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Evangelia Tsolaki, Angela Downes, William Speier, W Jeff Elias, Nader Pouratian
Magnetic Resonance-guided Focused UltraSound (MRgFUS) offers an incisionless approach to treat essential tremor (ET). Due to lack of evident internal anatomy on traditional structural imaging, indirect targeting must still be used to localize the lesion. Here, we investigate the potential predictive value of probabilistic tractography guided thalamic targeting by defining how tractography-defined targets, lesion size and location, and clinical outcomes interrelate. MR imaging and clinical outcomes from 12 ET patients that underwent MRgFUS thalamotomy in a pilot study at the University of Virginia were evaluated in this analysis...
2018: NeuroImage: Clinical
Alfonso Fasano, Andres M Lozano
No abstract text is available yet for this article.
February 27, 2018: Neurology
Narayanaswamy Venketasubramanian
No abstract text is available yet for this article.
February 27, 2018: Neurology
Chafic Karam, Robert C Griggs
No abstract text is available yet for this article.
February 27, 2018: Neurology
Constantin Tuleasca, Elena Najdenovska, Jean Régis, Tatiana Witjas, Nadine Girard, Jérôme Champoudry, Mohamed Faouzi, Jean-Philippe Thiran, Meritxell Bach Cuadra, Marc Levivier, Dimitri Van De Ville
OBJECTIVE: To evaluate functional connectivity (FC) of the ventro-lateral thalamus, a common target for drug-resistant essential tremor (ET), resting-state data were analyzed before and 1 year after stereotactic radiosurgical thalamotomy (SRS-T), and compared against healthy controls (HC). METHODS: 17 consecutive patients and 10 HC were enrolled. Tremor network was investigated using ventro-lateral ventral (VLV) nucleus as region-of-interest (ROI), extracted using automated segmentation from pretherapeutic diffusion MRI...
February 20, 2018: World Neurosurgery
Nuria E Martínez-Moreno, Arjun Sahgal, Antonio De Salles, Motohiro Hayashi, Marc Levivier, Lijun Ma, Ian Paddick, Jean Régis, Sam Ryu, Ben J Slotman, Roberto Martínez-Álvarez
OBJECTIVE The aim of this systematic review is to offer an objective summary of the published literature relating to stereotactic radiosurgery (SRS) for tremor and consensus guideline recommendations. METHODS This systematic review was performed up to December 2016. Article selection was performed by searching the MEDLINE (PubMed) and EMBASE electronic bibliographic databases. The following key words were used: "radiosurgery" and "tremor" or "Parkinson's disease" or "multiple sclerosis" or "essential tremor" or "thalamotomy" or "pallidotomy...
February 23, 2018: Journal of Neurosurgery
Tony R Wang, Robert F Dallapiazza, Shayan Moosa, Diane Huss, Binit B Shah, W Jeffrey Elias
BACKGROUND: A recent randomized controlled trial investigating unilateral MRI-guided focused ultrasound (FUS) for essential tremor demonstrated efficacy. The long-term durability of this thalamotomy, however, is unknown. Furthermore, the feasibility of stimulating a previously lesioned target such as the thalamic nucleus ventralis intermedius (Vim) is poorly understood. We report a case of tremor recurrence, following an initially successful FUS thalamotomy, in which Vim-DBS was subsequently utilized to regain tremor control...
February 12, 2018: Stereotactic and Functional Neurosurgery
Takashi Asahi, Takaomi Taira, Kiyonobu Ikeda, Jiro Yamamoto, Shuji Sato
Ventro-oral (Vo) thalamotomy is effective in patients with focal task-specific dystonias (FTSDs), but only in those with upper-limb symptoms. We describe a patient with drummer's dystonia who completely recovered after Vo thalamotomy. A 37-year-old man who started playing drums at 14 began having difficulty performing fine movements with his right foot when drumming at 22. He experienced right hand cramps while drumming 3 months before visiting our hospital. He was diagnosed with FTSD. Left Vo thalamotomy was performed, which led to complete improvement of symptoms...
