Aims and objectives
Focused ultrasound (FUS) thalamotomy is a novel neurointerventional minimally invasive technique developed for the treatment of essential tremor (ET) and Parkinson disease tremor (PD).
Several trials reported the efficacy of the procedure along with the possible side effects and complications,
however,
data about long-term follow-up are still few.
From the procedural point of view,
accurate targeting of the ventral intermediate nucleus of the thalamus (Vim) and sonication parameters tuning is of paramount importance to obtain the best clinical efficacy and safety profile of this intervention....
Methods and materials
We retrospectively evaluated treatments of 21 patients with essential tremor (ET) and Parkinson disease (PD) tremor.
In each patient,
we evaluated the intraprocedural accumulated thermal dose (ATD) size and temperature (fig.
1),
and the postprocedural MR imaging findings (lesion size measured on T2w and DW MRI,
lesion edema size measured on FLAIR MRI) the day after the procedure (fig.
2).
Treatment outcome was assessed using the Fahn-Tolosa-Marin scale immediately after the procedure and at 1- and three-months follow-up
Results
Statistical analysis revealed a significant negative correlation between ATD size and FTM scores immediately after the procedure and at both the 1-month and 3-months follow-up (p≤0.05).
Mean ATD temperature was significantly correlated only with a positive treatment outcome after the procedure.
Lesion size measured on DWI after the procedure was negatively correlated with clinical outcome immediately after the postprocedure,
at 1-month and 3-months follow-up (p≤0.05). We did not find any statistically significant correlation between clinical outcome and other periprocedural imaging findings.
Conclusion
According to our preliminary results,
intraprocedural ATD and MRI findings after the procedure may have a possible predictive value of treatment outcome after MRgFUS thalamotomy in patients with ET and PD tremor.
References
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Weintraub D,
Elias WJ (2017) The emerging role of transcranial magnetic resonance imaging–guided focused ultrasound in functional neurosurgery.
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Zaaroor M,
Sinai A,
Goldsher D,
et al (2017) Magnetic resonance–guided focused ultrasound thalamotomy for tremor: a report of 30 Parkinson’s disease and essential tremor cases.
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doi: 10.3171/2016.10.JNS16758
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Eran A,
Sinai A,
et al (2015) MRI guided...