Stepwise dual‐target magnetic resonance‐guided focused ultrasound in tremor‐dominant Parkinson disease: One‐year follow‐up
Background and Purpose Magnetic resonance‐guided focused ultrasound (MRgFUS) is a nonsurgical treatment for Parkinson disease (PD). Some selected anatomical structures can be targeted by MRgFUS in PD. However, there is no uniform target yet. We have reported that stepwise dual‐target MRgFUS was succ...
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| Veröffentlicht in: | European journal of neurology 2024-12, Vol.31 (12), p.e16468-n/a |
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| creator | Chen, Jui‐Cheng Chen, Chun‐Ming Aoh, Yu Lu, Ming‐Kuei Tsai, Chon‐Haw |
| description | Background and Purpose
Magnetic resonance‐guided focused ultrasound (MRgFUS) is a nonsurgical treatment for Parkinson disease (PD). Some selected anatomical structures can be targeted by MRgFUS in PD. However, there is no uniform target yet. We have reported that stepwise dual‐target MRgFUS was successfully applied to treat refractory tremors with akinetic–rigid features in PD. It generated two precise thermal ablations in the ventral intermediate nucleus (VIM) and pallidothalamic tract (PTT). Here, we report more PD patients to verify the safety and efficacy of stepwise dual‐target MRgFUS.
Methods
Ten tremor‐dominant PD patients (mean age = 66.7 ± 3.2 years, eight men) received the stepwise dual‐target MRgFUS treatment with a series of primary and secondary outcome measures. The VIM and PTT were navigated based on brain magnetic resonance images. Outcome measures were categorized into primary and secondary assessments. The primary outcome measures consisted of resting tremor, action/kinetic tremor, rigidity, and bradykinesia. Secondary outcome measures encompassed non‐motor symptoms scale of PD. Data collected at follow‐up time points, including 1 day, 3 months, 6 months, and 1 year posttreatment, were compared with baseline data.
Results
The severity of tremor and motor deficits represented by Clinical Rating Scale for Tremor parts A and B during off‐medication status and Unified Parkinson's Disease Rating Scale III on the treated side were significantly improved (p |
| doi_str_mv | 10.1111/ene.16468 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11555146</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3126823136</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3348-f24f4ef579f96a3ca16e500e1607ca62d1fb6c5864461b927438549cacee263b3</originalsourceid><addsrcrecordid>eNp1kc1u1DAQgCMEoj9w4AVQJC70kNZjx07CBaFq-ZEqigScLa8zWVwSe2vHrPbGgQfgGXkSZtlSARK-jK35_HnGUxSPgJ0CrTP0eAqqVu2d4hAoVCAE3KW9kFBJYHBQHKV0xRjjDWf3iwPR8bZRrDksvr2fcb1xCcs-m_HH1--ziSucy8msPM7OlhFT8MZbpNwqux77cgg2J4p5nKNJIfu-dL6cI04hEtWHydGNuXxn4mfn6XrZ0wMm4bPy0u88WzSRLOMYNnTK6wfFvcGMCR_exOPi48vFh_PX1cXlqzfnLy4qK0TdVgOvhxoH2XRDp4ywBhRKxhCoE2sU72FYKitbVdcKlh1vatHKurPGInIlluK4eL73rvNywt6ipwZGvY5uMnGrg3H674x3n_QqfNEAUkr6WTI8vTHEcJ0xzXpyyeI4Go8hJy2AqVq2HBihT_5Br0KOnvojiquWCxA74cmesjGkFHG4rQaY3g1X03D1r-ES-_jP8m_J39Mk4GwPbNyI2_-b9OLtYq_8Cf8yti8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3126823136</pqid></control><display><type>article</type><title>Stepwise dual‐target magnetic resonance‐guided focused ultrasound in tremor‐dominant Parkinson disease: One‐year follow‐up</title><source>MEDLINE</source><source>Wiley Online Library Open Access</source><source>Wiley Online Library Journals Frontfile Complete</source><source>PubMed Central</source><creator>Chen, Jui‐Cheng ; Chen, Chun‐Ming ; Aoh, Yu ; Lu, Ming‐Kuei ; Tsai, Chon‐Haw</creator><creatorcontrib>Chen, Jui‐Cheng ; Chen, Chun‐Ming ; Aoh, Yu ; Lu, Ming‐Kuei ; Tsai, Chon‐Haw</creatorcontrib><description>Background and Purpose
Magnetic resonance‐guided focused ultrasound (MRgFUS) is a nonsurgical treatment for Parkinson disease (PD). Some selected anatomical structures can be targeted by MRgFUS in PD. However, there is no uniform target yet. We have reported that stepwise dual‐target MRgFUS was successfully applied to treat refractory tremors with akinetic–rigid features in PD. It generated two precise thermal ablations in the ventral intermediate nucleus (VIM) and pallidothalamic tract (PTT). Here, we report more PD patients to verify the safety and efficacy of stepwise dual‐target MRgFUS.
