{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T18:15:12Z","timestamp":1776449712067,"version":"3.51.2"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":333,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000692","name":"Royal College of Surgeons of Edinburgh","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000692","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004337","name":"St. George's, University of London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004337","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Radiofrequency thalamotomy is a neurosurgical management option for medically-refractory tremor. In this observational study, we evaluate the MRI features of the resultant lesion, their temporal dynamics, and how they vary depending on surgical factors. We report on lesion characteristics including size and location, as well as how these vary over time and across different MRI sequences. Data from 12 patients (2 essential tremor, 10 Parkinson\u2019s disease) who underwent unilateral radiofrequency thalamotomy for tremor were analysed. Lesion characteristics were compared across five structural sequences. Volumetric analysis of lesion features was performed at early (&amp;lt;5 weeks) and late (&amp;gt;5 months) timepoints by manual segmentation. Lesion location was determined after registration of lesions to standard space. All patients showed tremor improvement (clinical global impressions scale) postoperatively. Chronic side-effects included balance disturbances (n = 4) and worsening mobility due to parkinsonism progression (n = 1). Early lesion features including a necrotic core, cytotoxic oedema and perilesional oedema were best demarcated on T2-weighted sequences. Multiple lesions were associated with greater cytotoxic oedema compared with single lesions (T2-weighted mean volume: 537 \u00b1 112\u2005mm\u00b3 versus 302 \u00b1 146\u2005mm\u00b3, P = 0.028). Total lesion volume reduced on average by 90% between the early and late scans (T2-weighted mean volume: 918 \u00b1 517 versus 75 \u00b1 50\u2005mm\u00b3, t = 3.592, P = 0.023, n = 5), with comparable volumes demonstrated at \u223c6 months after surgery. Lesion volumes on susceptibility-weighted images were larger than those of T2-weighted images at later timepoints. Radiofrequency thalamotomy produces focused and predictable lesion imaging characteristics over time. T2-weighted scans distinguish between the early lesion core and oedema characteristics, while lesions may remain more visible on susceptibility-weighted images in the months following surgery. Scanning patients in the immediate postoperative period and then at 6 months is clinically meaningful for understanding the anatomical basis of the transient and permanent effects of thalamotomy.<\/jats:p>","DOI":"10.1093\/braincomms\/fcad329","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T01:40:22Z","timestamp":1701394822000},"source":"Crossref","is-referenced-by-count":7,"title":["Radiofrequency thalamotomy for tremor produces focused and predictable lesions shown on magnetic resonance images"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3401-5388","authenticated-orcid":false,"given":"Bryony K","family":"Ishihara","sequence":"first","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s, University of London , London SW17 0RE , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1789-2039","authenticated-orcid":false,"given":"Michael G","family":"Hart","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s, University of London , London SW17 0RE , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1783-3650","authenticated-orcid":false,"given":"Thomas R","family":"Barrick","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s, University of London , London SW17 0RE , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7135-3351","authenticated-orcid":false,"given":"Franklyn A","family":"Howe","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s, University of London , London SW17 0RE , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9834-3639","authenticated-orcid":false,"given":"Francesca","family":"Morgante","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s, University of London , London SW17 0RE , UK"},{"name":"Department of Experimental and Clinical Medicine, University of Messina , 98122 Messina , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0452-4023","authenticated-orcid":false,"given":"Erlick A","family":"Pereira","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s, University of London , London SW17 0RE , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"issue":"1","key":"2023120918472716200_fcad329-B1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s13311-013-0230-5","article-title":"The treatment of tremor","volume":"11","author":"Schneider","year":"2014","journal-title":"Neurotherapeutics"},{"issue":"3","key":"2023120918472716200_fcad329-B2","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3171\/jns.1986.65.3.0296","article-title":"Long-term follow-up results of selective VIM-thalamotomy","volume":"65","author":"Nagaseki","year":"1986","journal-title":"J Neurosurg"},{"issue":"4","key":"2023120918472716200_fcad329-B3","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1093\/brain\/106.4.1001","article-title":"The correlation between tremor characteristics and the predicted volume of effective lesions in stereotaxic nucleus