Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism

Background. Magnetic resonance imaging (MRI)-guided focused ultrasound (FUS) VIM-thalamotomy has established efficacy and safety in tremor relief in patients with essential tremor and Parkinson’s disease. The efficacy and safety in patients with atypical parkinsonism have not been reported. Objectiv...

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Main Authors: Alon Sinai, Maria Nassar, Lev Shornikov, Marius Constantinescu, Menashe Zaaroor, Ilana Schlesinger
Format: Article
Language:English
Published: Hindawi Limited 2024-01-01
Series:Parkinson's Disease
Online Access:http://dx.doi.org/10.1155/2024/6643510
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author Alon Sinai
Maria Nassar
Lev Shornikov
Marius Constantinescu
Menashe Zaaroor
Ilana Schlesinger
author_facet Alon Sinai
Maria Nassar
Lev Shornikov
Marius Constantinescu
Menashe Zaaroor
Ilana Schlesinger
author_sort Alon Sinai
collection DOAJ
description Background. Magnetic resonance imaging (MRI)-guided focused ultrasound (FUS) VIM-thalamotomy has established efficacy and safety in tremor relief in patients with essential tremor and Parkinson’s disease. The efficacy and safety in patients with atypical parkinsonism have not been reported. Objective. To report on the efficacy and safety of FUS VIM-thalamotomy in 8 patients with parkinsonism, multiple system atrophy-Parkinsonian type (MSA-P) (n = 5), and dementia with Lewy bodies (DLB) (n = 3). Methods. Tremor was assessed in the treated hemibody using the Clinical Rating Scale for Tremor (CRST). The motor Unified MSA Rating Scale (UMSAR) was used in the MSA-P and motor sections of the Unified Parkinson’s Disease Rating Scale (UPDRS-III) in DLB patients. Cognition was measured using the Montreal Cognitive Assessment (MoCA). Results. In MSA-P and DLB patients, there was immediate tremor relief. CRST scores measured on the treated side improved compared to baseline. During the follow-up of up to 1 year tremor reduction persisted. The change in CRST scores at different time points did not reach statistical significance, probably due to the small sample size. Adverse events were transient and resolved within a year. Conclusions. In our experience, FUS VIM-thalamotomy was effective in patients with MSA-P and DLB. Larger, controlled studies are needed to verify our preliminary observations.
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spelling doaj.art-bffd6b898fb748d68ab932741d8fdf472024-03-13T00:00:02ZengHindawi LimitedParkinson's Disease2042-00802024-01-01202410.1155/2024/6643510Focused Ultrasound Thalamotomy for Tremor Relief in Atypical ParkisnsonismAlon Sinai0Maria Nassar1Lev Shornikov2Marius Constantinescu3Menashe Zaaroor4Ilana Schlesinger5Department of NeurosurgeryDepartment of NeurologyDepartment of NeurologyDepartment of NeurosurgeryDepartment of NeurosurgeryDepartment of NeurologyBackground. Magnetic resonance imaging (MRI)-guided focused ultrasound (FUS) VIM-thalamotomy has established efficacy and safety in tremor relief in patients with essential tremor and Parkinson’s disease. The efficacy and safety in patients with atypical parkinsonism have not been reported. Objective. To report on the efficacy and safety of FUS VIM-thalamotomy in 8 patients with parkinsonism, multiple system atrophy-Parkinsonian type (MSA-P) (n = 5), and dementia with Lewy bodies (DLB) (n = 3). Methods. Tremor was assessed in the treated hemibody using the Clinical Rating Scale for Tremor (CRST). The motor Unified MSA Rating Scale (UMSAR) was used in the MSA-P and motor sections of the Unified Parkinson’s Disease Rating Scale (UPDRS-III) in DLB patients. Cognition was measured using the Montreal Cognitive Assessment (MoCA). Results. In MSA-P and DLB patients, there was immediate tremor relief. CRST scores measured on the treated side improved compared to baseline. During the follow-up of up to 1 year tremor reduction persisted. The change in CRST scores at different time points did not reach statistical significance, probably due to the small sample size. Adverse events were transient and resolved within a year. Conclusions. In our experience, FUS VIM-thalamotomy was effective in patients with MSA-P and DLB. Larger, controlled studies are needed to verify our preliminary observations.http://dx.doi.org/10.1155/2024/6643510
spellingShingle Alon Sinai
Maria Nassar
Lev Shornikov
Marius Constantinescu
Menashe Zaaroor
Ilana Schlesinger
Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism
Parkinson's Disease
title Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism
title_full Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism
title_fullStr Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism
title_full_unstemmed Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism
title_short Focused Ultrasound Thalamotomy for Tremor Relief in Atypical Parkisnsonism
title_sort focused ultrasound thalamotomy for tremor relief in atypical parkisnsonism
url http://dx.doi.org/10.1155/2024/6643510
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