{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:54:50Z","timestamp":1791190490741,"version":"4.1.0"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Stereotact Funct Neurosurg"],"abstract":"<jats:p>Background: Traditional targeting based on the anterior commissure\u2013posterior commissure (AC\u2013PC) line in MR-guided focused ultrasound (MRgFUS) thalamotomy does not account for individual thalamic asymmetry, potentially leading to suboptimal outcomes or adverse effects. Objective: To investigate whether habenular torsion, an anatomical marker of thalamic asymmetry, predicts clinical outcomes and sensory side effects following ventral intermediate nucleus (Vim) thalamotomy. Methods: We retrospectively analyzed 157 patients (essential tremor: 121; Parkinson's disease: 36) who underwent unilateral MRgFUS thalamotomy. Angular metrics, including the Torsion Index (inter-hemispheric habenular angular difference) and the Lesion\u2013Habenula difference (based on a lesion axis originating from the midline-habenula intersection), were measured on axial MRI 2.0 mm dorsal to the AC\u2013PC line. Tremor improvement (CRST) and ventralis caudalis (Vc)-related sensory symptoms were evaluated immediately and at the 1-year follow-up. Results: Tremor improved by over 70% immediately after treatment, with no significant difference between torsion groups (p = 0.490), indicating that torsion did not compromise efficacy. However, Anterior Torsion (Torsion Index &lt; 0) was significantly associated with a higher incidence of both immediate (43.2% vs. 14.5%, p &lt; 0.001) and persistent (25.0% vs. 5.1%, p = 0.001) Vc symptoms. ROC analysis identified the Torsion Index (AUC 0.72\u20130.75) and Lesion\u2013Habenula difference (AUC 0.76\u20130.84) as robust predictors for sensory side effects, significantly outperforming the standard AP ratio (AUC 0.47\u20130.50). Conclusion: Habenular torsion is a critical anatomical biomarker for predicting post-operative sensory complications. Incorporating the Torsion Index into preoperative planning allows for a personalized, anatomy-driven targeting approach, potentially enhancing the safety and efficacy of stereotactic thalamotomy.<\/jats:p>","DOI":"10.1159\/sfn\/aeuag008","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:48:07Z","timestamp":1788954487000},"source":"Crossref","is-referenced-by-count":0,"title":["Habenula as a Marker of Thalamic Asymmetrical Skew and a Landmark for the Vim\u2013Vc Boundary in MRgFUS Thalamotomy"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-2394","authenticated-orcid":false,"given":"Namiko","family":"Nishida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Sugita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Sawada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Obora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Taruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Ishimori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Toda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,9,10]]},"container-title":["Stereotactic and Functional Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/sfn\/aeuag008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:31:23Z","timestamp":1791189083000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/sfn\/aeuag008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/sfn\/aeuag008","archive":["Portico"],"relation":{},"ISSN":["1011-6125","1423-0372"],"issn-type":[{"value":"1011-6125","type":"print"},{"value":"1423-0372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]}}}