Methods
Ten tremor‐dominant PD patients (mean age = 66.7 ± 3.2 years, eight men) received the stepwise dual‐target MRgFUS treatment with a series of primary and secondary outcome measures. The VIM and PTT were navigated based on brain magnetic resonance images. Outcome measures were categorized into primary and secondary assessments. The primary outcome measures consisted of resting tremor, action/kinetic tremor, rigidity, and bradykinesia. Secondary outcome measures encompassed non‐motor symptoms scale of PD. Data collected at follow‐up time points, including 1 day, 3 months, 6 months, and 1 year posttreatment, were compared with baseline data.
Results
The severity of tremor and motor deficits represented by Clinical Rating Scale for Tremor parts A and B during off‐medication status and Unified Parkinson's Disease Rating Scale III on the treated side were significantly improved (p < 0.05 by paired t‐test) at 1‐year follow‐up. At the 1‐year follow‐up, significant improvement was observed in the non‐motor symptoms scale. Additionally, no severe adverse effects were reported, except temporary treatment‐related discomfort during the procedure.
Conclusions
In conclusion, stepwise dual‐target MRgFUS emerges as a safe and effective therapeutic modality for PD patients, particularly in addressing medication‐refractory tremor and akinetic–rigid syndrome.</description><identifier>ISSN: 1351-5101</identifier><identifier>ISSN: 1468-1331</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.16468</identifier><identifier>PMID: 39287607</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Ablation ; Aged ; Effectiveness ; Female ; Follow-Up Studies ; Health services ; High-Intensity Focused Ultrasound Ablation - methods ; Humans ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medical treatment ; Middle Aged ; Movement Disorders ; MR‐guided focused ultrasound (MRgFUS) ; Neurodegenerative diseases ; Original ; pallidothalamic tract ; Parkinson disease ; Parkinson Disease - complications ; Parkinson Disease - diagnostic imaging ; Parkinson Disease - therapy ; Parkinson's disease ; Patients ; Rigidity ; Signs and symptoms ; stepwise dual‐target MRgFUS ; thalamotomy ; Treatment Outcome ; Tremor ; Tremor (Muscular contraction) ; Tremor - diagnostic imaging ; Tremor - etiology ; Tremor - therapy ; Tremors ; Ultrasonic imaging ; Ultrasound ; ventral intermediate nucleus</subject><ispartof>European journal of neurology, 2024-12, Vol.31 (12), p.e16468-n/a</ispartof><rights>2024 The Author(s). published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.</rights><rights>2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3348-f24f4ef579f96a3ca16e500e1607ca62d1fb6c5864461b927438549cacee263b3</cites><orcidid>0000-0002-2768-4399 ; 0009-0005-7146-1482</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555146/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555146/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39287607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Jui‐Cheng</creatorcontrib><creatorcontrib>Chen, Chun‐Ming</creatorcontrib><creatorcontrib>Aoh, Yu</creatorcontrib><creatorcontrib>Lu, Ming‐Kuei</creatorcontrib><creatorcontrib>Tsai, Chon‐Haw</creatorcontrib><title>Stepwise dual‐target magnetic resonance‐guided focused ultrasound in tremor‐dominant Parkinson disease: One‐year follow‐up</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and Purpose
Magnetic resonance‐guided focused ultrasound (MRgFUS) is a nonsurgical treatment for Parkinson disease (PD). Some selected anatomical structures can be targeted by MRgFUS in PD. However, there is no uniform target yet. We have reported that stepwise dual‐target MRgFUS was successfully applied to treat refractory tremors with akinetic–rigid features in PD. It generated two precise thermal ablations in the ventral intermediate nucleus (VIM) and pallidothalamic tract (PTT). Here, we report more PD patients to verify the safety and efficacy of stepwise dual‐target MRgFUS.
