Abstract Details

Title Factors that Influence Treatment Recommendations for MRI Guided Focused Ultrasound Referrals: A Single Center Experience

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 17-003

Objective To examine factors that influence treatment trajectories in MRI-guided Focused ultrasound (MRgFUS) thalamotomy for tremors.

Background After access to MRgFUS opened at our center, referrals swelled and exceeded those completing the procedure. We aim to identify factors that influence proceeding with MRgFUS such as social drivers of health (SDoH), accuracy of referral diagnosis, or adequate medication trials.

Design/Methods A retrospective chart review of individuals referred to our MRgFUS program between 2019-2022 was conducted. We coded patient demographics, clinical characteristics (referral diagnosis, post-workup diagnosis and treatment recommendation), decision to proceed with MRgFUS, and internal and external SDoHs (state and national Area Deprivation Index (ADIs/n), years of education, insurance status). Relationships were analyzed using chi-square and ANOVA.

Results We identified 280 individuals (of 297 referrals; 66.7% male, 93.9% White, Mage=71.26±9.22, Meducation=14.92±3.05. 64.6% were recommended MRgFUS (Mage=72.09), 13.2% had deep brain stimulation (DBS; Mage=68.92) and 22.1% were recommended an alternative or no procedure (Mage=65.75). The conversion rate of referrals recommended for MRgFUS/DBS to procedure was 83.9%. The average time to procedure was 11.5±17.09 weeks. Factors that influenced no procedure include: 9.64% physician recommendation of which 2% were incompatible with MRgFUS; 2.7% of patients’ diagnosis was changed and alternate treatments recommended; 24.3% patient ultimately declined procedure. Patient age (p=.004) and insurance (p=.002) had an impact on type of procedure. Other demographics, age, and ADI did not relate to recommended intervention nor time to treatment intervention.

Conclusions Most patients referred for MRgFUS for tremors were accurately diagnosed but often elected not to proceed with this therapy for personal reasons and/or lack of symptom severity; SDoH factors did not influence treatment, intervention.

Authors/Disclosures
Gulsah S. Yildiz PRESENTER	Mrs. Yildiz has nothing to disclose.
David Gonzalez (Rush University Medical Center)	David Gonzalez has nothing to disclose.
Sepehr Sani	The institution of Sepehr Sani has received research support from NIH. Sepehr Sani has received intellectual property interests from a discovery or technology relating to health care. Sepehr Sani has received publishing royalties from a publication relating to health care.
Neepa J. Patel, MD, FAAN (Rush University Medical Center)	Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie Pharmaceuticals. Dr. Patel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal Pharmaceuticals. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernius Pharmaceuticals. Dr. Patel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific.

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