Stereotactic and Functional Neurosurgery

Sastre-Bataller I.a· Campins-Romeu M.a· Marcos-Carrión A.b· Gutiérrez-Martín A.c· Conde-Sardón R.c· Losada-López M.d· Santabárbara-Gómez J.M.b· León- Guijarro J.L.e· Belloch V.e· Lozano A.M.f· Martínez-Torres I.a

Author affiliations

aMovement Disorders Unit, Department of Neurology, Hospital La Fe, Valencia, Spain
bBiomedical Engineering Unit, Ascires Biomedical Group, Valencia, Spain
cUnit of Functional Neurosurgery, Department of Neurosurgery, Hospital La Fe, Valencia, Spain
dDepartment of Neurology, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
eNeuroradiology Unit, Ascires Biomedical Group, Valencia, Spain
fUniversity Health Network, Toronto, ON, Canada

Stereotact Funct Neurosurg

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Article / Publication Details

First-Page Preview

Received: January 16, 2022
Accepted: September 07, 2022
Published online: January 25, 2023

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Abstract

Introduction: Essential tremor (ET) is one of the most prevalent movement disorders in adults and may be highly disabling for some. Magnetic resonance image-guided high-intensity focused ultrasound (MRIgFUS) has been shown to control tremor efficaciously and with acceptable risk. To date, paresthesia and ataxia are the most common adverse effects (AE). Nevertheless, the impact of MRIgFUS thalamotomy on balance is not well established. Methods: Thirty-two patients underwent MRIgFUS for ET and completed 6 months of follow-up. Tremor severity and functional disability were assessed using the Essential Tremor Rating Scale and the Quality of Life in Essential Tremor Questionnaire. The Berg Balance Scale (BBS) was applied to objectively measure balance status. Results: All treatments were successful. The sonication target was 1–2 mm above the depth of the intercommissural line. Procedures lasted less the 2 h, with an average of 8 sonications per patient. Twenty-four patients were included in the tremor analysis. The hand tremor score was improved by 76% after 6 months of follow-up and 87% of patients self-reported marked improvement (≥75%). Disability scores showed marked improvement (78%), leading to a significant improvement in quality of life. At the final follow-up, 48% of the patients reported no side effects. When present, AE were generally transient and were considered mild in 96% of affected patients. Paresthesia and subjective feeling of unsteadiness were the most common persistent complaints (23% and 20%, respectively). Regarding objective ataxia, BBS scores remained stable throughout follow-up for most patients. Only 2 patients suffered a mild worsening of balance although no patients experienced moderate or severe ataxia. Conclusions: Subjective feeling of unsteadiness is one of the most frequent AE after MRIgFUS, although objective ataxia is infrequent and mild. Selecting the most appropriate lesion location and procedural parameters should increase treatment benefits while reducing side effects.

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First-Page Preview

Received: January 16, 2022
Accepted: September 07, 2022
Published online: January 25, 2023

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

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