Unilateral Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy Thalamotomy for Essential Tremor.
essential tremor
laser interstitial thermal therapy
magnetic resonance imaging
neurosurgery
thalamotomy
Journal
Movement disorders : official journal of the Movement Disorder Society
ISSN: 1531-8257
Titre abrégé: Mov Disord
Pays: United States
ID NLM: 8610688
Informations de publication
Date de publication:
26 Mar 2024
26 Mar 2024
Historique:
revised:
11
03
2024
received:
27
08
2023
accepted:
13
03
2024
medline:
27
3
2024
pubmed:
27
3
2024
entrez:
27
3
2024
Statut:
aheadofprint
Résumé
Essential tremor (ET) affects numerous adults, impacting quality of life (QOL) and often defying pharmacological treatment. Surgical interventions like deep brain stimulation (DBS) and lesional approaches, including radiofrequency, gamma-knife radiosurgery, and magnetic resonance imaging (MRI)-guided focused ultrasound, offer solutions but are not devoid of limitations. This retrospective, single-center, single-blinded pilot study aimed to assess the safety and efficacy of unilateral MRI-guided laser interstitial thermal therapy (MRIg-LITT) thalamotomy for medically intractable ET. Nine patients with ET, unresponsive to medications and unsuitable for DBS, underwent unilateral MRIg-LITT thalamotomy. We assessed tremor severity, QOL, cognitive function, and adverse events (AE) over a 12-month period. Tremor severity significantly improved, with a reduction of 83.37% at 12 months post-procedure. QOL scores improved by 74.60% at 12 months. Reported AEs predominantly included transient dysarthria, proprioceptive disturbances, and gait balance issues, which largely resolved within a month. At 3 months, 2 patients (22%) exhibited contralateral hemiparesis requiring physiotherapy, with 1 patient (11%) exhibiting persistent hemiparesis at 12 months. No significant cognitive impairment was detected post-procedure. Unilateral MRIg-LITT thalamotomy yielded substantial and enduring tremor alleviation and enhanced QOL in patients with ET that is resistant to medication. The AE profile was acceptable. Our findings support the need for additional research with expanded patient cohorts and extended follow-up to corroborate these outcomes and to refine the role of MRIg-LITT as a targeted and minimally invasive approach for ET management. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Sections du résumé
BACKGROUND
BACKGROUND
Essential tremor (ET) affects numerous adults, impacting quality of life (QOL) and often defying pharmacological treatment. Surgical interventions like deep brain stimulation (DBS) and lesional approaches, including radiofrequency, gamma-knife radiosurgery, and magnetic resonance imaging (MRI)-guided focused ultrasound, offer solutions but are not devoid of limitations.
OBJECTIVES
OBJECTIVE
This retrospective, single-center, single-blinded pilot study aimed to assess the safety and efficacy of unilateral MRI-guided laser interstitial thermal therapy (MRIg-LITT) thalamotomy for medically intractable ET.
METHODS
METHODS
Nine patients with ET, unresponsive to medications and unsuitable for DBS, underwent unilateral MRIg-LITT thalamotomy. We assessed tremor severity, QOL, cognitive function, and adverse events (AE) over a 12-month period.
RESULTS
RESULTS
Tremor severity significantly improved, with a reduction of 83.37% at 12 months post-procedure. QOL scores improved by 74.60% at 12 months. Reported AEs predominantly included transient dysarthria, proprioceptive disturbances, and gait balance issues, which largely resolved within a month. At 3 months, 2 patients (22%) exhibited contralateral hemiparesis requiring physiotherapy, with 1 patient (11%) exhibiting persistent hemiparesis at 12 months. No significant cognitive impairment was detected post-procedure.
