{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:37:41Z","timestamp":1788633461560,"version":"build-2803163510"},"reference-count":60,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T00:00:00Z","timestamp":1737158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Magnetic resonance\u2013guided focused ultrasound (MRgFUS) thalamotomy of ventral intermediate (Vim) nucleus is useful to treat drug\u2010resistant tremor\u2010dominant Parkinson's disease (TdPD), but tremor relapse may occur. Predictors of relapse have been poorly investigated so far.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study is to evaluate the role of clinico\u2010demographic, procedural, and neuroradiological variables in determining clinical response, relapse, and adverse events (AEs) in TdPD after MRgFUS Vim\u2010thalamotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010two TdPD patients who consecutively underwent unilateral MRgFUS Vim\u2010thalamotomy were prospectively evaluated at baseline and after 24\u2009hours, 1 month, 6 months, and 12\u2009months using MDS\u2010UPDRS\u2010III in <jats:italic>off<\/jats:italic> and <jats:italic>on<\/jats:italic> medication conditions. AEs were collected at each evaluation. Lesion volume was calculated at 24\u2010hour magnetic resonance imaging (MRI). Patients with tremor improvement &lt;30% in <jats:italic>off<\/jats:italic> medication were considered nonresponders (when detected after 24\u2009hours) or relapsers (if detected from 1\u2010month visit onward).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients showed tremor improvement &gt;30% at 24 hours. Tremor relapse occurred in 12 patients (23%), exclusively during the first month after thalamotomy. Relapse was associated with younger age (<jats:italic>P<\/jats:italic>\u2009=\u20090.030) and smaller lesion volume (<jats:italic>P<\/jats:italic>\u2009=\u20090.030). At 1\u2009month, 22 patients (42%) had AEs; at 6 and 12\u2009months, AEs persisted in 19% and 6% of cases. AEs at 6\u2009months were associated with larger lesions (<jats:italic>P<\/jats:italic>\u2009=\u20090.018). All AEs were mild.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MRgFUS Vim\u2010thalamotomy is effective in treating tremor in TdPD. Relapse is associated with younger age and smaller lesion volume, but larger lesions make AEs more likely to persist. We suggest that a lesion volume between 145 and 220\u2009mm<jats:sup>3<\/jats:sup> on T1\u2010weighted MRI may be the therapeutic window that ensures tremor control without long\u2010lasting AEs. \u00a9 2025 The Author(s). <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.30093","type":"journal-article","created":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T07:25:00Z","timestamp":1737185100000},"page":"478-489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Magnetic Resonance\u2013Guided Focused Ultrasound Thalamotomy in a Prospective Cohort of 52 Patients with Parkinson's Disease: A Possible Critical Role of Age and Lesion Volume for Predicting Tremor Relapse"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1119-7518","authenticated-orcid":false,"given":"Arianna","family":"Braccia","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3555-5367","authenticated-orcid":false,"given":"Nico","family":"Golfr\u00e8 Andreasi","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2183-5077","authenticated-orcid":false,"given":"Francesco","family":"Ghielmetti","sequence":"additional","affiliation":[{"name":"Health Department Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1289-9573","authenticated-orcid":false,"given":"Domenico","family":"Aquino","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0973-7650","authenticated-orcid":false,"given":"Anna Paola","family":"Savoldi","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1990-1939","authenticated-orcid":false,"given":"Roberto","family":"Cilia","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8099-3142","authenticated-orcid":false,"given":"Roberta","family":"Telese","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"},{"name":"PhD Program in Neuroscience University of Milano\u2014Bicocca  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-8153","authenticated-orcid":false,"given":"Fabiana","family":"Colucci","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"},{"name":"Department of Neuroscience and Rehabilitation University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0229-8493","authenticated-orcid":false,"given":"Gianfranco","family":"Gaudiano","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-1035","authenticated-orcid":false,"given":"Luigi Michele","family":"Romito","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5917-7578","authenticated-orcid":false,"given":"Antonio Emanuele","family":"Elia","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-7540","authenticated-orcid":false,"given":"Valentina","family":"Leta","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"},{"name":"Parkinson's Centre of Excellence at King's College Hospital and King's College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2713-6357","authenticated-orcid":false,"given":"Vincenzo","family":"Levi","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Functional Neurosurgery Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5214-0548","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Castelli","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Functional Neurosurgery Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9688-4231","authenticated-orcid":false,"given":"Grazia","family":"Devigili","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5945-132X","authenticated-orcid":false,"given":"Sara","family":"Rinaldo","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5843-0965","authenticated-orcid":false,"given":"Mario","family":"Stanziano","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3105-3343","authenticated-orcid":false,"given":"Valentina","family":"Caldiera","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology and Interventional Neuroradiology Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Grisoli","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6716-2923","authenticated-orcid":false,"given":"Elisa Francesca Maria","family":"Ciceri","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology and Interventional Neuroradiology Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6035-9715","authenticated-orcid":false,"given":"Roberto","family":"Eleopra","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.5334\/tohm.712"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3098"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600159"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25126"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2022.6.JNS212483"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1301240"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000002518"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29569"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29658"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29965"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25878"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-322745"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1356613"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2022.105230"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.10.JNS16758"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27348"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13662"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25383"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29200"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cireng.2023.02.002"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23429"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12921"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13681"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13911"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.015"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3808"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2022.2147826"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20147"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10359"},{"key":"e_1_2_9_33_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2022"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v014.i09"},{"key":"e_1_2_9_35_1","volume-title":"Using the R Commander: A Point\u2010and\u2010Click Interface or R","author":"Fox J","year":"2017"},{"key":"e_1_2_9_36_1","unstructured":"FoxJ Bouchet\u2010ValatM.Rcmdr: R Commander;2022. R package version 2.8\u20100."},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-023-00543-8"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004268"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.11.FOCUS17614"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/219149"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.786734"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.21037\/qims-22-1403"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11154502"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29751"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91175-T"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0041598"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2021.07.051"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21793"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2017.02.011"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12469-z"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2022.120196"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10579"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx376"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.56.3.334"},{"key":"e_1_2_9_56_1","first-page":"271","volume-title":"Parkinson's Disease and Movement Disorders","author":"Fahn S","year":"1993"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.47.8.831"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1362712"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy278"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-10431-7"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13126"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.30093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:21:00Z","timestamp":1760952060000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.30093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,18]]},"references-count":60,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/mds.30093"],"URL":"https:\/\/doi.org\/10.1002\/mds.30093","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,18]]},"assertion":[{"value":"2024-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}