Aim - 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±5.2 years). The time between two surgeries ranged from 1 to 5 years (mean 2.5±0.5 years). The surgeries were conducted on CRW Radionics stereotactic system using StereoPlan, Atlas (Radionics) andFraimLink (Medtronic) software for target calculating. The neuropsychological status was assessed by UPDRS II, Hoehn and Yahr scale, Schwab and England scale, MMSE. The postoperative follow-up was from 6 months to 5.5 years (mean 3.2±0.9 years). After surgeries tremor stopped or significantly regressed in 9 (90.0%) patients, muscle tone returned to normal in 8 (80.0%) cases and in 7 (70.0%) bradykinesia partially regressed. The increase of motor activity was observed in 8 (80.0%) patients. Levodopa-induced dyskinesia stopped in 5 (50.0%) patients and motor fluctuations regressed in 4 of 5 (80.0%) patients. After the surgery the dose of levodopa decreased on average by 36% - from 885±245 mg/day to 570±165 mg/day. The indices of Schwab and England Activities of daily living improved from 56.1% to 80.7%. The postoperative complications were observed in2 (20.0%) cases. Our results demonstrate that bilateral ablative surgery is an effective and safe method of treatment of PD. Stereotactic radiofrequency thalamotomy and contralateral subthalamotomyimprove overall motor function, increase patient's mobility, allow patients to reduce levodopa dose and improve the quality of life.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Damage to the Contralateral Thalamus after Magnetic Resonance Imaging-guided, Focused Ultrasound Surgery for Essential Tremor: A Case Report.
NMC Case Rep J
November 2024
Department of Neurosurgery, Fukuoka Neurosurgical Hospital, Fukuoka, Fukuoka, Japan.
This study involved a 73-year-old man who underwent thalamotomy via magnetic resonance imaging (MRI)-guided, focused ultrasound surgery, in which the left thalamic ventral intermediate nucleus is targeted, as a treatment for action tremor of the right-hand fingers caused by essential tremor. Following treatment, the action tremor of the right-hand fingers mostly disappeared, but new symptoms of paresis and sensory impairment were evident in the left upper and lower limbs. Head MRI exhibited a hyperintense lesion on diffusion-weighted imaging and a decreased apparent diffusion coefficient in a region of the right thalamus following the anterior choroidal artery, medial posterior choroidal artery, and thalamogeniculate artery territory.
View Article and Find Full Text PDFMinimum and early high-energy sonication protocol of MR-guided focused ultrasound thalamotomy for low-skull density ratio patients with essential tremor and Parkinson's disease.
Neurosurg Focus
September 2024
Departments of1Neurosurgery.
Objective: MR-guided focused ultrasound (MRgFUS) thalamotomy is an incisionless neurosurgical treatment for patients with medically refractory essential tremor and tremor-dominant Parkinson's disease. A low skull density ratio (SDR) < 0.40 is a known risk factor for treatment failure.
View Article and Find Full Text PDFSafety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor: An Open-Label Clinical Trial.
JAMA Neurol
September 2024
Department of Neurology, West Virginia University, Morgantown.
Importance: Unilateral magnetic resonance-guided focused ultrasound ablation of ventralis intermedius nucleus of the thalamus for essential tremor reduces tremor on 1 side, but untreated contralateral or midline symptoms remain limiting for some patients. Historically, bilateral lesioning produced unacceptable risks and was supplanted by deep brain stimulation; increasing acceptance of unilateral focused ultrasound lesioning has led to interest in a bilateral option.
Objective: To evaluate the safety and efficacy of staged, bilateral focused ultrasound thalamotomy.
Early cortico-muscular coherence and cortical network changes in Parkinson's patients treated with MRgFUS.
Front Neurol
March 2024
Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Introduction: To investigate cortical network changes using Magnetoencephalography (MEG) signals in Parkinson's disease (PD) patients undergoing Magnetic Resonance-guided Focused Ultrasound (MRgFUS) thalamotomy.
Methods: We evaluated the MEG signals in 16 PD patients with drug-refractory tremor before and after 12-month from MRgFUS unilateral lesion of the ventralis intermediate nucleus (Vim) of the thalamus contralateral to the most affected body side. We recorded patients 24 h before (T0) and 24 h after MRgFUS (T1).
Unilateral Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy Thalamotomy for Essential Tremor.
Mov Disord
June 2024
Expert Center for Parkinson's Disease, Amiens Picardie University Hospital, Amiens, France.
Background: Essential tremor (ET) affects numerous adults, impacting quality of life (QOL) and often defying pharmacological treatment. Surgical interventions like deep brain stimulation (DBS) and lesional approaches, including radiofrequency, gamma-knife radiosurgery, and magnetic resonance imaging (MRI)-guided focused ultrasound, offer solutions but are not devoid of limitations.
Objectives: This retrospective, single-center, single-blinded pilot study aimed to assess the safety and efficacy of unilateral MRI-guided laser interstitial thermal therapy (MRIg-LITT) thalamotomy for medically intractable ET.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!