ventralis intermedius thalamotomy","volume":"106","author":"Hirai","year":"1983","journal-title":"Brain"},{"issue":"7","key":"2023120918472716200_fcad329-B4","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1136\/jnnp-2017-316302","article-title":"Functional lesional neurosurgery for tremor: A systematic review and meta-analysis","volume":"89","author":"Schreglmann","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"7","key":"2023120918472716200_fcad329-B5","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1056\/NEJMoa1300962","article-title":"A pilot study of focused ultrasound thalamotomy for essential tremor","volume":"369","author":"Elias","year":"2013","journal-title":"N Engl J Med"},{"issue":"2","key":"2023120918472716200_fcad329-B6","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S0090-3019(97)00459-X","article-title":"Deep brain stimulation is preferable to thalamotomy for tremor suppression","volume":"49","author":"Tasker","year":"1998","journal-title":"Surg Neurol"},{"key":"2023120918472716200_fcad329-B7","volume-title":"Atlas for stereotaxy of the human brain","author":"Hassler","year":"1977","edition":"2nd edn"},{"issue":"Suppl 2","key":"2023120918472716200_fcad329-B8","doi-asserted-by":"crossref","first-page":"T44","DOI":"10.1016\/j.neuroimage.2009.04.018","article-title":"A high resolution and high contrast MRI for differentiation of subcortical structures for DBS targeting: The Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR)","volume":"47","author":"Sudhyadhom","year":"2009","journal-title":"Neuroimage"},{"issue":"1 Suppl","key":"2023120918472716200_fcad329-B9","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1016\/j.neuroimage.2008.10.055","article-title":"Bayesian analysis of neuroimaging data in FSL","volume":"45","author":"Woolrich","year":"2009","journal-title":"Neuroimage"},{"issue":"Suppl 1","key":"2023120918472716200_fcad329-B10","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.neuroimage.2004.07.051","article-title":"Advances in functional and structural MR image analysis and implementation as FSL","volume":"23","author":"Smith","year":"2004","journal-title":"Neuroimage"},{"issue":"3","key":"2023120918472716200_fcad329-B11","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.neuroimage.2011.02.046","article-title":"A Bayesian model of shape and appearance for subcortical brain segmentation","volume":"56","author":"Patenaude","year":"2011","journal-title":"Neuroimage"},{"issue":"2","key":"2023120918472716200_fcad329-B12","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1006\/nimg.2002.1132","article-title":"Improved optimization for the robust and accurate linear registration and motion correction of brain images","volume":"17","author":"Jenkinson","year":"2002","journal-title":"Neuroimage"},{"issue":"2","key":"2023120918472716200_fcad329-B13","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S1361-8415(01)00036-6","article-title":"A global optimisation method for robust affine registration of brain images","volume":"5","author":"Jenkinson","year":"2001","journal-title":"Med Image Anal"},{"key":"2023120918472716200_fcad329-B14","author":"McCarthy"},{"issue":"5","key":"2023120918472716200_fcad329-B15","doi-asserted-by":"crossref","first-page":"891","DOI":"10.3174\/ajnr.A3808","article-title":"Imaging findings in MR imaging-guided focused ultrasound treatment for patients with essential tremor","volume":"39","author":"Wintermark","year":"2014","journal-title":"Am J Neuroradiol"},{"issue":"3","key":"2023120918472716200_fcad329-B16","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/hbm.10062","article-title":"Fast robust automated brain extraction","volume":"17","author":"Smith","year":"2002","journal-title":"Hum Brain Mapp"},{"key":"2023120918472716200_fcad329-B17","volume-title":"Non-linear registration, aka spatial normalization","author":"Andersson","year":"2007"},{"key":"2023120918472716200_fcad329-B18","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.neuroimage.2017.05.015","article-title":"Toward defining deep brain stimulation targets in MNI space: A subcortical atlas based on multimodal MRI, histology and structural connectivity","volume":"170","author":"Ewert","year":"2018","journal-title":"Neuroimage"},{"issue":"5","key":"2023120918472716200_fcad329-B19","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/ana.26326","article-title":"Personalizing deep brain stimulation using advanced imaging sequences","volume":"91","author":"Neudorfer","year":"2022","journal-title":"Ann Neurol"},{"key":"2023120918472716200_fcad329-B20","doi-asserted-by":"crossref","first-page":"63","DOI":"10.12688\/wellcomeopenres.15191.1","article-title":"Raincloud plots: A multi-platform tool for robust data visualization","volume":"4","author":"Allen","year":"2019","journal-title":"Wellcome Open Res"},{"issue":"2","key":"2023120918472716200_fcad329-B21","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2017.11.FOCUS17587","article-title":"Volumetric analysis of magnetic resonance-guided focused ultrasound thalamotomy lesions","volume":"44","author":"Harary","year":"2018","journal-title":"Neurosurg Focus"},{"key":"2023120918472716200_fcad329-B22","doi-asserted-by":"crossref","first-page":"579","DOI":"10.3171\/jns.1991.74.4.0579","article-title":"Sequential magnetic resonance imaging following stereotactic radiofrequency ventralis lateralis thalamotomy","volume":"74","author":"Tomlinson","year":"1991","journal-title":"J