Magnetic Resonance–Guided Focused Ultrasound Thalamotomy in a Prospective Cohort of 52 Patients with Parkinson's Disease: A Possible Critical Role of Age and Lesion Volume for Predicting Tremor Relapse
Movement Disorders,
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 18, 2025
Abstract
Background
Magnetic
resonance–guided
focused
ultrasound
(MRgFUS)
thalamotomy
of
ventral
intermediate
(Vim)
nucleus
is
useful
to
treat
drug‐resistant
tremor‐dominant
Parkinson's
disease
(TdPD),
but
tremor
relapse
may
occur.
Predictors
have
been
poorly
investigated
so
far.
Objective
The
aim
this
study
evaluate
the
role
clinico‐demographic,
procedural,
and
neuroradiological
variables
in
determining
clinical
response,
relapse,
adverse
events
(AEs)
TdPD
after
MRgFUS
Vim‐thalamotomy.
Methods
Fifty‐two
patients
who
consecutively
underwent
unilateral
Vim‐thalamotomy
were
prospectively
evaluated
at
baseline
24
hours,
1
month,
6
months,
12
months
using
MDS‐UPDRS‐III
off
on
medication
conditions.
AEs
collected
each
evaluation.
Lesion
volume
was
calculated
24‐hour
magnetic
resonance
imaging
(MRI).
Patients
with
improvement
<30%
considered
nonresponders
(when
detected
hours)
or
relapsers
(if
from
1‐month
visit
onward).
Results
All
showed
>30%
hours.
Tremor
occurred
(23%),
exclusively
during
first
month
thalamotomy.
Relapse
associated
younger
age
(
P
=
0.030)
smaller
lesion
0.030).
At
22
(42%)
had
AEs;
persisted
19%
6%
cases.
larger
lesions
0.018).
mild.
Conclusions
effective
treating
TdPD.
volume,
make
more
likely
persist.
We
suggest
that
a
between
145
220
mm
3
T1‐weighted
MRI
be
therapeutic
window
ensures
control
without
long‐lasting
AEs.
©
2025
Author(s).
Movement
Disorders
published
by
Wiley
Periodicals
LLC
behalf
International
Parkinson
Disorder
Society.
Язык: Английский
Early re-emerging tremor after MRgFUS thalamotomy: case–control analysis of procedural and imaging features
Frontiers in Neurology,
Год журнала:
2024,
Номер
15
Опубликована: Июнь 6, 2024
Purpose
This
study
aimed
to
identify
possible
prognostic
factors
determining
early
tremor
relapse
after
Magnetic
Resonance
guided
Focused
Ultrasound
Surgery
(MRgFUS)
thalamotomy
in
patients
with
essential
(ET)
and
Parkinson’s
disease
(PD).
Methods
Nine
(six
ET
three
PD)
who
underwent
Vim
MRgFUS
a
single
institution
developed
re-emergent
were
analyzed.
A
control
group
of
matched
pairwise
for
sex,
pathology,
age,
duration,
skull
density
ratio
(SDR)
was
selected
compare
the
technical-procedural
data
MR
imaging
evidence.
findings
compared
between
groups
included
lesion
shape
volume
multiparametric
sequences,
as
well
Fractiona
Anisotropy
(FA)
Apparent
Diffusion
Coefficient
(ADC)
values
derived
from
Tensor
Imaging
Weighted
(DTI)
(DWI)
sequences.
Results
We
did
not
find
statistically
significant
differences
gender
age
two
groups.
Technical
procedural
parameters
also
similar
both
treatment
In
MRI
analysis,
we
found
lesions
size
but
greater
caudal
extension
stable
outcomes
relapse.
Conclusion
our
analysis
recurrences
focused
ultrasound,
there
neither
technical
nor
related
or
ablation
temperatures.
Greater
without
recurrence
might
suggest
importance
spatial
consolidation
during
treatment.
Язык: Английский