학술논문

Comprehensive Evaluation of Factors Affecting Tremor Relapse after MRgFUS Thalamotomy: A Case-Control Study
Document Type
article
Source
Brain Sciences, Vol 11, Iss 9, p 1183 (2021)
Subject
tremor
Parkinson’s disease
MRgFUS thalamotomy
DTI
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Language
English
ISSN
2076-3425
Abstract
Objective: To identify possible relevant factors contributing to tremor relapse after MRgFUS thalamotomy in patients with essential tremor (ET) and Parkinson’s disease (PD). Methods: We identified patients with tremor relapse from a series of 79 treatments in a single institution. The demographic and clinical characteristics of the study group patients were compared to those of patients who did not relapse in the same follow-up period. Imaging and procedural factors were compared using a control group matched for clinical and demographic characteristics. Results: Concerning clinical and demographic characteristics, we did not find statistically significant differences in gender and age. Seventy-three percent of patients with tremor relapse were Parkinson’s disease patients. Using MRI, we found larger thalamotomy lesions at the 1-year follow-up in the control group with stable outcomes, compared to patients with tremor relapse. In the tractography evaluation, we found a more frequent eccentric position of the DRTt in patients with tremor relapse. Conclusions: The most relevant determining factors for tremor relapse after MRgFUS thalamotomy appear to be tremor from Parkinson’s disease and inaccurate thalamic targeting. Size of the thalamotomy lesion can also influence the outcome of treatment.