{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:57:04Z","timestamp":1790287024295,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Focused ultrasound thalamotomy (FUS-T) was recently approved for the treatment of refractory essential tremor (ET). Despite its noninvasive approach, FUS-T reinitiated concerns about the adverse effects and long-term efficacy after lesioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To prospectively assess the outcomes of FUS-T in 10 ET patients using tractography-based targeting of the ventral intermediate nucleus (VIM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>VIM was identified at the intercommissural plane based on its neighboring tracts: the pyramidal tract and medial lemniscus. FUS-T was performed at the center of tractography-defined VIM. Tremor outcomes, at baseline and 3 mo, were assessed independently by the Tremor Research Group. We analyzed targeting coordinates, clinical outcomes, and adverse events. The FUS-T lesion location was analyzed in relation to unbiased thalamic parcellation using probabilisitic tractography. Quantitative diffusion-weighted imaging changes were also studied in fiber tracts of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The tractography coordinates were more anterior than the standard. Intraoperatively, therapeutic sonications at the tractography target improved tremor (&gt;50% improvement) without motor or sensory side effects. Sustained improvement in tremor was observed at 3 mo (tremor score: 18.3 \u00b1 6.9 vs 8.1 \u00b1 4.4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001). No motor weakness and sensory deficits after FUS-T were observed during 6-mo follow-up. Ataxia was observed in 3 patients. FUS-T lesions overlapped with the VIM parcellated with probablisitic tractography. Significant microstructural changes were observed in the white matter connecting VIM with cerebellum and motor cortex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This is the first report of prospective VIM targeting with tractography for FUS-T. These results suggest that tractography-guided targeting is safe and has satisfactory short-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyy020","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T15:15:22Z","timestamp":1516374922000},"page":"160-168","source":"Crossref","is-referenced-by-count":91,"title":["Prospective Tractography-Based Targeting for Improved Safety of Focused Ultrasound Thalamotomy"],"prefix":"10.1227","volume":"84","author":[{"given":"Vibhor","family":"Krishna","sequence":"first","affiliation":[{"name":"Center for Neuromodulation, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sammartino","sequence":"additional","affiliation":[{"name":"Center for Neuromodulation, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punit","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Center for Neuromodulation, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara K","family":"Changizi","sequence":"additional","affiliation":[{"name":"Center for Neuromodulation, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Bourekas","sequence":"additional","affiliation":[{"name":"De-partment of Radiology, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael V","family":"Knopp","sequence":"additional","affiliation":[{"name":"De-partment of Radiology, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Rezai","sequence":"additional","affiliation":[{"name":"Center for Neuromodulation, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,1]]},"reference":[{"key":"bib1-20231011","article-title":"A Review of the Current Therapies, Challenges, and Future Directions of Transcranial Focused Ultrasound TechnologyAdvances in Diagnosis and Treatment [published online ahead of print December 11, 2017]","author":"Krishna","journal-title":"JAMA Neurol"},{"issue":"6","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/ana.21801","article-title":"High-intensity focused ultrasound for noninvasive functional neurosurgery","volume":"66","author":"Martin","year":"2009","journal-title":"Ann Neurol"},{"key":"bib3-20231011","article-title":"FDA Approves First MRI-Guided Focused Ultrasound Device to Treat Essential Tremor"},{"issue":"4","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1002\/mds.22838","article-title":"How common is the most common adult movement disorder? 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