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Magnetic resonance-guided focused ultrasound thalamotomy for tremor.

Authors: Chen JA, White PJ, Cosgrove GR, Rolston JD

Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has emerged as an effective treatment for tremor, particularly in those patients who are excluded from deep brain stimulation. The authors illustrate an example of MRgFUS thalamotomy, targeting the ventralis intermedius nucleus, in a 78-year-old patient with tremor who had features of essential tremor and tremor-predominant Parkinson's disease. Significant tremor improvement was seen during the procedure. The authors review step-by-step the preoperative considerations, Vim targeting, treatment, and outcomes for this evolving treatment modality. The video can be found here: https://stream.cadmore.media/r10.3171/2024.7.FOCVID249.

Introduction

Purpose Thermal ablation
Study Objective To demonstrate and review step-by-step MR-guided focused ultrasound thalamotomy targeting the ventralis intermedius nucleus for tremor treatment in a patient with features of essential tremor and tremor-predominant Parkinson’s disease.
Animal model / Human subject Human (Homo sapiens), N/A, 78 years, sex not specified
Disease model Tremor (essential tremor; tremor-predominant Parkinson's disease)
MRI or image guidance method Magnetic resonance-guided focused ultrasound (MRgFUS)
Targeted brain region(s) Ventralis Intermedius Nucleus

Outcomes and Safety

Summary of Outcomes MRgFUS thalamotomy targeting the ventralis intermedius nucleus produced significant intraoperative tremor improvement in a 78-year-old patient with features of essential tremor and tremor-predominant Parkinson’s disease; no multiple focused ultrasound parameter comparisons were reported.
Safety-related matter The provided text does not mention any safety concerns or adverse effects; no adverse effects were reported in the supplied excerpt.

Brain Region

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None
Treatment frequency single session

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