February 8, 2018: Acta Neurochirurgica
Constantin Tuleasca, Jean Régis, Elena Najdenovska, Tatiana Witjas, Nadine Girard, Jérôme Champoudry, Mohamed Faouzi, Jean-Philippe Thiran, Meritxell Bach Cuadra, Marc Levivier, Dimitri Van De Ville
OBJECTIVE: To correlate pretherapeutic resting-state functional MRI (rs-fMRI) measures with pretherapeutic head tremor presence and/or further improvement 1 year after stereotactic radiosurgical thalamotomy (SRS-T) for essential tremor (ET). METHODS: We prospectively collected head tremor scores (range 0-3) and rs-fMRI data for a cohort of 17 consecutive ET patients in pretherapeutic and 1 year after SRS-T states. We additionally acquired rs-fMRI data for a healthy control (HC) group (n=12)...
January 31, 2018: World Neurosurgery
Na Young Jung, Chang Kyu Park, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang
OBJECTIVE Although neurosurgical procedures are effective treatments for controlling involuntary tremor in patients with essential tremor (ET), they can cause cognitive decline, which can affect quality of life (QOL). The purpose of this study is to assess the changes in the neuropsychological profile and QOL of patients following MR-guided focused ultrasound (MRgFUS) thalamotomy for ET. METHODS The authors prospectively analyzed 20 patients with ET who underwent unilateral MRgFUS thalamotomy at their institute in the period from March 2012 to September 2014...
February 2018: Neurosurgical Focus
Domenico Gerardo Iacopino, Cesare Gagliardo, Antonella Giugno, Giuseppe Roberto Giammalva, Alessandro Napoli, Rosario Maugeri, Francesca Graziano, Francesca Valentino, Giuseppe Cosentino, Marco D'Amelio, Tommaso Vincenzo Bartolotta, Carlo Catalano, Brigida Fierro, Massimo Midiri, Roberto Lagalla
OBJECTIVE Transcranial magnetic resonance-guided focused ultrasound surgery (tcMRgFUS) is one of the emerging noninvasive technologies for the treatment of neurological disorders such as essential tremor (ET), idiopathic asymmetrical tremor-dominant Parkinson's disease (PD), and neuropathic pain. In this clinical series the authors present the preliminary results achieved with the world's first tcMRgFUS system integrated with a 1.5-T MRI unit. METHODS The authors describe the results of tcMRgFUS in a sample of patients with ET and with PD who underwent the procedure during the period from January 2015 to September 2017...
February 2018: Neurosurgical Focus
Aaron E Bond, W Jeffrey Elias
OBJECTIVE The goal of this study was to improve the predictability of lesion size during focused ultrasound (FUS) thalamotomy procedures. METHODS Treatment profiles and T2-weighted MRI (T2 MRI) studies obtained in 63 patients who participated in 3 clinical trials of FUS thalamotomy from February 2011 to March 2015 were reviewed retrospectively. Four damage estimate models were compared with lesion sizes measured on postprocedural T2 MRI. Models were based on 54°C × 3 seconds, 240 cumulative equivalent minutes at 43°C, and simple thermal threshold analysis, which recorded the maximum diameter that reached a temperature of at least 51°C and 54°C...
February 2018: Neurosurgical Focus
Maya Harary, Walid I Essayed, Pablo A Valdes, Nathan McDannold, G Rees Cosgrove
OBJECTIVE Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy was recently approved for use in the treatment of medication-refractory essential tremor (ET). Previous work has described lesion appearance and volume on MRI up to 6 months after treatment. Here, the authors report on the volumetric segmentation of the thalamotomy lesion and associated edema in the immediate postoperative period and 1 year following treatment, and relate these radiographic characteristics with clinical outcome. METHODS Seven patients with medication-refractory ET underwent MRgFUS thalamotomy at Brigham and Women's Hospital and were monitored clinically for 1 year posttreatment...
February 2018: Neurosurgical Focus
Nasser Mohammed, Devi Patra, Anil Nanda
OBJECTIVE Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel technique that uses high-intensity focused ultrasound to achieve target ablation. Like a lens focusing the sun's rays, the ultrasound waves are focused to generate heat. This therapy combines the noninvasiveness of Gamma Knife thalamotomy and the real-time ablation of deep brain stimulation with acceptable complication rates. The aim of this study was to analyze the overall outcomes and complications of MRgFUS in the treatment of essential tremor (ET)...
