Case Report on Deep Brain Stimulation Rescue After Suboptimal MR-Guided Focused Ultrasound Thalamotomy for Essential Tremor: A Tractography-Based Investigation

Frontiers in Human Neuroscience
Sabir SalujaCasey H Halpern

Abstract

Essential tremor (ET) is the most prevalent movement disorder in adults, and can often be medically refractory, requiring surgical intervention. MRI-guided focused ultrasound (MRgFUS) is a less invasive procedure that uses ultrasonic waves to induce lesions in the ventralis intermedius nucleus (VIM) to treat refractory ET. As with all procedures for treating ET, optimal targeting during MRgFUS is essential for efficacy and durability. Various studies have reported cases of tremor recurrence following MRgFUS and long-term outcome data is limited to 3-4 years. We present a tractography-based investigation on a case of DBS rescue for medically refractory ET that was treated with MRgFUS that was interrupted due to the development of dysarthria during the procedure. After initial improvement, her hand tremor started to recur within 6 months after treatment, and bilateral DBS was performed targeting the VIM 24 months after MRgFUS. DBS induced long-term tremor control with monopolar stimulation. Diffusion MRI tractography was used to reconstruct the dentatorubrothalamic (DRTT) and corticothalmic (CTT) tracts being modulated by the procedures to understand the variability in efficacy between MRgFUS and DBS in treating ET in our patient...Continue Reading

References

Oct 27, 2004·NeuroImage·Stephen M SmithPaul M Matthews
Feb 23, 2010·Movement Disorders : Official Journal of the Movement Disorder Society·Elan D Louis, Joaquim J Ferreira
Jul 14, 2010·Movement Disorders : Official Journal of the Movement Disorder Society·Eliana Della FloraGuy J Maddern
Jan 18, 2012·NeuroImage·Bruce Fischl
Dec 15, 2012·NeuroImage·Robert E SmithAlan Connelly
Dec 29, 2013·AJNR. American Journal of Neuroradiology·M WintermarkW J Elias
Feb 16, 2016·Journal of Therapeutic Ultrasound·Marc N GallayDaniel Jeanmonod
Aug 25, 2016·The New England Journal of Medicine·W Jeffrey EliasJin W Chang
Apr 4, 2017·Movement Disorders : Official Journal of the Movement Disorder Society·Vinod K RavikumarCasey H Halpern
Aug 16, 2017·Stereotactic and Functional Neurosurgery·Minsoo KimJin Woo Chang
Feb 13, 2018·Stereotactic and Functional Neurosurgery·Tony R WangW Jeffrey Elias
Nov 20, 2018·Brain : a Journal of Neurology·Alexandre BoutetAndres M Lozano
Jan 11, 2019·Operative Neurosurgery·Allen L HoCasey H Halpern
Jan 22, 2020·Nature Reviews. Neurology·Elan D Louis, Phyllis L Faust

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Citations

Aug 11, 2021·Annals of Biomedical Engineering·Vismaya S BachuBetty Tyler
Aug 13, 2021·Journal of Neuro-oncology·Lior Lev-TovVivek P Buch

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Software Mentioned

Freesurfer
Insightec
MRtrix
FSL

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