Neurologia · 2025
Unilateral thalamotomy with high-intensity focused ultrasound in refractory tremor. First results of a public hospital in Spain.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Fernández-Pajarín G, Blanco-Ulla M, Arán E, Ares B, Román-Pena P, Mosqueira A J, Jiménez-Martín I, Gelabert-González M, Prieto-González J M, Sesar Á
Аннотация
INTRODUCTION: Unilateral high-intensity focused ultrasound (HIFU) thalamotomy is a novel and efficient treatment for refractory tremor. In the most recent studies, the tremor is reduced by at least 70%. The objective of this study is to analyse the results of the first series of cases treated in a public hospital in Spain.
METHODS: In our centre, from March 2021 to March 2022, 46 patients have undergone a HIFU thalamotomy. The treatment area was predetermined on the inferior surface of the ventral intermediate nucleus of the thalamus using automatic anatomical segmentation on an individual basis. The data of 44 patients six months after the procedure have been analysed.
RESULTS: The mean age of the treated patients was 70.5 ± 14.4 years, and 68% were male. The most common diagnosis was essential tremor (40 cases). Prior to HIFU treatment, the Clinical Rating Scale for Tremor of the treated body side (CRST A + B) was 22.4 ± 5.9, and tremor-related disability (CRST C) was 18.3 ± 4.8. The mean number of sonications was 6.8 ± 1.7. Six months after treatment, CRST scales were 4.5 ± 5.6 and 4.2 ± 5.2, respectively (P < 0.0001). Twenty patients had head tremor. We observed a significant improvement with HIFU (1.9 ± 0.7 to 0.7 ± 0.8, P < 0.0001). Only four patients presented adverse effects at six months, all of them mild.
CONCLUSIONS: The clinical benefit after HIFU thalamotomy reaches an 80% reduction in tremor and has a low rate of adverse effects six months after the procedure. The target localisation method used allowed for fewer sonications.
METHODS: In our centre, from March 2021 to March 2022, 46 patients have undergone a HIFU thalamotomy. The treatment area was predetermined on the inferior surface of the ventral intermediate nucleus of the thalamus using automatic anatomical segmentation on an individual basis. The data of 44 patients six months after the procedure have been analysed.
RESULTS: The mean age of the treated patients was 70.5 ± 14.4 years, and 68% were male. The most common diagnosis was essential tremor (40 cases). Prior to HIFU treatment, the Clinical Rating Scale for Tremor of the treated body side (CRST A + B) was 22.4 ± 5.9, and tremor-related disability (CRST C) was 18.3 ± 4.8. The mean number of sonications was 6.8 ± 1.7. Six months after treatment, CRST scales were 4.5 ± 5.6 and 4.2 ± 5.2, respectively (P < 0.0001). Twenty patients had head tremor. We observed a significant improvement with HIFU (1.9 ± 0.7 to 0.7 ± 0.8, P < 0.0001). Only four patients presented adverse effects at six months, all of them mild.
CONCLUSIONS: The clinical benefit after HIFU thalamotomy reaches an 80% reduction in tremor and has a low rate of adverse effects six months after the procedure. The target localisation method used allowed for fewer sonications.