{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:55:49Z","timestamp":1786125349420,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:00:00Z","timestamp":1570665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>In recent years, transcranial Magnetic Resonance Imaging-guided Focused Ultrasound (tcMRgFUS) treatments for functional neurological disorders are giving a new thrust to the field of therapeutic brain lesioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To present the case of a patient affected by tremor combined with Parkinsonism who underwent a second tcMRgFUS thalamotomy because of relapsing tremor after a few months from the first tcMRgFUS treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A 72-yr-old, right-handed man, came to our observation because of a disabling tremor affecting his upper limbs, refusing any invasive surgical procedure and already treated by tcMRgFUS left Vim thalamotomy. However, clinical benefit had brief duration, as a progressive recurrence of tremor on the right upper limb was observed after a few months from the first treatment. Thus, the patient underwent a new left-sided tcMRgFUS procedure 6 mo after the former treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After the second procedure, an immediate and complete relief from tremor on the right upper limb was achieved with clinical benefit that persisted up to a 6-mo follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Since tcMRgFUS doesn\u2019t use ionizing radiations and it is incision-less, repeated and staged treatment procedures have always been hypothesized. Our report suggests that tcMRgFUS retreatment might actually be a feasible, safe, and effective option in selected patients in whom an optimal clinical outcome is not achieved after the first treatment session. However, future well-designed studies in large samples are needed to assess the possible risks of retreatment and the optimal timing of reintervention as well as eligibility and exclusion criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz300","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T03:15:11Z","timestamp":1570677311000},"page":"577-582","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Is Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound a Repeatable Treatment Option? Case Report of a Retreated Patient With Tremor Combined With Parkinsonism"],"prefix":"10.1227","volume":"18","author":[{"given":"Francesca","family":"Valentino","sequence":"first","affiliation":[{"name":"Neurology Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8691-3430","authenticated-orcid":false,"given":"Giuseppe","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Palermo, Italy"},{"name":"Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Paltermo, Italy"},{"name":"Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Palermo, Italy"},{"name":"Department of Brain and Behavioural Sciences, University of Pavia, Italy, IRCCS Mondino Foundation, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Maugeri","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Paltermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Giammalva","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Paltermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo Domenico","family":"Iacopino","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Paltermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Marrale","sequence":"additional","affiliation":[{"name":"Department of Physics and Chemistry, University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso Vincenzo","family":"Bartolotta","sequence":"additional","affiliation":[{"name":"Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4088-2020","authenticated-orcid":false,"given":"Cesare","family":"Gagliardo","sequence":"additional","affiliation":[{"name":"Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, University of Palermo, Palermo, 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