Gray matter alterations in tremor-dominant Parkinson’s disease after MRgFUS thalamotomy are correlated with tremor improvement: a pilot study

Wang, Xiaoyu; Wang, Song; Lin, Ji; Zhang, Dong; Lu, Haoxuan; Xiong, Yongqin; Deng, Lei; Zhang, Dekang; Bian, Xiaowei; Zhou, Jiayou; Pan, Longsheng; Lou, Xin

doi:10.21037/qims-22-1403

Cited by 2 publications

(4 citation statements)

References 34 publications

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“…In three studies, total CRST scores were documented. Wang et al ( 35 ) observed an initial score of 45.89 ± 8.94, which significantly reduced to 17.89 ± 11.92 1 year post-surgery. Saporito et al ( 34 ) recorded a baseline score of 35.79 ± 14.39, which dropped to 23.03 ± 10.95 6 months postoperatively.…”

Section: Resultsmentioning

confidence: 98%

“…This meta-analysis included 20 studies published between 2014 and 2023 (5,9,11,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), encompassing 258 patients. Among these, two were retrospective studies and 18 were prospective.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three studies (21,27,29) documented cases of bilateral pallidothalamic tractotomy (PTT) ablation, while the rest reported unilateral ablations (5, 9, 11, 20, 22-26, 28, 30-36). Regarding the surgical targets: 11 studies (5,9,11,22,23,(30)(31)(32)(34)(35)(36) selected the VIM nucleus; PTT was chosen as the target in 4 studies (20,21,27,29); whereas STN (24,33) and GPI (25,28) were each selected in 2 studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…By 12 months, all adverse effects resolved. Other complications were discussed with the conditions of ET patients Wang et al (2023) (34). 0 Mild dizziness (n = 4), which was relieved within 24 h.Saporito et al (2023) post-treatment AE included dyskinesias (n = 3), clumsiness/weakness (n = 1), facial asymmetry (n = 1), dysarthria (n = 2), reduced verbal fluency (n = 1), unsteady gait (n = 1), weight gain (n = 3).…”

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confidence: 99%

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Efficacy and safety of magnetic resonance-guided focused ultrasound for Parkinson’s disease: a systematic review and meta-analysis

Tian,

Hu,

et al. 2023

Front. Neurol.

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ObjectiveMagnetic resonance imaging-guided focused ultrasound (MRgFUS) is a novel noninvasive treatment for drug-resistant Parkinson’s disease (PD) related tremor. This study aims to evaluate MRgFUS’s efficacy and safety in PD through a systematic review and meta-analysis, examining pre-and post-treatment MDS-UPDRSIII and/or CRST scores and associated adverse events.Materials and methodsWe conducted an extensive literature search across PubMed, Embase, Web of Science, and Cochrane Library databases, screening studies based on set criteria and analyzing MDS-UPDRSIII, CRST, and adverse events pre- and post-MRgFUS treatment.ResultsOut of 468 retrieved articles, 20 studies involving 258 patients, spanning 2014–2023, were included.17 studies indicated significant MDS-UPDRSIII score reductions post-MRgFUS treatment, while 3 showed significant CRST score declines. In the “on” medication state, pooled MDS-UPDRSIII scores at 1, 3, 6, and 12 months were 12.18 (95% CI: 5.83–18.52), 12.10 (95% CI: 8.22–15.97), 14.85 (95% CI: 9.28–20.41), and 20.65 (95% CI: 12.15–29.14) respectively. In the “off” state, scores were 11.45 (95% CI: −3.50-26.40), 14.71 (95% CI: 4.95–24.46), 21.52 (95% CI: 19.28–23.75), and 22.28 (95% CI: 15.26–29.30). Adverse events were typically mild and transient, with speech disturbances, ataxia, and sensory abnormalities being common post-operative neurological complications.ConclusionMRgFUS offers an effective and relatively safe treatment option for patients with drug-resistant PD-related tremor.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, No. CRD42023428332.

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Section: Resultsmentioning

confidence: 98%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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confidence: 99%

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Efficacy and safety of magnetic resonance-guided focused ultrasound for Parkinson’s disease: a systematic review and meta-analysis

Tian,

Hu,

et al. 2023

Front. Neurol.

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Beyond the CTCT: Remote Structural Changes After VIM-MRgFUS in Essential Tremor

Krauß,

Upadhyay,

Purrer

et al. 2024

Preprint

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Introduction: Essential tremor (ET) is a progressive disorder characterized by altered network connectivity between the cerebellum, thalamus, and cortical regions. Magnetic Resonanceguided Focused Ultrasound (MRgFUS) of the ventral intermediate nucleus (VIM) is an effective, minimally invasive treatment for ET. Increasing clinical use in ET facilitates research on structural changes after thalamic lesions. Methods: Forty-six patients with medication-resistant ET underwent unilateral VIM-MRgFUS. Voxel-based morphometry was applied to investigate Gray Matter Volume (GMV) changes over a time span of 6 months in the whole brain and the thalamus in particular to investigate local and distant effects. Results: Clinically, contralateral tremor significantly decreased by 68 % at 6 months following MRgFUS. In addition to local changes in thalamic nuclei (VIM, ventral lateral posterior, centromedian thalamus and pulvinar), VBM revealed remote GMV decreases in the ipsilesional insula and the anterior cingulate cortex as well as the contralesional middle occipital gyrus. Increased GMV was found in both temporal gyri. There was no significant correlation between regional GMV declines and tremor improvement. However, temporal volume increases were associated with improved motor-related functional abilities and quality of life outcomes. Conclusion: Our findings implicate distributed structural changes following unilateral VIMMRgFUS. Structural losses could reflect Wallerian degeneration of VIM output neurons or plasticity due to decreased sensory input following tremor improvement.

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Gray matter alterations in tremor-dominant Parkinson’s disease after MRgFUS thalamotomy are correlated with tremor improvement: a pilot study

Cited by 2 publications

References 34 publications

Efficacy and safety of magnetic resonance-guided focused ultrasound for Parkinson’s disease: a systematic review and meta-analysis

Efficacy and safety of magnetic resonance-guided focused ultrasound for Parkinson’s disease: a systematic review and meta-analysis

Beyond the CTCT: Remote Structural Changes After VIM-MRgFUS in Essential Tremor

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