Evidence map›Paper›PMID 26446066›Full record

ArticleNeurology2015

A prospective single-blind study of Gamma Knife thalamotomy for tremor.

Tatiana Witjas, Romain Carron, Paul Krack, Alexandre Eusebio, Marianne Vaugoyeau, Marwan Hariz, Jean Philippe Azulay, Jean Régis

Open access · bronzeAbstract readClinical Study
PubMed Publisher
In one paragraph

Article in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 140 citations in OpenAlex.

  1. Radiosurgical thalamotomy for the management of tremors: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Pooled it
  2. Pooled it
  3. Trial
  4. Essential Tremor Suppression with a Novel Anti-Tremor Orthosis: A Randomized Crossover Trial.Movement disorders : official journal of the Movement Disorder Society · 2025
    Trial
  5. Observational
  6. Article
  7. Review
  8. Surgical Treatment of Tremor Syndromes: A Guide to the Clinician.Movement disorders clinical practice · 2026
    Review
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  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Tatiana WitjasFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France. tatiana.witjas@ap-hm.fr.
Romain CarronFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Paul KrackFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Alexandre EusebioFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Marianne VaugoyeauFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Marwan HarizFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Jean Philippe AzulayFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Jean RégisFrom the Department of Neurology and Movement Disorders (T.W., A.E., J.P.A.) and Department of Functional and Stereotactic Neurosurgery and Radiosurgery (R.C., J.R.), Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital; Institut de Neurosciences de la Timone (T.W., A.E., J.P.A.), UMR 7289, CNRS Aix-Marseille Université, Marseille, France; Université Grenoble Alpes (P.K.), GIN INSERM U318 and CHU de Grenoble, Movement Disorder Unit, Grenoble, France; CNRS-Aix-Marseille Université (M.V.), Laboratory of Cognitive Neurosciences, FR 3 C, Marseille, France; Unit of Functional Neurosurgery (M.H.), UCL Institute of Neurology, Queen Square, London, UK; Department of Clinical Neuroscience (M.H.), Umeå University, Sweden; and INSERM (R.C., J.R.), UMR 1106, Aix-Marseille Université, Marseille, France.
Centre National de la Recherche Scientifique · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the safety and efficacy of unilateral Gamma Knife thalamotomy (GKT) for treatment of severe tremor with a prospective blinded assessment.

methodsFifty patients (mean age: 74.5 years; 32 men) with severe refractory tremor (36 essential, 14 parkinsonian) were treated with unilateral GKT. Targeting of the ventral intermediate nucleus (Vim) was achieved with Leksell Gamma Knife with a single shot through a 4-mm collimator helmet. The prescription dose was 130 Gy. Neurologic and neuropsychological assessments including a single-blinded video assessment of the tremor severity performed by a movement disorders neurologist from another center were performed before and 12 months after treatment. MRI follow-up occurred at 3, 6, and 12 months.

resultsThe upper limb tremor score improved by 54.2% on the blinded assessment (p < 0.0001). All tremor components (rest, postural, and intention) were improved. Activities of daily living were improved by 72.2%. Cognitive functions remained unchanged. Following GKT, the median delay of improvement was 5.3 months (range 1-12 months). The only side effect was a transient hemiparesis associated with excessive edema around the thalamotomy in one patient.

conclusionThis blinded prospective assessment demonstrates that unilateral GKT is a safe and efficient procedure for severe medically refractory tremor. Side effects were rare and transient in this study. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with severe refractory tremor, GKT is well tolerated and effective in reducing tremor impairment.

Indexed as

Activities of Daily LivingAgedAged, 80 and overCohort StudiesEssential TremorFemaleHumansMaleMiddle AgedParkinson DiseaseProspective StudiesRadiosurgerySeverity of Illness IndexSingle-Blind MethodThalamusTreatment Outcome

Identifiers

PMID26446066
OpenAlexW2173431927

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