{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:25:43Z","timestamp":1794324343163,"version":"4.9.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Thalamotomy of the ventral intermediate nucleus (VIM) is effective in alleviating medication-resistant tremor in patients with essential tremor (ET) and Parkinson's disease (PD). MR-guided focused ultrasound (MRgFUS) is an innovative technology that enables noninvasive thalamotomy via thermal ablation.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patients with severe medication-resistant tremor underwent unilateral VIM thalamotomy using MRgFUS. Effects on tremor were evaluated using the Clinical Rating Scale for Tremor (CRST) in patients with ET and by the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS) in patients with PD and ET-PD (defined as patients with ET who developed PD many years later). Quality of life in ET was measured by the Quality of Life in Essential Tremor (QUEST) questionnaire and in PD by the PD Questionnaire (PDQ-39).<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Thirty patients underwent MRgFUS, including 18 with ET, 9 with PD, and 3 with ET-PD. The mean age of the study population was 68.9 \u00b1 8.3 years (range 46\u201387 years) with a mean disease duration of 12.1 \u00b1 8.9 years (range 2\u201330 years). MRgFUS created a lesion at the planned target in all patients, resulting in cessation of tremor in the treated hand immediately following treatment. At 1 month posttreatment, the mean CRST score of the patients with ET decreased from 40.7 \u00b1 11.6 to 9.3 \u00b1 7.1 (p < 0.001) and was 8.2 \u00b1 5.0 six months after treatment (p < 0.001, compared with baseline). Average QUEST scores decreased from 44.8 \u00b1 12.9 to 13.1 \u00b1 13.2 (p < 0.001) and was 12.3 \u00b1 7.2 six months after treatment (p < 0.001). In patients with PD, the mean score of the motor part of the UPDRS decreased from 24.9 \u00b1 8.0 to 16.4 \u00b1 11.1 (p = 0.042) at 1 month and was 13.4 \u00b1 9.2 six months after treatment (p = 0.009, compared with baseline). The mean PDQ-39 score decreased from 38.6 \u00b1 16.8 to 26.1 \u00b1 7.2 (p = 0.036) and was 20.6 \u00b1 8.8 six months after treatment (p = 0.008). During follow-up of 6\u201324 months (mean 11.5 \u00b1 7.2 months, median 12.0 months), tremor reappeared in 6 of the patients (2 with ET, 2 with PD, and 2 with ET-PD), to a lesser degree than before the procedure in 5. Adverse events that transiently occurred during sonication included headache (n = 11), short-lasting vertigo (n = 14) and dizziness (n = 4), nausea (n = 3), burning scalp sensation (n = 3), vomiting (n = 2) and lip paresthesia (n = 2). Adverse events that lasted after the procedure included gait ataxia (n = 5), unsteady feeling (n = 4), taste disturbances (n = 4), asthenia (n = 4), and hand ataxia (n = 3). No adverse event lasted beyond 3 months. Patients underwent on average 21.0 \u00b1 6.9 sonications (range 14\u201345 sonications) with an average maximal sonication time of 16.0 \u00b1 3.0 seconds (range 13\u201324 seconds). The mean maximal energy reached was 12,500 \u00b1 4274 J (range 5850\u201323,040 J) with a mean maximal temperature of 56.5\u00b0 \u00b1 2.2\u00b0C (range 55\u00b0\u201360\u00b0C).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n MRgFUS VIM thalamotomy to relieve medication-resistant tremor was safe and effective in patients with ET, PD, and ET-PD. Current results emphasize the superior adverse events profile of MRgFUS over other surgical approaches for treating tremor with similar efficacy. Large randomized studies are needed to assess prolonged efficacy and safety.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.10.jns16758","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T09:59:50Z","timestamp":1487930390000},"page":"202-210","source":"Crossref","is-referenced-by-count":182,"title":["Magnetic resonance\u2013guided focused ultrasound thalamotomy for tremor: a report of 30 Parkinson's disease and essential tremor cases"],"prefix":"10.3171","volume":"128","author":[{"given":"Menashe","family":"Zaaroor","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Technion Faculty of Medicine, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Sinai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorith","family":"Goldsher","sequence":"additional","affiliation":[{"name":"Technion Faculty of Medicine, Haifa, Israel"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayelet","family":"Eran","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nassar","sequence":"additional","affiliation":[{"name":"Neurology, Rambam Health Care Campus; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilana","family":"Schlesinger","sequence":"additional","affiliation":[{"name":"Technion Faculty of Medicine, Haifa, Israel"},{"name":"Neurology, Rambam Health Care Campus; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 1","key":"b1-jns16758","series-title":"Parkinsonism Relat Disord","first-page":"S197","article-title":"Noninvasive functional neurosurgery using transcranial MR imaging-guided focused ultrasound","volume":"20","author":"Bauer R,","year":"2014","unstructured":"Bauer R, Martin E, Haegele-Link S, Kaegi G, von Specht M, Werner B: Noninvasive functional neurosurgery using transcranial MR imaging-guided focused ultrasound. 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