Focused Ultrasound Thalamotomy for Tremor-dominant Parkinson’s Disease: A Prospective 1-year Follow-up Study
| Autor: | Hisashi Ito, Takashi Odo, Tetsumasa Kamei, Kazuaki Yamamoto, Takaomi Taira, Shigeru Fukutake, Toshio Yamaguchi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Movement disorders Essential Tremor medicine.medical_treatment Placebo 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine Thalamus Randomized controlled trial Interquartile range law Tremor Humans Medicine Prospective Studies Adverse effect Prospective cohort study Aged business.industry Thalamotomy ventralis intermedius nucleus transcranial focused ultrasound Parkinson Disease tremor-dominant Parkinson’s disease thalamotomy Magnetic Resonance Imaging Treatment Outcome Cohort Original Article Female Surgery Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 0470-8105 |
| DOI: | 10.2176/nmc.oa.2020-0370 |
| Popis: | Transcranial magnetic resonance (MR)-guided focused ultrasound (FUS) therapy is an emerging and minimally invasive treatment for movement disorders. There are limited reports on its long-term outcomes for tremor-dominant Parkinson's disease (TDPD). We aimed to investigate the 1-year outcomes of ventralis intermedius (VIM) thalamotomy with FUS in patients with TDPD. Patients with medication-refractory TDPD were enrolled and underwent unilateral VIM-FUS thalamotomy. Neurologists specializing in movement disorders evaluated the tremor symptoms and disability using Parts A, B, and C of the Clinical Rating Scale for Tremor (CRST) at baseline and at 1, 3, and 12 months. In all, 11 patients (mean age: 71.6 years) were included in the analysis. Of these, five were men. The median (interquartile range) improvement from baseline in hand tremor score, the total score, and functional disability score were 87.9% (70.5-100.0), 65.3% (55.7-87.7), and 66.7% (15.5-85.1), respectively, at 12 months postoperatively. This prospective study demonstrated an improvement in the tremor and disability of patients at 12 months after unilateral VIM-FUS thalamotomy for TDPD. In addition, there were no serious persistent adverse events. Our results indicate that VIM-FUS thalamotomy can be safely and effectively used to treat patients with TDPD. A randomized controlled trial with a larger cohort and long blinded period would help investigate the recurrence, adverse effects, placebo effects, and longer efficacy of this technique. |
| Databáze: | OpenAIRE |
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