Methods
Ten tremor‐dominant PD patients (mean age = 66.7 ± 3.2 years, eight men) received the stepwise dual‐target MRgFUS treatment with a series of primary and secondary outcome measures. The VIM and PTT were navigated based on brain magnetic resonance images. Outcome measures were categorized into primary and secondary assessments. The primary outcome measures consisted of resting tremor, action/kinetic tremor, rigidity, and bradykinesia. Secondary outcome measures encompassed non‐motor symptoms scale of PD. Data collected at follow‐up time points, including 1 day, 3 months, 6 months, and 1 year posttreatment, were compared with baseline data.
Results
The severity of tremor and motor deficits represented by Clinical Rating Scale for Tremor parts A and B during off‐medication status and Unified Parkinson's Disease Rating Scale III on the treated side were significantly improved (p < 0.05 by paired t‐test) at 1‐year follow‐up. At the 1‐year follow‐up, significant improvement was observed in the non‐motor symptoms scale. Additionally, no severe adverse effects were reported, except temporary treatment‐related discomfort during the procedure.
Conclusions
In conclusion, stepwise dual‐target MRgFUS emerges as a safe and effective therapeutic modality for PD patients, particularly in addressing medication‐refractory tremor and akinetic–rigid syndrome.</description><subject>Ablation</subject><subject>Aged</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health services</subject><subject>High-Intensity Focused Ultrasound Ablation - methods</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Movement Disorders</subject><subject>MR‐guided focused ultrasound (MRgFUS)</subject><subject>Neurodegenerative diseases</subject><subject>Original</subject><subject>pallidothalamic tract</subject><subject>Parkinson disease</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson Disease - diagnostic imaging</subject><subject>Parkinson Disease - therapy</subject><subject>Parkinson's disease</subject><subject>Patients</subject><subject>Rigidity</subject><subject>Signs and symptoms</subject><subject>stepwise dual‐target MRgFUS</subject><subject>thalamotomy</subject><subject>Treatment Outcome</subject><subject>Tremor</subject><subject>Tremor (Muscular contraction)</subject><subject>Tremor - diagnostic imaging</subject><subject>Tremor - etiology</subject><subject>Tremor - therapy</subject><subject>Tremors</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><subject>ventral intermediate nucleus</subject><issn>1351-5101</issn><issn>1468-1331</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAQgCMEoj9w4AVQJC70kNZjx07CBaFq-ZEqigScLa8zWVwSe2vHrPbGgQfgGXkSZtlSARK-jK35_HnGUxSPgJ0CrTP0eAqqVu2d4hAoVCAE3KW9kFBJYHBQHKV0xRjjDWf3iwPR8bZRrDksvr2fcb1xCcs-m_HH1--ziSucy8msPM7OlhFT8MZbpNwqux77cgg2J4p5nKNJIfu-dL6cI04hEtWHydGNuXxn4mfn6XrZ0wMm4bPy0u88WzSRLOMYNnTK6wfFvcGMCR_exOPi48vFh_PX1cXlqzfnLy4qK0TdVgOvhxoH2XRDp4ywBhRKxhCoE2sU72FYKitbVdcKlh1vatHKurPGInIlluK4eL73rvNywt6ipwZGvY5uMnGrg3H674x3n_QqfNEAUkr6WTI8vTHEcJ0xzXpyyeI4Go8hJy2AqVq2HBihT_5Br0KOnvojiquWCxA74cmesjGkFHG4rQaY3g1X03D1r-ES-_jP8m_J39Mk4GwPbNyI2_-b9OLtYq_8Cf8yti8</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Chen, Jui‐Cheng</creator><creator>Chen, Chun‐Ming</creator><creator>Aoh, Yu</creator><creator>Lu, Ming‐Kuei</creator><creator>Tsai, Chon‐Haw</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2768-4399</orcidid><orcidid>https://orcid.org/0009-0005-7146-1482</orcidid></search><sort><creationdate>202412</creationdate><title>Stepwise dual‐target magnetic resonance‐guided focused ultrasound in tremor‐dominant Parkinson disease: One‐year follow‐up</title><author>Chen, Jui‐Cheng ; Chen, Chun‐Ming ; Aoh, Yu ; Lu, Ming‐Kuei ; Tsai, Chon‐Haw</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3348-f24f4ef579f96a3ca16e500e1607ca62d1fb6c5864461b927438549cacee263b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ablation</topic><topic>Aged</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health services</topic><topic>High-Intensity Focused Ultrasound Ablation - methods</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Movement Disorders</topic><topic>MR‐guided focused ultrasound (MRgFUS)</topic><topic>Neurodegenerative diseases</topic><topic>Original</topic><topic>pallidothalamic tract</topic><topic>Parkinson disease</topic><topic>Parkinson Disease - complications</topic><topic>Parkinson Disease - diagnostic imaging</topic><topic>Parkinson Disease - therapy</topic><topic>Parkinson's