February 2018: Neurosurgical Focus
Tony R Wang, Aaron E Bond, Robert F Dallapiazza, Aaron Blanke, David Tilden, Thomas E Huerta, Shayan Moosa, Francesco U Prada, W Jeffrey Elias
Although the use of focused ultrasound (FUS) in neurosurgery dates to the 1950s, its clinical utility was limited by the need for a craniotomy to create an acoustic window. Recent technological advances have enabled efficient transcranial delivery of US. Moreover, US is now coupled with MRI to ensure precise energy delivery and monitoring. Thus, MRI-guided transcranial FUS lesioning is now being investigated for myriad neurological and psychiatric disorders. Among the first transcranial FUS treatments is thalamotomy for the treatment of various tremors...
February 2018: Neurosurgical Focus
Ying Meng, Nir Lipsman
No abstract text is available yet for this article.
February 2018: Neurosurgical Focus
Constantin Tuleasca, Elena Najdenovska, Jean Régis, Tatiana Witjas, Nadine Girard, Jérôme Champoudry, Mohamed Faouzi, Jean-Philippe Thiran, Meritxell Bach Cuadra, Marc Levivier, Dimitri Van De Ville
INTRODUCTION: Essential tremor (ET) is the most common movement disorder. Drug-resistant ET can benefit from standard surgical stereotactic procedures (deep brain stimulation, thalamotomy) or minimally invasive high-intensity focused ultrasound (HIFU) or stereotactic radiosurgical thalamotomy (SRS-T). Resting-state fMRI (rs-fMRI) is a non-invasive imaging method acquired in absence of a task. We examined whether rs-fMRI correlates with tremor score on the treated hand (TSTH) improvement 1 year after SRS-T...
January 15, 2018: Acta Neurochirurgica
Benjamin B Whiting, Alexander C Whiting, Donald M Whiting
The use of deep brain stimulation (DBS) of the thalamus has been proven to be a safe and efficacious treatment for the management of many diseases. The most common indication for thalamic DBS remains essential tremor (ET), one of the most common movement disorders in the world. ET patients should be considered for surgical intervention when their tremor has demonstrated to be refractory to medication, a characteristic estimated to be present in roughly 50% of ET cases. Advantages of DBS over thalamotomy include its reversibility, the ability to adjust stimulation settings to optimize efficacy and minimize side effects, the ability to perform bilateral procedures safely, and an association with a lower risk of postoperative cognitive problems...
2018: Progress in Neurological Surgery
Edward A Monaco Iii, Samuel S Shin, Ajay Niranjan, L Dade Lunsford
Tremor is a common movement disorder that can be disabling, and its initial treatment is in the form of medical therapies. Often patients are refractory and seek surgical intervention. Treatment options for these patients include surgical radiofrequency thalamotomy and deep brain stimulation. There are a subset of patients who, for various reasons, are not candidates for open surgical procedures, or who opt to avoid them. For these patients, radiosurgical thalamotomy is a safe and useful alternative. Herein, we provide a review of the use of radiosurgical thalamotomy for the treatment of medically refractory tremor by discussing its history, defining the technique and its indications, evaluating its efficacy, and exploring its complications and shortcomings...
2018: Progress in Neurological Surgery
C Tuleasca, E Najdenovska, J Régis, T Witjas, N Girard, J Champoudry, M Faouzi, J-P Thiran, M Bach Cuadra, M Levivier, D Van De Ville
OBJECTIVE: Essential tremor (ET) represents the most common movement disorder. Drug-resistant ET can benefit from standard stereotactic procedures (deep brain stimulation or radiofrequency thalamotomy) or alternatively minimally invasive high-focused ultrasound or radiosurgery. All aim at same target, thalamic ventro-intermediate nucleus (Vim). METHODS: The study included a cohort of 17 consecutive patients, with ET, treated only with left unilateral stereotactic radiosurgical thalamotomy (SRS-T) between September 2014 and August 2015...
January 7, 2018: Acta Neurologica Scandinavica
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