ObjectiveTo test the hypothesis that transcranial magnetic resonance–guided focused ultrasound (tcMRgFUS) thalamotomy is effective, durable, and safe for patients with medication-refractory essential tremor (ET), we assessed clinical outcomes at 3-year follow-up of a controlled multicenter prospective trial.MethodsOutcomes were based on the Clinical Rating Scale for Tremor, including hand combined tremor–motor (scale of 0–32), functional disability (scale of 0–32), and postural tremor (scale of 0–4) scores, and total scores from the Quality of Life in Essential Tremor Questionnaire (scale of 0–100). Scores at 36 months were compared with baseline and at 6 months after treatment to assess for efficacy and durability. Adverse events were also reported.ResultsMeasured scores remained improved from baseline to 36 months (all p < 0.0001). Range of improvement from baseline was 38%–50% in hand tremor, 43%–56% in disability, 50%–75% in postural tremor, and 27%–42% in quality of life. When compared to scores at 6 months, median scores increased for hand tremor (95% confidence interval [CI] 0–2, p = 0.0098) and disability (95% CI 1–4, p = 0.0001). During the third follow-up year, all previously noted adverse events remained mild or moderate, none worsened, 2 resolved, and no new adverse events occurred.ConclusionsResults at 3 years after unilateral tcMRgFUS thalamotomy for ET show continued benefit, and no progressive or delayed complications. Patients may experience mild degradation in some treatment metrics by 3 years, though improvement from baseline remains significant.Clinicaltrials.gov identifierNCT01827904.Classification of evidenceThis study provides Class IV evidence that for patients with severe ET, unilateral tcMRgFUS thalamotomy provides durable benefit after 3 years.
The purpose of this study is to explore the influences of the negative corporate CEO and corporate social responsibility reputations on the changes in consumers’ brand attitudes and purchase intentions. To perform this study purpose, we proposed the relationships between brand awareness and perceived quality and initial brand attitude and purchase intention by relying on the hierarchy of effects model; then we assessed the changes in brand attitude and purchase intention after providing information on negative corporate reputation. Multiple regression analysis and paired samples T-tests were conducted to test the hypothesized relationships using a convenience sample of 212 respondents. The empirical results support significant effects of brand awareness and perceived quality on brand attitude and purchase intention. Furthermore, respondents’ brand attitudes and purchase intentions are reduced after they are being provided with the information on negative corporate reputation. This result confirms that negative corporate reputation significantly aggravates consumers’ attitudes and purchase intention. However, the type of reputation is not a decisive factor for consumers’ cognitive processes. The results imply that marketing managers need to manage a negative reputation carefully because negative corporate reputation aggravates consumers’ cognitive process However, consumers are not influenced by specific type of negative information, thus a company can mitigate the negative impact of their negative reputation by another type of positive reputation.
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