A single case of MRI-guided focused ultrasound ventro-oral thalamotomy for musician's dystonia

Journal of Neurosurgery
Shiro HorisawaTakaomi Taira

Abstract

Musician's dystonia (MD) is a type of focal hand dystonia that develops only while playing musical instruments and interferes with skilled and fine movements. Lesioning of the ventro-oral (Vo) nucleus of the thalamus (Vo-thalamotomy) using radiofrequency can cause dramatic improvement in MD symptoms. Focused ultrasound (FUS) can make intracranial focal lesions without an incision. The authors used MRI-guided FUS (MRgFUS) to create a lesion on the Vo nucleus to treat a patient with MD. Tubiana's MD scale (TMDS) was used to evaluate the condition of musical play ranging from 1 to 5 (1: worst, 5: best). The patient was a 35-year-old right-handed man with involuntary flexion of the right second, third, and fourth fingers, which occurred while playing a classical guitar. Immediately after therapeutic sonications of FUS Vo-thalamotomy, there was dramatic improvement in the MD symptoms. The TMDS scores before; at 0 and 1 week after; and at 1, 3, 6, and 12 months after MRgFUS Vo-thalamotomy were 1, 4, 4, 5, 5, 5, and 5, respectively. No complications were observed. Focused ultrasound Vo-thalamotomy can be an effective treatment for MD.

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Citations

Aug 14, 2020·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·V A PopovA S Sedov
Jul 14, 2020·Current Opinion in Neurology·Raúl Martínez-Fernández, José A Pineda-Pardo
Oct 24, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Ian O BledsoeMarta San Luciano
Oct 28, 2020·Nature Reviews. Neurology·Ying MengNir Lipsman
Dec 12, 2020·Advanced Science·Roland Beisteiner, Andres M Lozano
May 30, 2021·Movement Disorders : Official Journal of the Movement Disorder Society·Shiro HorisawaTakaomi Taira
Jul 27, 2021·Movement Disorders Clinical Practice·Raúl Martínez-FernándezJose A Obeso
Jul 3, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Navnika Gupta, Sanjay Pandey
Oct 12, 2021·Frontiers in Neurology·Lennart H StieglitzAlain Kaelin-Lang

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