Neurosurg"},{"issue":"9","key":"2023120918472716200_fcad329-B23","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1136\/jnnp-2020-322745","article-title":"Multimodal MRI for MRgFUS in essential tremor: Post-treatment radiological markers of clinical outcome","volume":"91","author":"Kapadia","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"3","key":"2023120918472716200_fcad329-B24","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/ons\/opab169","article-title":"Radiofrequency ablation for movement disorders: Risk factors for intracerebral hemorrhage, a retrospective analysis","volume":"21","author":"Horisawa","year":"2021","journal-title":"Oper Neurosurg"},{"issue":"2","key":"2023120918472716200_fcad329-B25","doi-asserted-by":"crossref","first-page":"315","DOI":"10.3171\/2017.4.JNS162803","article-title":"Clinical improvement associated with targeted interruption of the cerebellothalamic tract following MR-guided focused ultrasound for essential tremor","volume":"129","author":"Chazen","year":"2018","journal-title":"J Neurosurg"},{"key":"2023120918472716200_fcad329-B26","doi-asserted-by":"crossref","first-page":"102235","DOI":"10.1016\/j.nicl.2020.102235","article-title":"PSA and VIM DBS efficiency in essential tremor depends on distance to the dentatorubrothalamic tract","volume":"26","author":"Dembek","year":"2020","journal-title":"NeuroImage Clin"},{"issue":"12","key":"2023120918472716200_fcad329-B27","doi-asserted-by":"crossref","first-page":"3405","DOI":"10.1093\/brain\/awy278","article-title":"Focused ultrasound thalamotomy location determines clinical benefits in patients with essential tremor","volume":"141","author":"Boutet","year":"2018","journal-title":"Brain"},{"key":"2023120918472716200_fcad329-B28","doi-asserted-by":"crossref","first-page":"120193","DOI":"10.1016\/j.jns.2022.120193","article-title":"Focused ultrasound and other lesioning in the treatment of tremor","volume":"435","author":"Binder","year":"2022","journal-title":"J Neurol Sci"},{"key":"2023120918472716200_fcad329-B29","doi-asserted-by":"crossref","first-page":"162","DOI":"10.3171\/2014.8.JNS132603","article-title":"Different magnetic resonance imaging patterns after transcranial magnetic resonance\u2013guided focused ultrasound of the ventral intermediate nucleus of the thalamus and anterior limb of the internal capsule in patients with essential tremor or obsessive-compulsive disorder","volume":"122","author":"Jung","year":"2015","journal-title":"J Neurosurg"},{"issue":"5","key":"2023120918472716200_fcad329-B30","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1159\/000338249","article-title":"Impact of parameters of radiofrequency coagulation on volume of stereotactic lesion in pallidotomy and thalamotomy","volume":"90","author":"Hirabayashi","year":"2012","journal-title":"Stereotact Funct Neurosurg"},{"issue":"9","key":"2023120918472716200_fcad329-B31","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s00234-020-02433-9","article-title":"MRI follow-up after magnetic resonance-guided focused ultrasound for non-invasive thalamotomy: The neuroradiologist\u2019s perspective","volume":"62","author":"Keil","year":"2020","journal-title":"Neuroradiology"},{"issue":"12","key":"2023120918472716200_fcad329-B32","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1177\/0284185114559958","article-title":"Intracranial hemorrhage detection over time using susceptibility-weighted magnetic resonance imaging","volume":"56","author":"Schelhorn","year":"2015","journal-title":"Acta radiol"},{"issue":"9","key":"2023120918472716200_fcad329-B33","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.3390\/brainsci11091183","article-title":"Comprehensive evaluation of factors affecting tremor relapse after MRgFUS thalamotomy: A case\u2013control study","volume":"11","author":"Bruno","year":"2021","journal-title":"Brain Sci"},{"issue":"4","key":"2023120918472716200_fcad329-B34","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4329\/wjr.v10.i4.30","article-title":"Susceptibility weighted imaging: Clinical applications and future directions","volume":"10","author":"Halefoglu","year":"2018","journal-title":"World J Radiol"},{"issue":"1","key":"2023120918472716200_fcad329-B35","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s12984-021-00905-4","article-title":"A method for measuring time spent in bradykinesia and dyskinesia in people with Parkinson\u2019s disease using an ambulatory monitor","volume":"18","author":"Khodakarami","year":"2021","journal-title":"J Neuroeng Rehabil"}],"container-title":["Brain Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/braincomms\/advance-article-pdf\/doi\/10.1093\/braincomms\/fcad329\/53959163\/fcad329.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/braincomms\/article-pdf\/5\/6\/fcad329\/54182527\/fcad329.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/braincomms\/article-pdf\/5\/6\/fcad329\/54182527\/fcad329.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T18:47:48Z","timestamp":1702147668000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/braincomms\/article\/doi\/10.1093\/braincomms\/fcad329\/7455974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/braincomms\/fcad329","relation":{},"ISSN":["2632-1297"],"issn-type":[{"value":"2632-1297","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023]]},"published":{"date-parts":[[2023]]},"article-number":"fcad329"}}