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Parkinson’s Disease
Volume 2015 (2015), Article ID 219149, 4 pages
http://dx.doi.org/10.1155/2015/219149
Research Article

MRI Guided Focused Ultrasound Thalamotomy for Moderate-to-Severe Tremor in Parkinson’s Disease

1Department of Neurology, Rambam Health Care Campus, Haifa, Israel
2Technion Faculty of Medicine, Haifa, Israel
3Department of Radiology, Rambam Health Care Campus, Haifa, Israel
4Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel

Received 8 June 2015; Revised 6 August 2015; Accepted 9 August 2015

Academic Editor: Jan O. Aasly

Copyright © 2015 Ilana Schlesinger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Thalamotomy is effective in alleviating tremor in Parkinson’s disease (PD). Methods. Seven PD patients, mean age 59.4 ± 9.8 years (range, 46–74) with a mean disease duration of 5.4 ± 2.8 years (range, 2–10) suffering from severe refractory tremor, underwent ventral intermediate nucleus thalamotomy using MRI guided focused ultrasound (MRgFUS), an innovative technology that enables noninvasive surgery. Results. Tremor stopped in the contralateral upper extremity in all patients immediately following treatment. Total UPDRS decreased from 37.4 ± 12.2 to 18.8 ± 11.1 and PDQ-39 decreased from 42.3 ± 16.4 to 21.6 ± 10.8 following MRgFUS. These effects were sustained (mean follow-up 7.3 months). Adverse events during MRgFUS included headache , dizziness , vertigo , and lip paresthesia and following MRgFUS were hypogeusia , unsteady feeling when walking (, resolved), and disturbance when walking tandem (, resolved). Conclusions. Thalamotomy using MRgFUS is safe and effective in PD patients. Large randomized studies are needed to assess prolonged efficacy and safety.