The use of MR-guided focused ultrasound surgery (MRgFUS) may be very effective in alleviating tremor and other types of movement disorders as demonstrated by research findings presented at the 80th Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS) in Miami.
For stereotactic neurosurgeons, MRgFUS presents a new treatment model. With the arrival of phased-array transducers, practitioners have the ability to perform exact noninvasive transcranial ultrasound lesioning. In addition, MR thermometry allows for real-time monitoring of both the treatment location as well as the intensity.
The researchers performed the study on 15 medication-refractory essential tremor patients receiving a unilateral MRgFUS ventral intermediate nucleus (Vim) thalamotomy, and who are being investigated under an FDA-approved protocol. Pre and post assessments with a validated rating scale for tremor and MRI were obtained throughout the study period at time points of one day, one week, one month and three months, respectively. Adverse events were recorded throughout the study period. The results of this study, Results of a Phase 1 study of MR guided Focused Ultrasound Thalamotomy for Essential Tremor
, will be presented by William J. Elias, MD, FAANS, 2:30-2:54 p.m., on Monday, April 16. Co-authors are Diane Huss, PhD; Mohamad Khaled, MD; Stephen Monteith, MD; Johanna Loomba; Eyal Zadacario, PhD; Matt Eames, PhD; Robert Frysinger, PhD; Madaline Harrison, MD; Tiffini Voss, MD; and Max Wintermark, MD.
Throughout the three-month study period, researchers noted substantial reductions in contralateral appendicular tremor within the subjects. The adverse event profile was comparable to stereotactic thalamic procedures. Adverse events included headache, warm sensations, dizziness and nausea. All of the outcomes and adverse events found during the study will be presented. Neuromodulation at low power sonications was performed in a few patients, based on their intraprocedural clinical testing.
As a result of this study, the researchers conclude that this initial investigation of MRgFUS thalamotomy seems both safe and effective in alleviating contralateral appendicular tremor. This noninvasive technique, utilized in concert with neuromodulation acoustic parameters, may prove very effective for people with tremor and other movement disorders.
Disclosure: the author reports no conflicts of interest.
The 2012 AANS Annual Meeting press kit includes releases on highlighted scientific research, AANS officer and award winners, and National Neurosurgery Awareness Week. These releases will be posted under Media/Press on the 2012 AANS Annual Meeting website page.
Media Representatives: If you would like to cover the meeting or interview a neurosurgeon - either on-site or via telephone - please contact John Iwanski, AANS Director of Member and Public Outreach, at 847-378-0517, or call the Annual Scientific Meeting Press Room beginning Monday, April 16 at 786-276-4501.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 8,100 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the spinal column, spinal cord, brain and peripheral nerves.