CONCLUSIONS
CONCLUSIONS
Unilateral MRIg-LITT thalamotomy yielded substantial and enduring tremor alleviation and enhanced QOL in patients with ET that is resistant to medication. The AE profile was acceptable. Our findings support the need for additional research with expanded patient cohorts and extended follow-up to corroborate these outcomes and to refine the role of MRIg-LITT as a targeted and minimally invasive approach for ET management. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Références
Louis ED, Ottman R, Hauser WA. How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world. Mov Disord 1998;13(1):5–10. https://doi.org/10.1002/mds.870130105
Welton T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers 2021;7(1):83. https://doi.org/10.1038/s41572-021-00314-w
Bhatia KP, Bain P, Bajaj N, et al. Consensus statement on the classification of tremors. From the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord 2018;33(1):75–87. https://doi.org/10.1002/mds.27121
Louis ED, Bares M, Benito‐Leon J, et al. Essential tremor‐plus: a controversial new concept. Lancet Neurol 2020;19(3):266–270. https://doi.org/10.1016/S1474-4422(19)30398-9
Ferreira JJ, Mestre TA, Lyons KE, et al. MDS evidence‐based review of treatments for essential tremor. Mov Disord 2019;34(7):950–958. https://doi.org/10.1002/mds.27700
Louis ED, Rios E, Henchcliffe C. How are we doing with the treatment of essential tremor (ET)?: persistence of patients with ET on medication: data from 528 patients in three settings. Eur J Neurol 2010;17(6):882–884. https://doi.org/10.1111/j.1468-1331.2009.02926.x
Wong JK, Hess CW, Almeida L, et al. Deep brain stimulation in essential tremor: targets, technology, and a comprehensive review of clinical outcomes. Expert Rev Neurother 2020;20(4):319–331. https://doi.org/10.1080/14737175.2020.1737017
Katz M, Kilbane C, Rosengard J, Alterman RL, Tagliati M. Referring patients for deep brain stimulation: an improving practice. Arch Neurol 2011;68(8):1027–1032. https://doi.org/10.1001/archneurol.2011.151
Kondapavulur S, Silva AB, Molinaro AM, Wang DD. A systematic review comparing focused ultrasound surgery with radiosurgery for essential tremor. Neurosurgery 2023;93(3):524–538. https://doi.org/10.1227/neu.0000000000002462
Schuurman PR, Bosch DA, Bossuyt PM, et al. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N Engl J Med 2000;342(7):461–468. https://doi.org/10.1056/NEJM200002173420703
Diaz R, Ivan ME, Hanft S, et al. Laser interstitial thermal therapy: lighting the way to a new treatment option in neurosurgery. Neurosurgery 2016;79(Suppl 1):S3–S7. https://doi.org/10.1227/NEU.0000000000001435
Ashraf O, Patel NV, Hanft S, Danish SF. Laser‐induced thermal therapy in neuro‐oncology: a review. World Neurosurg 2018;112:166–177. https://doi.org/10.1016/j.wneu.2018.01.123
Grewal SS, Tatum WO. Laser thermal ablation in epilepsy. Expert Rev Neurother 2019;19(12):1211–1218. https://doi.org/10.1080/14737175.2019.1650642
Harris M, Steele J, Williams R, Pinkston J, Zweig R, Wilden JA. MRI‐guided laser interstitial thermal thalamotomy for medically intractable tremor disorders. Mov Disord 2019;34(1):124–129. https://doi.org/10.1002/mds.27545
Aubignat M, Tir M, Ouendo M, Constans JM, Lefranc M. Stereotactic robot‐assisted MRI‐guided laser interstitial thermal therapy thalamotomy for medically intractable Parkinson's disease tremor: technical note and preliminary effects on 2 cases. Acta Neurochir 2023;165(6):1453–1460. https://doi.org/10.1007/s00701-023-05614-6
McNichols RJ, Gowda A, Kangasniemi M, Bankson JA, Price RE, Hazle JD. MR thermometry‐based feedback control of laser interstitial thermal therapy at 980 nm. Lasers Surg Med 2004;34(1):48–55. https://doi.org/10.1002/lsm.10243
Patel NV, Frenchu K, Danish SF. Does the thermal damage estimate correlate with the magnetic resonance imaging predicted ablation size after laser interstitial thermal therapy? Oper Neurosurg (Hagerstown) 2018;15(2):179–183. https://doi.org/10.1093/ons/opx191
Fahn S, Tolosa E, Conceppcion M. Clinical rating scale for tremor. Parkinson's Disease and Movement Disorders. Baltimore, MD: Williams and Wilkins; 1993:271–280.