disease</topic><topic>Patients</topic><topic>Rigidity</topic><topic>Signs and symptoms</topic><topic>stepwise dual‐target MRgFUS</topic><topic>thalamotomy</topic><topic>Treatment Outcome</topic><topic>Tremor</topic><topic>Tremor (Muscular contraction)</topic><topic>Tremor - diagnostic imaging</topic><topic>Tremor - etiology</topic><topic>Tremor - therapy</topic><topic>Tremors</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>ventral intermediate nucleus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Jui‐Cheng</creatorcontrib><creatorcontrib>Chen, Chun‐Ming</creatorcontrib><creatorcontrib>Aoh, Yu</creatorcontrib><creatorcontrib>Lu, Ming‐Kuei</creatorcontrib><creatorcontrib>Tsai, Chon‐Haw</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Jui‐Cheng</au><au>Chen, Chun‐Ming</au><au>Aoh, Yu</au><au>Lu, Ming‐Kuei</au><au>Tsai, Chon‐Haw</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stepwise dual‐target magnetic resonance‐guided focused ultrasound in tremor‐dominant Parkinson disease: One‐year follow‐up</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2024-12</date><risdate>2024</risdate><volume>31</volume><issue>12</issue><spage>e16468</spage><epage>n/a</epage><pages>e16468-n/a</pages><issn>1351-5101</issn><issn>1468-1331</issn><eissn>1468-1331</eissn><abstract>Background and Purpose
Magnetic resonance‐guided focused ultrasound (MRgFUS) is a nonsurgical treatment for Parkinson disease (PD). Some selected anatomical structures can be targeted by MRgFUS in PD. However, there is no uniform target yet. We have reported that stepwise dual‐target MRgFUS was successfully applied to treat refractory tremors with akinetic–rigid features in PD. It generated two precise thermal ablations in the ventral intermediate nucleus (VIM) and pallidothalamic tract (PTT). Here, we report more PD patients to verify the safety and efficacy of stepwise dual‐target MRgFUS.
Methods
Ten tremor‐dominant PD patients (mean age = 66.7 ± 3.2 years, eight men) received the stepwise dual‐target MRgFUS treatment with a series of primary and secondary outcome measures. The VIM and PTT were navigated based on brain magnetic resonance images. Outcome measures were categorized into primary and secondary assessments. The primary outcome measures consisted of resting tremor, action/kinetic tremor, rigidity, and bradykinesia. Secondary outcome measures encompassed non‐motor symptoms scale of PD. Data collected at follow‐up time points, including 1 day, 3 months, 6 months, and 1 year posttreatment, were compared with baseline data.
Results
The severity of tremor and motor deficits represented by Clinical Rating Scale for Tremor parts A and B during off‐medication status and Unified Parkinson's Disease Rating Scale III on the treated side were significantly improved (p < 0.05 by paired t‐test) at 1‐year follow‐up. At the 1‐year follow‐up, significant improvement was observed in the non‐motor symptoms scale. Additionally, no severe adverse effects were reported, except temporary treatment‐related discomfort during the procedure.
Conclusions
In conclusion, stepwise dual‐target MRgFUS emerges as a safe and effective therapeutic modality for PD patients, particularly in addressing medication‐refractory tremor and akinetic–rigid syndrome.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>39287607</pmid><doi>10.1111/ene.16468</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2768-4399</orcidid><orcidid>https://orcid.org/0009-0005-7146-1482</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Open Access; Wiley Online Library Journals Frontfile Complete; PubMed Central |
| subjects | Ablation Aged Effectiveness Female Follow-Up Studies Health services High-Intensity Focused Ultrasound Ablation - methods Humans Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medical treatment Middle Aged Movement Disorders MR‐guided focused ultrasound (MRgFUS) Neurodegenerative diseases Original pallidothalamic tract Parkinson disease Parkinson Disease - complications Parkinson Disease - diagnostic imaging Parkinson Disease - therapy Parkinson's disease Patients Rigidity Signs and symptoms stepwise dual‐target MRgFUS thalamotomy Treatment Outcome Tremor Tremor (Muscular contraction) Tremor - diagnostic imaging Tremor - etiology Tremor - therapy Tremors Ultrasonic imaging Ultrasound ventral intermediate nucleus |
| title | Stepwise dual‐target magnetic resonance‐guided focused ultrasound in tremor‐dominant Parkinson disease: One‐year follow‐up |
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