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Clinical outcomes a...
Clinical outcomes after MRI connectivity-guided radiofrequency thalamotomy for tremor
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- Wirth, Thomas (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurology Department, Strasbourg University Hospital, Strasbourg, France; Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, France
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- Goedemans, Taco (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Neurosurgical Center, Amsterdam, Netherlands
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- Rajabian, Ali (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Dayal, Viswas (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurology Department, Auckland City Hospital, Auckland, New Zealand
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- Abuhusain, Hazem (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurosurgery Department, Royal Hallamshire Hospital, Sheffield, United Kingdom
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- Vijiaratnam, Nirosen (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Athauda, Dilan (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Hariz, Marwan (författare)
- Umeå universitet,Neurovetenskaper,Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Foltynie, Thomas (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Limousin, Patricia (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Akram, Harith (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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- Zrinzo, Ludvic (författare)
- Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom
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(creator_code:org_t)
- American Association of Neurological Surgeons, 2024
- 2024
- Engelska.
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Ingår i: Journal of Neurosurgery. - : American Association of Neurological Surgeons. - 0022-3085 .- 1933-0693. ; 140:4, s. 1148-1154
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
Ämnesord
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- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- connectivity-guided stereotactic neurosurgery
- essential tremor
- functional neurosurgery
- Parkinson's disease
- radiofrequency thalamotomy
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Wirth, Thomas
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Goedemans, Taco
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Rajabian, Ali
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Dayal, Viswas
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Abuhusain, Hazem
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Vijiaratnam, Nir ...
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Athauda, Dilan
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Hariz, Marwan
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Foltynie, Thomas
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Limousin, Patric ...
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Akram, Harith
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Zrinzo, Ludvic
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