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Functional lesional neurosurgery for tremor-a protocol for a systematic review and meta-analysis.

Abstract：

INTRODUCTION:The recent introduction of incision-less lesional neurosurgery using Gamma Knife and MRI-guided focused ultrasound has revived interest in lesional treatment options for tremor disorders. Preliminary literature researches reveal that the consistency of treatment effects after lesional neurosurgery for tremor has not formally been assessed yet. Similarly, the efficacy of different targets for lesional treatment and incidence of persistent side effects of lesional neurosurgical interventions has not been comprehensively assessed. This work therefore aims to describe a suitable process how to review the existing literature on efficacy and persistent side effects of lesional neurosurgical treatment for tremor due to Parkinson's disease, essential tremor, multiple sclerosis and midbrain/rubral tremor. METHODS AND ANALYSIS:We will search electronic databases (Medline, Cochrane) and reference lists of included articles for studies reporting lesional interventions for tremor in cohorts homogeneous for tremor aetiology and intervention (technique and target). We will include cohorts with a minimum number of five subjects and follow-up of 2 months. One investigator will perform the initial literature search and two investigators then independently decide which references to include for final efficacy and safety analysis. After settling of disagreement, data will be extracted from articles using a standardised template. We will perform a random-effect meta-analysis calculating standardised mean differences (Hedge's g) for comparison in Forest plots and subgroup analysis after assessment of heterogeneity using I2 statistics. ETHICS AND DISSEMINATION:This study will summarise the available evidence on the efficacy of lesional interventions for the most frequent tremor disorders, as well as for the incidence rate of persisting side effects after unilateral lesional treatment. This data will be useful to guide future work on incision-less lesional interventions for tremor. SYSTEMATIC REVIEW REGISTRATION:This study has been registered with the PROSPERO database (no. CRD42016048049).

journal_name

BMJ Open

journal_title

BMJ open

authors

Schreglmann SR,Krauss JK,Chang JW,Bhatia KP,Kägi G

doi

10.1136/bmjopen-2016-015409

subject

Has Abstract

pub_date

2017-05-09 00:00:00

pages

e015409

issue

5

issn

2044-6055

pii

bmjopen-2016-015409

journal_volume

7

pub_type

杂志文章,meta分析

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