Tröster AI, Pahwa R, Fields JA, Tanner CM, Lyons KE. Quality of life in essential tremor questionnaire (QUEST): development and initial validation. Parkinsonism Relat Disord 2005;11(6):367–373. https://doi.org/10.1016/j.parkreldis.2005.05.009
Folstein MF, Robins LN, Helzer JE. The mini‐mental state examination. Arch Gen Psychiatry 1983;40(7):812. https://doi.org/10.1001/archpsyc.1983.01790060110016
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53(4):695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
Carl B, Bopp M, Saß B, Waldthaler J, Timmermann L, Nimsky C. Visualization of volume of tissue activated modeling in a clinical planning system for deep brain stimulation. J Neurosurg Sci 2024;68(1):59–69. https://doi.org/10.23736/S0390-5616.19.04827-6
Rf D, Dj L, De Vloo P, et al. Outcomes from stereotactic surgery for essential tremor. J Neurol Neurosurg Psychiatry 2019;90(4):474–482. https://doi.org/10.1136/jnnp-2018-318240
Serra C, Guida L, Staartjes VE, Krayenbühl N, Türe U. Historical controversies about the thalamus: from etymology to function. Neurosurg Focus 2019;47(3):E13. https://doi.org/10.3171/2019.6.FOCUS19331
Giordano M, Caccavella VM, Zaed I, et al. Comparison between deep brain stimulation and magnetic resonance‐guided focused ultrasound in the treatment of essential tremor: a systematic review and pooled analysis of functional outcomes. J Neurol Neurosurg Psychiatry 2020;91(12):1270–1278. https://doi.org/10.1136/jnnp-2020-323216
Rohringer CR, Sewell IJ, Gandhi S, et al. Cognitive effects of unilateral thalamotomy for tremor: a meta‐analysis. Brain Commun 2022;4(6):fcac287. https://doi.org/10.1093/braincomms/fcac287
Alshaikh J, Fishman PS. Revisiting bilateral thalamotomy for tremor. Clin Neurol Neurosurg 2017;158:103–107. https://doi.org/10.1016/j.clineuro.2017.04.025
Levi V, Eleopra R, Franzini A, Romito L. Is deep brain stimulation still an option for tremor recurrence after focused ultrasound thalamotomy? A case report. J Clin Neurosci 2019;68:344–346. https://doi.org/10.1016/j.jocn.2019.07.035
Joutsa J, Lipsman N, Horn A, Cosgrove GR, Fox MD. The return of the lesion for localization and therapy. Brain 2023;146(8):3146–3155. https://doi.org/10.1093/brain/awad123
Iorio‐Morin C, Yamamoto K, Sarica C, et al. Bilateral focused ultrasound thalamotomy for essential tremor (BEST‐FUS phase 2 trial). Mov Disord 2021;36(11):2653–2662. https://doi.org/10.1002/mds.28716
Fukutome K, Hirabayashi H, Osakada Y, Kuga Y, Ohnishi H. Bilateral magnetic resonance imaging‐guided focused ultrasound thalamotomy for essential tremor. Stereotact Funct Neurosurg 2022;100(1):44–52. https://doi.org/10.1159/000518662
Martínez‐Fernández R, Mahendran S, Pineda‐Pardo JA, et al. Bilateral staged magnetic resonance‐guided focused ultrasound thalamotomy for the treatment of essential tremor: a case series study. J Neurol Neurosurg Psychiatry 2021;92(9):927–931. https://doi.org/10.1136/jnnp-2020-325278
Cacho‐Asenjo E, Honorato‐Cia C, Nuñez‐Cordoba JM, et al. Factors associated with headache and nausea during magnetic resonance‐guided focused ultrasound for tremor. Mov Disord Clin Pract 2021;8(5):701–708. https://doi.org/10.1002/mdc3.13210
He X, Oshino S, Hosomi K, Kanemoto M, Tani N, Kishima H. Characteristics of pain during MRI‐guided focused ultrasound thalamotomy. Neurosurgery 2023;93(2):358–365. https://doi.org/10.1227/neu.0000000000002420