{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:42:51Z","timestamp":1793493771305,"version":"4.5.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Medial thalamotomies were introduced in the late 1940s. Pain relief was shown to be achieved for all body locations. With some exceptions, these early relatively small series showed frequent, more or less complete recurrence of the original pain. The posterior part of the central lateral nucleus in the human medial thalamus was identified in the 1990s using multiarchitectonic studies and intraoperative single-cell recordings and was confirmed as a surgical target. This retrospective patient series extended over 11 years. Its goal was to demonstrate the efficacy and risk profile of the MR-guided focused ultrasound (MRgFUS) central lateral thalamotomy (CLT) against chronic and therapy-resistant neuropathic (i.e., neurogenic) pain.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>In this single-center, nonrandomized retrospective cross-sectional analysis of consecutive patients, 63 consecutive MRgFUS CLT interventions were performed in 55 patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The mean follow-up duration was 55 months. A total of 112 CLT targets were performed, and the CLT was applied bilaterally in 48 patients and contralateral to their pain in 7 patients. Repeat MRgFUS interventions were performed in 8 patients. One serious adverse event with numbness of the upper lip was recorded. The mean pain relief rated by patients was 42% \u00b1 32% at 3 months, 43% \u00b1 36% at 1 year, and 42% \u00b1 37% at the last follow-up (n = 63). The proportions of cases with \u2265 30% pain relief were 65% at 3 months, 63% at 1 year, and 61% at the last follow-up. Good outcomes (\u2265 50% pain relief) were found in 54% of patients at 3 months, 49% at 1 year, and 51% at the last follow-up. The reduction in mean VAS scores showed similar percentage reductions as those for pain relief (\u221241% for continuous pain and \u221249% for pain attacks) at the 1-year follow-up. The mean frequency of pain attacks was reduced by 92%. Allodynia was reduced or suppressed in 68% of patients and never appeared de novo after MRgFUS CLT.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>These results suggest that MRgFUS CLT against neuropathic pain is a safe approach and its results are stable over time. At a mean follow-up duration of 55 months, the mean pain relief was 42% and more than 50% of patients still reported \u2265 50% pain relief. Patients with classical and idiopathic trigeminal neuralgia reported a higher mean pain relief compared with the whole patient group.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.1.jns222879","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T15:19:12Z","timestamp":1678461552000},"page":"615-624","source":"Crossref","is-referenced-by-count":24,"title":["Magnetic resonance\u2013guided focused ultrasound central lateral thalamotomy against chronic and therapy-resistant neuropathic pain: retrospective long-term follow-up analysis of 63 interventions"],"prefix":"10.3171","volume":"139","author":[{"given":"Marc N.","family":"Gallay","sequence":"first","affiliation":[{"name":"SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk E.","family":"Magara","sequence":"additional","affiliation":[{"name":"SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Moser","sequence":"additional","affiliation":[{"name":"SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milek","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Privatklinik Obach, Solothurn, Switzerland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9lanie","family":"Kaeser","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Jeanmonod","sequence":"additional","affiliation":[{"name":"SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Pain\u2014Its Neurosurgical Management","first-page":"50","article-title":"Intralaminar thalamotomy (thalamolaminotomy) and postero-medial hypothalamotomy in the treatment of intractable pain","volume":"Vol 8","author":"Sano K","year":"1977","unstructured":"Sano K. 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Rev Neurol (Paris). 1949;81(11):917\u2013931."},{"issue":"2","key":"b3","series-title":"Confin Neurol","first-page":"146","article-title":"Unilateral thalamic tractotomy for the relief of bilateral pain in malignant tumors","volume":"29","author":"Fairman D","year":"1967","unstructured":"Fairman D. Unilateral thalamic tractotomy for the relief of bilateral pain in malignant tumors. Confin Neurol. 1967;29(2):146\u2013152."},{"issue":"2","key":"b4","series-title":"Confin Neurol","first-page":"139","article-title":"Thalamotomy for intractable pain","volume":"29","author":"Richardson DE","year":"1967","unstructured":"Richardson DE. Thalamotomy for intractable pain. Confin Neurol. 1967;29(2):139\u2013145."},{"key":"b5","series-title":"Modern Stereotactic Neurosurgery","first-page":"269","article-title":"Mesencephalotomy and thalamotomy for chronic pain","author":"Laitinen LV","year":"1988","unstructured":"Laitinen LV. Mesencephalotomy and thalamotomy for chronic pain. In: Lunsford LD, ed. 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