Department of Neurology, St Vincent's Health Network Sydney, Sydney, Australia.
School of Medical Sciences, The University of New South Wales, Sydney, Australia.
Mov Disord. 2024 Jan;39(1):173-182. doi: 10.1002/mds.29658. Epub 2023 Nov 14.
The current literature comparing outcomes after a unilateral magnetic resonance image-guided focused ultrasound (MRgFUS) thalamotomy between tremor syndromes is limited and remains a possible preoperative factor that could help predict the long-term outcomes.
The aim was to report on the outcomes between different tremor syndromes after a unilateral MRgFUS thalamotomy.
A total of 66 patients underwent a unilateral MRgFUS thalamotomy for tremor between November 2018 and May 2020 at St Vincent's Hospital Sydney. Each patient's tremor syndrome was classified prior to treatment. Clinical assessments, including the hand tremor score (HTS) and Quality of Life in Essential Tremor Questionnaire (QUEST), were performed at baseline and predefined intervals to 36 months.
A total of 63 patients, comprising 30 essential tremor (ET), 24 dystonic tremor (DT), and 9 Parkinson's disease tremor (PDT) patients, returned for at least one follow-up. In the ET patients, at 24 months there was a 61% improvement in HTS and 50% improvement in QUEST compared to baseline. This is in comparison to PDT patients, where an initial benefit in HTS and QUEST was observed, which waned at each follow-up, remaining significant only up until 12 months. In the DT patients, similar results were observed to the ET patients: at 24 months there was a 61% improvement in HTS and 43% improvement in QUEST compared to baseline.
These results support the use of unilateral MRgFUS thalamotomy for the treatment of DT, which appears to have a similar expected outcome to patients diagnosed with ET. Patients with PDT should be warned that there is a risk of treatment failure. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
目前比较单侧磁共振引导聚焦超声（MRgFUS）丘脑切开术后不同震颤综合征结果的文献有限，仍然是一种可能的术前因素，可以帮助预测长期结果。
报告单侧 MRgFUS 丘脑切开术后不同震颤综合征的结果。
2018 年 11 月至 2020 年 5 月，共有 66 例震颤患者在悉尼圣文森特医院接受单侧 MRgFUS 丘脑切开术。每位患者的震颤综合征在治疗前进行分类。在基线和预先设定的间隔至 36 个月时进行临床评估，包括手部震颤评分（HTS）和原发性震颤生活质量问卷（QUEST）。
共有 63 例患者返回至少一次随访，其中包括 30 例特发性震颤（ET）、24 例肌张力障碍性震颤（DT）和 9 例帕金森病震颤（PDT）患者。在 ET 患者中，与基线相比，24 个月时 HTS 改善 61%，QUEST 改善 50%。与 PDT 患者相比，在最初观察到 HTS 和 QUEST 受益后，每次随访时都出现了下降，仅在 12 个月时仍有显著改善。在 DT 患者中，观察到与 ET 患者相似的结果：与基线相比，24 个月时 HTS 改善 61%，QUEST 改善 43%。
这些结果支持使用单侧 MRgFUS 丘脑切开术治疗 DT，其预期结果似乎与 ET 患者相似。应警告 PDT 患者存在治疗失败的风险。 © 2023 作者。运动障碍由 Wiley 期刊代表国际帕金森病和运动障碍协会出版。
