNSNSNSNS
Chang et al., 2015050000Sonication failures (3)
Wintermark et al., 2014000000Pin site burn (2), occipital numbness (4)
Elias et al., 2016212131704Pin site edema (3), back pain (5), anxiety (3)
TABLE 4.

Complications occurring between 0 and 3 months (resolved and persisting)

Authors & YearParesthesias or DysesthesiasDysarthriaDysphagiaGait Instability, Ataxia, or Unsteady FeelingLimb WeaknessDysmetriaTinnitusFatigueDysgeusia
Zaaroor et al., 2018000500001
Schreglmann et al., 2017000210000
Elias et al., 20131510911000
Lipsman et al., 2013200000000
Huss et al., 20151410510000
Kim et al., 2017100100001
Chang et al., 2015000100000
Wintermark et al., 2014000910000
Elias et al., 201614101827332
TABLE 5.

Summary of critical appraisal of included studies using the Newcastle-Ottawa Scale for assessing the quality of observational studies

StudySelectionComparabilityExposure
Zaaroor et al., 2018*****
Schreglmann et al., 2017***
Elias et al., 2013***
Lipsman et al., 2013**
Huss et al., 2015******
Kim et al., 2017******
Chang et al., 2015**
Wintermark et al., 2014**
Elias et al., 2016*********

Each of the 3 categories has further subcategories of assessment for which an asterisk is given. Studies with the maximum number of asterisks have a higher quality than those with fewer asterisks. Empty cells indicate that no asterisks could be scored for that category.

We apologize to the editors and readership for any confusion our errors may have caused, and we are grateful for the opportunity to correct them. The corrected figure and tables appear on the following pages.

The article has been corrected online as of July 1, 2018.

References

  • 1

    Chang WSJung HHKweon EJZadicario ERachmilevitch IChang JW: Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes. J Neurol Neurosurg Psychiatry 86:2572642015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Schreglmann SRBauer RHägele-Link SBhatia KPNatchev PWegener N: Unilateral cerebellothalamic tract ablation in essential tremor by MRI-guided focused ultrasound. Neurology 88:132913332017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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Article Information

INCLUDE WHEN CITING DOI: 10.3171/2018.5.FOCUS17628a.

© AANS, except where prohibited by US copyright law.

Figures

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    Pooled estimate of in-procedure complications, and complications at 3 and 12 months postprocedure. A: Pooled estimate of in-procedure dizziness. B: Pooled estimate of in-procedure nausea and vomiting. C: Pooled estimate of paresthesias occurring in patients at 3 months postprocedure. D: Pooled estimate of ataxia occurring in patients at 3 months postprocedure. E: Pooled estimate of paresthesias occurring in patients at 12 months postprocedure. F: Pooled estimate of ataxia occurring in patients at 12 months postprocedure.

References

  • 1

    Chang WSJung HHKweon EJZadicario ERachmilevitch IChang JW: Unilateral magnetic resonance guided focused ultrasound thalamotomy for essential tremor: practices and clinicoradiological outcomes. J Neurol Neurosurg Psychiatry 86:2572642015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Schreglmann SRBauer RHägele-Link SBhatia KPNatchev PWegener N: Unilateral cerebellothalamic tract ablation in essential tremor by MRI-guided focused ultrasound. Neurology 88:132913332017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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