Clinical outcomes after MRI connectivity-guided radiofrequency thalamotomy for tremor
OBJECTIVE: Radiofrequency thalamotomy (RF-T) is an established treatment for refractory tremor. It is unclear whether connectivity-guided targeting strategies could further augment outcomes. The aim of this study was to evaluate the efficacy and safety of MRI connectivity-guided RF-T in severe tremor.
METHODS: Twenty-one consecutive patients with severe tremor (14 with essential tremor [ET], 7 with Parkinson's disease [PD]) underwent unilateral RF-T at a single institution between 2017 and 2020. Connectivity-derived thalamic segmentation was used to guide targeting. Changes in the Fahn-Tolosa-Marin Rating Scale (FTMRS) were recorded in treated and nontreated hands as well as procedure-related side effects.
RESULTS: Twenty-three thalamotomies were performed (with 2 patients receiving a repeated intervention). The mean postoperative assessment time point was 14.1 months. Treated-hand tremor scores improved by 63.8%, whereas nontreated-hand scores deteriorated by 10.1% (p < 0.01). Total FTMRS scores were significantly better at follow-up compared with baseline (mean 34.7 vs 51.7, p = 0.016). Baseline treated-hand tremor severity (rho = 0.786, p < 0.01) and total FTMRS score (rho = 0.64, p < 0.01) best correlated with tremor improvement. The most reported side effect was mild gait ataxia (n = 11 patients).
CONCLUSIONS: RF-T guided by connectivity-derived segmentation is a safe and effective option for severe tremor in both PD and ET.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:140 |
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| Enthalten in: |
Journal of neurosurgery - 140(2024), 4 vom: 01. Apr., Seite 1148-1154 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wirth, Thomas [VerfasserIn] |
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| Links: |
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| Themen: |
Connectivity-guided stereotactic neurosurgery |
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| Anmerkungen: |
Date Completed 03.04.2024 Date Revised 03.04.2024 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.3171/2023.7.JNS222744 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363488707 |
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| 520 | |a OBJECTIVE: Radiofrequency thalamotomy (RF-T) is an established treatment for refractory tremor. It is unclear whether connectivity-guided targeting strategies could further augment outcomes. The aim of this study was to evaluate the efficacy and safety of MRI connectivity-guided RF-T in severe tremor | ||
| 520 | |a METHODS: Twenty-one consecutive patients with severe tremor (14 with essential tremor [ET], 7 with Parkinson's disease [PD]) underwent unilateral RF-T at a single institution between 2017 and 2020. Connectivity-derived thalamic segmentation was used to guide targeting. Changes in the Fahn-Tolosa-Marin Rating Scale (FTMRS) were recorded in treated and nontreated hands as well as procedure-related side effects | ||
| 520 | |a RESULTS: Twenty-three thalamotomies were performed (with 2 patients receiving a repeated intervention). The mean postoperative assessment time point was 14.1 months. Treated-hand tremor scores improved by 63.8%, whereas nontreated-hand scores deteriorated by 10.1% (p < 0.01). Total FTMRS scores were significantly better at follow-up compared with baseline (mean 34.7 vs 51.7, p = 0.016). Baseline treated-hand tremor severity (rho = 0.786, p < 0.01) and total FTMRS score (rho = 0.64, p < 0.01) best correlated with tremor improvement. The most reported side effect was mild gait ataxia (n = 11 patients) | ||
| 520 | |a CONCLUSIONS: RF-T guided by connectivity-derived segmentation is a safe and effective option for severe tremor in both PD and ET | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Parkinson’s disease | |
| 650 | 4 | |a connectivity-guided stereotactic neurosurgery | |
| 650 | 4 | |a essential tremor | |
| 650 | 4 | |a functional neurosurgery | |
| 650 | 4 | |a radiofrequency thalamotomy | |
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| 700 | 1 | |a Hariz, Marwan |e verfasserin |4 aut | |
| 700 | 1 | |a Foltynie, Thomas |e verfasserin |4 aut | |
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| 700 | 1 | |a Akram, Harith |e verfasserin |4 aut | |
| 700 | 1 | |a Zrinzo, Ludvic |e verfasserin |4 aut | |
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