{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:55:45Z","timestamp":1773402945064,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,18]],"date-time":"2021-04-18T00:00:00Z","timestamp":1618704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>During magnetic resonance\u2013guided focused ultrasound for essential or parkinsonian tremor, adverse events (headache, nausea\/vomiting, or anxiety) may alter the outcome of the procedure despite being mostly transient and mild.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim was to analyze the relationship between demographic, procedural, and anesthetic characteristics with magnetic resonance\/ultrasound\u2010related events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study at the Clinica Universidad de Navarra of patients undergoing thalamotomy with magnetic resonance\u2013guided focused ultrasound between September 2018 and October 2019. The anesthesia protocol included headache and nausea\/vomiting prophylaxis and rescue therapy. Dexmedetomidine was used for anxiolysis in some patients after thorough multidisciplinary assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 123 patients were included. Headache was directly related to skull density ratio (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and skull thickness (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Patients with a skull density ratio\u2009less than\u20090.48 had 3 times the odds of experiencing moderate or severe headache (odds ratio [OR],\u00a03.08; 95% confidence interval [CI], 1.21\u20137.82) and had a higher odds of aborting sonication due to pain. Sex was associated with increased nausea (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.007). Women had 4 times the odds of nausea than men (OR,\u00a04.4; 95% CI, 1.61\u201312.11). Dexmedetomidine did not reduce headache or nausea incidence. Patients who received dexmedetomidine had a higher number (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) and total minutes of sonication (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with lower skull density ratios and higher skull thicknesses could benefit from an aggressive analgesic prophylaxis. Women are more likely to experience nausea. Dexmedetomidine did not reduce headache and nausea, but increased the number and duration of sonications. Its exact effect on tremor is still unclear.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13210","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T13:44:56Z","timestamp":1617457496000},"page":"701-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors Associated with Headache and Nausea During Magnetic Resonance\u2013Guided Focused Ultrasound for Tremor"],"prefix":"10.1002","volume":"8","author":[{"given":"Elena","family":"Cacho\u2010Asenjo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Clinica Universidad de Navarra  Pamplona Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Honorato\u2010Cia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Clinica Universidad de Navarra  Pamplona Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge M.","family":"Nu\u00f1ez\u2010Cordoba","sequence":"additional","affiliation":[{"name":"Research Support Service, Central Clinical Trials Unit Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Fernandez\u2010Martinez","sequence":"additional","affiliation":[{"name":"Department of Radiology Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lain H.","family":"Gonzalez\u2010Quarante","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iciar","family":"Aviles\u2010Olmos","sequence":"additional","affiliation":[{"name":"Department of Neurology Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Aranzazu","family":"Gorospe","sequence":"additional","affiliation":[{"name":"Department of Neurology Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Panadero","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Cruz","family":"Rodr\u00edguez\u2010Oroz","sequence":"additional","affiliation":[{"name":"Department of Neurology Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Guridi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Clinica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3039-4798","authenticated-orcid":false,"given":"Antonio","family":"Martinez\u2010Simon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Clinica Universidad de Navarra  Pamplona Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600159"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1300962"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70048-6"},{"key":"e_1_2_8_5_1","unstructured":"FDA approves first MRI\u2010guided focused ultrasound device to treat essential tremor.https:\/\/www.fda.gov\/newsevents\/newsroom\/pressannouncements\/ucm510595.htm. Published July 11 2016."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3098"},{"key":"e_1_2_8_7_1","first-page":"8124624","article-title":"MRI\u2010guided focused ultrasound in Parkinson's disease: a review","volume":"2017","author":"Schlesinger I","year":"2017","journal-title":"Parkinsons Dis"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-020-01644-1"},{"key":"e_1_2_8_9_1","first-page":"9764807","article-title":"The role of the anesthesiologist during magnetic resonance\u2010guided focused ultrasound thalamotomy for tremor: a single\u2010center experience","volume":"2018","author":"Sinai A","year":"2018","journal-title":"Parkinsons Dis"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.11.FOCUS17628"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.10.JNS16758"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-307642"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3129"},{"key":"e_1_2_8_14_1","first-page":"1","article-title":"The relevance of skull density ratio in selecting candidates for transcranial MR\u2010guided focused ultrasound","volume":"3","author":"Boutet A","year":"2019","journal-title":"J Neurosurg"},{"key":"e_1_2_8_15_1","first-page":"1","article-title":"Impact of skull density ratio on efficacy and safety of magnetic resonance\u2010guided focused ultrasound treatment of essential tremor","volume":"26","author":"D'Souza M","year":"2019","journal-title":"J Neurosurg"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27726"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyz566"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.3.JNS142592"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2006.03.015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004833"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1618321"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.23.10.1105.32750"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000766"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14657"},{"key":"e_1_2_8_25_1","first-page":"1105","article-title":"Efficacy of intraoperative dexmedetomidine compared with placebo for surgery in adults: a meta\u2010analysis of published studies","volume":"81","author":"Le Bot A","year":"2015","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen320"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001620"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441732"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13210","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.13210","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:13:42Z","timestamp":1760951622000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.13210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,18]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1002\/mdc3.13210"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.13210","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,18]]},"assertion":[{"value":"2020-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}