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It targets the ventrointermedius (Vim) nucleus, which is the thalamic relay in a proprioceptive pathway, and contains kinesthetic cells. Although MRgFUS thalamotomy reduces some risks associated with more invasive surgeries, it still has side effects, such as balance and gait disturbances; these may be caused by the lesion impacting proprioception.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim was to quantitatively measure the effects of MRgFUS on proprioception and limb use in essential tremor patients. We hypothesized that this thalamotomy alters proprioception, because the sensorimotor Vim thalamus is lesioned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Proprioception was measured using the Kinarm exoskeleton robot in 18 patients. Data were collected pre\u2010operatively, and then 1\u2009day, 3\u2009months, and 1\u2009year after surgery. Patients completed four tasks, assessing motor coordination and postural control, goal\u2010directed movement and bimanual planning, position sense, and kinesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Immediately after surgery there were changes in posture speed (indicating tremor improvement), and in bimanual hand use, with the untreated limb being preferred. However, these measures returned to pre\u2010operative baseline over time. There were no changes in parameters related to proprioception. None of these measures correlated with lesion size or lesion\u2010overlap with the dentato\u2010rubro\u2010thalamic tract.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first quantitative assessment of proprioception and limb preference following MRgFUS thalamotomy. Our results suggest that focused\u2010ultrasound lesioning of the Vim thalamus does not degrade proprioception but alters limb preference. This change may indicate a required \u201crelearning\u201d in the treated limb, because the effect is transient. \u00a9 2023 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29350","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T14:42:27Z","timestamp":1679496147000},"page":"831-842","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Limb Preference Changes after Focused\u2010Ultrasound Thalamotomy for Tremor"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5749-2024","authenticated-orcid":false,"given":"Catherine A.","family":"Swytink\u2010Binnema","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Schulich School of Engineering, University of Calgary  Calgary Alberta Canada"},{"name":"Department of Clinical Neurosciences Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5403-7138","authenticated-orcid":false,"given":"Conrad P.","family":"Rockel","sequence":"additional","affiliation":[{"name":"Department of Radiology Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-0487","authenticated-orcid":false,"given":"Davide","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0609-981X","authenticated-orcid":false,"given":"Sean P.","family":"Dukelow","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-683X","authenticated-orcid":false,"given":"G. 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