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Unilateral Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy Thalamotomy for Essential Tremor.
Aubignat, Mickael; Tir, Mélissa; Ouendo, Martial; Boussida, Salem; Constans, Jean-Marc; Lefranc, Michel.
Afiliação
  • Aubignat M; Department of Neurology and Movement Disorders, Amiens Picardie University Hospital, Amiens, France.
  • Tir M; Expert Center for Parkinson's Disease, Amiens Picardie University Hospital, Amiens, France.
  • Ouendo M; Department of Neurology and Movement Disorders, Amiens Picardie University Hospital, Amiens, France.
  • Boussida S; Expert Center for Parkinson's Disease, Amiens Picardie University Hospital, Amiens, France.
  • Constans JM; Expert Center for Parkinson's Disease, Amiens Picardie University Hospital, Amiens, France.
  • Lefranc M; Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, Amiens, France.
Mov Disord ; 39(6): 1006-1014, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38532534
ABSTRACT

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:

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:

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:

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:

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tálamo / Imageamento por Ressonância Magnética / Tremor Essencial / Terapia a Laser Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Mov Disord Assunto da revista: NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tálamo / Imageamento por Ressonância Magnética / Tremor Essencial / Terapia a Laser Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Mov Disord Assunto da revista: NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França