AGR-6: Comparison of Neurocognitive Outcomes Following High-Intensity Focused Ultrasound (HIFU) and Deep Brain Stimulation (DBS) for the Treatment of Essential Tremor (ET)

Abstract Objective: Deep brain stimulation (DBS) has been a mainstay for the treatment of medication refractory essential tremor (ET) for the past 30 years. HIFU, approved for ET by the US Food and Drug Administration (FDA) in 2016, has emerged as a new neurosurgical technique that evades the traditional mechanical (excision-based) surgical intervention. There is debate in terms of neurocognitive risk between DBS and HIFU. Method/Data Selection: Two patients of similar age and backgrounds, that presented with generally normal functioning, will be used to illustrate the application of reliable change indices relative to neuropsychological risk to DBS and HIFU among individuals diagnosed with ET. Results/Data Synthesis: Tables below provide neuropsychological domain indices, collected from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), to help illustrate neurocognitive outcomes of DBS and HIFU. Differences between pre-surgical and post-surgical index scores were calculated for both patients. Conclusions: Comparison of outcomes showed a small but consistent decline in verbal learning and memory that fell below the 90% RCI confidence interval for HIFU with contrasting findings observed in the DBS case. This data suggests that HIFU may include neuropsychological risk, beyond traditional DBS procedures, that may also include physical concerns such as dysarthria and imbalance beyond what has already been established.