Introduction: Tremors in the elderly can significantly impact daily life, leading to increased dependency, social isolation, anxiety, depression, and cognitive decline, which in turn exacerbate frailty and CFS. HIFU has been shown to effectively treat tremors, potentially improving CFS by reducing hand, vocal, and head tremors. However, we have observed that the HIFU outcomes are influenced by marked CFS, highlighting a bidirectional relationship.
Methods: Retrospective review of patients with tremors who underwent HiFU thalamotomy with at least 12 months of followup. We examined the relationship. between preoperative CFS and outcomes on one hand, in addition, we evaluated the change of CFS after HiFU treatment.
Results: Out of 56 patients, 84% experienced improvements in their hand tremors. Additionally, 75% showed enhancements in vocal tremors, while 54% expressed improved head tremors. These changes led to a reduction in CFS in 80% of the HIFU patients, improving hand movement and fostering self-reliance. The success rate for treating hand tremors in mild CFS (CFS-1 to CFS-5) was 97%, compared to just 50% in those with marked CFS (CFS-6 to CFS-9). The failure rate of HIFU in marked CFS was six times higher than in mild CFS. In comparing post-HIFU complications between marked CFS and mild CFS, ataxia was significantly higher in the marked CFS (19% vs. 10%), slurred speech (8% vs. 3%), tongue numbness (11% vs. 3%), and hand ataxia (8% vs. 3%). Severe imbalance, observed exclusively in marked CFS,
In addition, 83 % of patients had reduced CFS by at least 1 point as a result of treatment. 35% of patients improved their CFS by 2 points.
Conclusion : A bidirectional relationship exists between CFS and HIFU in the treatment of hand tremors. HIFU effectively alleviates tremors and lowers CFS levels. However, marked CFS negatively impacts the effectiveness of HIFU treatment.
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