How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Methods

    NICE identified studies and reviews relevant to MRI-guided focused ultrasound thalamotomy for moderate to severe tremor in Parkinson's from the medical literature. The following databases were searched between the date they started to 23 January 2024: MEDLINE, EMBASE, Cochrane Library and other databases. Trial registries and the internet were also searched (see the literature search strategy). Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.

    The following inclusion criteria were applied to the abstracts identified by the literature search.

    • Publication type: clinical studies were included with emphasis on identifying good quality studies. Abstracts were excluded if they did not report clinical outcomes. Reviews, editorials, and laboratory or animal studies, were also excluded and so were conference abstracts, because of the difficulty of appraising study methodology, unless they reported specific adverse events that not available in the published literature.

    • Patients with Parkinson's and tremor.

    • Intervention or test: MRgFUS thalamotomy.

    • Outcome: articles were retrieved if the abstract contained information relevant to the safety, efficacy, or both.

    If selection criteria could not be determined from the abstracts the full paper was retrieved.

    Potentially relevant studies not included in the main evidence summary are listed in the section on other relevant studies.

    Find out more about how NICE selects the evidence for the committee.

    Table 4 literature search strategy

    Databases

    Date searched

    Version/files

    MEDLINE ALL (Ovid) 

    23/01/2024 

    1946 to January 22, 2024  

    EMBASE (Ovid) 

    23/01/2024 

    1974 to January 22 2024 

    Cochrane Database of Systematic Reviews – CDSR (Cochrane Library) 

    23/01/2024 

     Issue 1 of 12, January 2024 

    Cochrane Central Database of Controlled Trials – CENTRAL (Cochrane Library) 

    23/01/2024 

     Issue 1 of 12 January 2024 

    International HTA database (INAHTA) 

    23/01/2024 

    The following search strategy was used to identify papers in MEDLINE. A similar strategy was used to identify papers in other databases.

    MEDLINE search strategy

    1 Parkinson Disease/ 84286  

    2 Parkinsonian Disorders/ 9451  

    3 PD.tw. 193005  

    4 parkinson*.tw. 147490  

    5 Tremor/ or Essential Tremor/ 13254  

    6 Tremor*.tw. 26936  

    7 Movement Disorders/ 16990  

    8 ((movement* or motor) adj4 (disord* or diseas* or dysfunct*)).tw. 57655  

    9 (shaking palsy or shaking palsies).tw. 83  

    10 (Paralysis adj4 agitans).tw. 204  

    11 or/1-10 355249  

    12 Magnetic Resonance Imaging/ 482375  

    13 Magnetic Resonance Imaging, Interventional/ 1871  

    14 MRI.tw. 317937  

    15 ((MR or magnet*) adj4 (guid* or imag* or resonanc*)).tw. 470159  

    16 or/12-15 800244  

    17 exp Ultrasonic Therapy/ 14094  

    18 Ultrasonography, Interventional/ 28603  

    19 High-Intensity Focused Ultrasound Ablation/ 2254  

    20 ((ultraso* or ultra-so*) adj4 (therap* or surg* or ablat* or thalamotom*)).tw. 17476  

    21 ((High-intensity or focus*) adj4 (ultraso* or ultra-so* or thalamotom*)).tw. 10839  

    22 (focus* adj4 acoustic* adj4 energy*).tw. 65  

    23 (ultrasonograph* adj4 intervention*).tw. 463  

    24 HIFU.tw. 3007  

    25 thermoablat*.tw. 542  

    26 (therm* adj4 ablat*).tw. 5970  

    27 or/17-26 66218  

    28 11 and 16 and 27 457  

    29 (MRgFUS or MRgHIFU).tw. 711  

    30 28 or 29 969  

    31 exablate.tw. 69  

    32 30 or 31 992  

    33 animals/ not humans/ 5155377  

    34 32 not 33 897  

    35 limit 34 to ed=20230118-20240131 73  

    36 limit 34 to dt=20230118-20240131 102  

    37 35 or 36 116