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Staged Bilateral MRI-Guided Focused Ultrasound Subthalamotomy for Parkinson Disease.
JAMA Neurol
June 2024
HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.
Importance: Unilateral magnetic resonance imaging (MRI)-guided focused ultrasound subthalamotomy (FUS-STN) improves cardinal motor features among patients with asymmetrical Parkinson disease (PD). The feasibility of bilateral FUS-STN is as yet unexplored.
Objective: To assess the safety and effectiveness of staged bilateral FUS-STN to treat PD.
Stereotactic Staged Asymmetric Bilateral Radiofrequency Lesioning for Parkinson's Disease.
Stereotact Funct Neurosurg
December 2023
Department of Functional Neurosurgery and Neuromodulation, SI "Romodanov Neurosurgery Institute NAMS of Ukraine", Kyiv, Ukraine.
Introduction: Parkinson's disease (PD) is one of the most common neurodegenerative progressive disorders. Despite the dominance of neurostimulation technology, stereotactic lesioning operations play a significant role in the treatment of PD. The aim of the study was to evaluate the effectiveness and safety of staged bilateral asymmetric radiofrequency (RF) stereotactic lesioning in a highly selected group of PD patients.
View Article and Find Full Text PDFThe role of high-intensity focused ultrasound as a symptomatic treatment for Parkinson's disease.
Mov Disord
September 2019
University of Maryland School of Medicine, Baltimore, Maryland, USA.
MR-guided focused ultrasound is a novel, minimally invasive surgical procedure for symptomatic treatment of PD. With this technology, the ventral intermediate nucleus, STN, and internal globus pallidus have been targeted for therapeutic cerebral ablation, while also minimizing the risk of hemorrhage and infection from more invasive neurosurgical procedures. In a double-blinded, prospective, sham-controlled randomized controlled trial of MR-guided focused ultrasound thalamotomy for treatment of tremor-dominant PD, 62% of treated patients demonstrated improvement in tremor scores from baseline to 3 months postoperatively, as compared to 22% in the sham group.
View Article and Find Full Text PDFDuring a decision process, the evidence supporting alternative options is integrated over time, and the choice is made when the accumulated evidence for one of the options reaches a decision threshold. Humans and animals have an ability to control the decision threshold, that is, the amount of evidence that needs to be gathered to commit to a choice, and it has been proposed that the subthalamic nucleus (STN) is important for this control. Recent behavioral and neurophysiological data suggest that, in some circumstances, the decision threshold decreases with time during choice trials, allowing overcoming of indecision during difficult choices.
View Article and Find Full Text PDFAim - to evaluate the efficacy of combined bilateral stereotactic destruction of subcortical nucleus - thalamotomy and contralateral subthalamotomy in patients with Parkinson disease. The study included 10 patients with PD, aged 54-73 (mean age 61.1±5.
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