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Transcranial Magnetic Resonance-Guided Focused Ultrasound Thalamotomy in Essential Tremor: A Comprehensive Lesion Characterization

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dc.contributor.author Pineda Pardo, José Ángel
dc.contributor.author Urso, Daniele
dc.contributor.author Martínez Fernández, Raul
dc.contributor.author Rodríguez Rojas, Rafael
dc.contributor.author del Alamo, Marta
dc.contributor.author Millar Vernetti, Patricio
dc.contributor.author Máñez Miró, Jorge U.
dc.contributor.author Hernández Fernández, Frida
dc.contributor.author de Luis Pastor, Esther
dc.contributor.author Vela Desojo, Lydia
dc.contributor.author Obeso, José A.
dc.date.accessioned 2019-10-24T17:45:49Z
dc.date.available 2019-10-24T17:45:49Z
dc.date.issued 2020-08-01
dc.identifier.citation Pineda Pardo, J.A., Urso, D., Martínez Fernández, R., Rodríguez Rojas, R., Del Alamo, M., Millar Vernetti, P., Máñez Miró, J.U., Hernández Fernández, F., de Luis Pastor, E., Vela Desojo, L., Obeso, J.A., 2020. Transcranial Magnetic Resonance-Guided Focused Ultrasound Thalamotomy in Essential Tremor: A Comprehensive Lesion Characterization. Neurosurgery 87, 256-265. https://doi.org/10.1093/neuros/nyz395 en_US
dc.identifier.uri https://repositorio.fleni.org.ar/handle/123456789/69
dc.identifier.uri https://doi.org/10.1093/neuros/nyz395
dc.description.abstract BACKGROUND Transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) thalamotomy is a novel and effective treatment for controlling tremor in essential tremor patients. OBJECTIVE To provide a comprehensive characterization of the radiological, topographical, and volumetric aspects of the tcMRgFUS thalamic lesion, and to quantify how they relate to the clinical outcomes. METHODS In this study, clinical and radiological data from forty patients with medically-refractory essential tremor treated with unilateral tcMRgFUS thalamotomy were retrospectively analyzed. Treatment efficacy was assessed with Clinical Rating Scale for Tremor (CRST). Lesions were manually segmented on T1, T2, and susceptibility-weighted images, and 3-dimensional topographical analysis was then carried out. Statistical comparisons were performed using nonparametric statistics. RESULTS The greatest clinical improvement was correlated with a more inferior and posterior lesion, a bigger lesion volume, and percentage of the ventral intermediate nucleus covered by the lesion; whereas, the largest lesions accounted for the occurrence of gait imbalance. Furthermore, the volume of the lesion was significantly predicted by the number of sonications surpassing 52°C. CONCLUSION Here we provide a comprehensive characterization of the thalamic tcMRgFUS lesion including radiological and topographical analysis. Our results indicate that the location and volume of the lesion were significantly associated with the clinical outcome and that mid-temperatures may be responsible for the lesion size. This could serve ultimately to improve targeting and judgment and to optimize clinical outcome of tcMRgFUS thalamotomy. en_US
dc.language.iso eng en_US
dc.publisher Oxford Academic en_US
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Essential Tremor en_US
dc.subject Temblor Esencial en_US
dc.subject Tálamo en_US
dc.subject Thalamus en_US
dc.subject Ultrasonografía en_US
dc.subject Ultrasonography en_US
dc.title Transcranial Magnetic Resonance-Guided Focused Ultrasound Thalamotomy in Essential Tremor: A Comprehensive Lesion Characterization en_US
dc.type info:eu-repo/semantics/publishedVersion
dc.type info:eu-repo/semantics/article en_US
dc.description.fil Fil: Pineda Pardo, José Ángel. Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España. Instituto Carlos III Network Center for Biomedical Research on Neurodegenerative Diseases; España.
dc.description.fil Fil: Urso, Daniele. Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España.King's College London. Institute of Psychiatry, Psychology and Neuroscience. Neurodegeneration Imaging Group; Reino Unido
dc.description.fil Fil: Martínez Fernández, Raul.Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias ; España. Instituto Carlos III Network Center for Biomedical Research on Neurodegenerative Diseases; España.
dc.description.fil Fil: del Alamo, Marta. Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España.
dc.description.fil Fil: Millar Vernetti, Patricio. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina.
dc.description.fil Fil: Máñez Miró, Jorge U.Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España.
dc.description.fil Fil: Hernández Fernández, Frida. Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España.Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Nursing; España
dc.description.fil Fil: de Luis Pastor, Esther. Hospital Universitario HM Puerta del Sur .Radiology Department; España
dc.description.fil Fil: Vela Desojo, Lydia. Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España.
dc.description.fil Fil: Obeso, José A.Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España. Instituto Carlos III Network Center for Biomedical Research on Neurodegenerative Diseases; España.
dc.description.fil Fil: Rodríguez Rojas, Rafael.Hospital Universitario HM Puerta del Sur. Centro Integral de Neurociencias; España. Instituto Carlos III Network Center for Biomedical Research on Neurodegenerative Diseases; España.
dc.relation.ispartofVOLUME 87
dc.relation.ispartofNUMBER 2
dc.relation.ispartofPAGINATION 256-265.
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Nueva York
dc.relation.ispartofTITLE Neurosurgery
dc.relation.ispartofISSN 1524-4040
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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