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"Quality over quantity:" smaller, targeted lesions optimize quality of life outcomes after MR-guided focused ultrasound thalamotomy for essential tremor.
Front Neurol
November 2024
Department of Neurosurgery, Stanford University, Stanford, CA, United States.
Introduction: MRI-guided focused ultrasound (MRgFUS) thalamotomy of the nucleus ventralis intermedius (VIM) has emerged as a powerful and safe treatment modality for refractory essential tremor. While the efficacy of this technique has been extensively described, much remains unclear about how to optimize MRgFUS for patient quality of life (QoL), which may depend as much on a patient's adverse effect profile as on the magnitude of tremor suppression. Diffusion tensor imaging (DTI) has been used to help guide targeting strategies but can pose certain challenges for scalability.
View Article and Find Full Text PDFFragile X-associated tremor/ataxia syndrome treated with multitarget deep brain stimulation.
BMJ Case Rep
May 2024
Neurosurgery Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a progressive hereditary neurodegenerative disorder which causes intention tremor and cerebellar ataxia. It typically affects the ageing population. Deep brain stimulation (DBS) is widely accepted in the treatment of common movement disorders and has been trialled in treating rare and complex neurodegenerative disorders.
View Article and Find Full Text PDFFocused Ultrasound for Treatment of Movement Disorders: A Review of Non-Food and Drug Administration Approved Indications.
Stereotact Funct Neurosurg
April 2024
Department of Neurological Surgery, UCSF, San Francisco, California, USA.
Introduction: MRI-guided focused ultrasound (FUS) is an incisionless thermo-ablative procedure that may be used to treat medication-refractory movement disorders, with a growing number of potential anatomic targets and clinical applications. As of this article's publication, the only US Food and Drug Administration (FDA)-approved uses of FUS for movement disorders are thalamotomy for essential tremor (ET) and tremor-dominant Parkinson's Disease (PD), and pallidotomy for other cardinal symptoms of PD. We present a state-of-the-art review on all non-FDA approved indications of FUS for movement disorders, beyond the most well-described indications of ET and PD.
View Article and Find Full Text PDFLong-term follow-up of task-specific tremor after thalamotomy: a retrospective observational study.
Ann Clin Transl Neurol
February 2024
Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
Objective: This study aimed to report the long-term results of thalamotomy in 23 patients with task-specific tremor.
Methods: Data of 23 patients with task-specific tremor who underwent ventralis intermedius nucleus and posterior part of ventro-oral nucleus thalamotomy at the Tokyo Women's Medical University Hospital between 2010 and 2022 were retrospectively analyzed. To evaluate neurological conditions, the severity of task-specific tremor was divided into 0 (no tremor), 1 (slightly tremulous), 2 (moderately tremulous), 3 (accomplishing tasks with great difficulty), and 4 (unable to complete tasks).
Effects of ventro-oral thalamic deep brain stimulation in a patient with musician's dystonia: illustrative case.
J Neurosurg Case Lessons
October 2023
Departments of1Neurosurgery.
Background: Musician's dystonia is a task-specific focal hand dystonia characterized by involuntary contraction of muscles while playing a musical instrument. Current treatment options are often insufficient.
Observations: We present the effects of ventro-oral thalamic deep brain stimulation in a patient with musician's dystonia.
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