HIFU MRg Unit - JCC Diagnostic Imaging & HOPCA Saúde, installed in partnership at Hospital São Francisco do Porto, Portugal.
Arq Neuropsiquiatr. 2024 Aug;82(8):1-7. doi: 10.1055/s-0044-1788668. Epub 2024 Aug 26.
The magnetic resonance imaging-guided focused ultrasound (MRgFUS) has emerged as an innovative treatment for patients with medically refractory essential tremor (ET).
This retrospective observational study aims to present the results of the first five patients with medically refractory ET who underwent MRgFUS treatment at this pioneering medical unit in Portugal.
We conducted a retrospective chart review for the first five patients who underwent unilateral MRgFUS thalamotomy of the ventral intermediate (Vim) nucleus to treat medically refractory ET at our medical unit.
The mean patient age was 65.4 (26-84) years, and 60% were male. All patients had a family history of ET. The mean duration of disease was 17.4 years (range 10-24 years), and their dominant hand was the right. According to personal preference, the thalamotomy was performed on the left side in four patients, and on the right side in one. The MRgFUS thalamotomy led to significant improvements in both the clinical rating scale for tremor (CRST) score, by 62%, and the CRST composite score for the treated hand, by 73%. All patients experienced improvements in functionality and quality of life, by 52%. No severe adverse events were observed, and those that did occur during and following the procedure were mild and transient.
The initial results from Portugal's first MRgFUS medical unit indicate promising outcomes, with improvement in quality of life, as well as mild and temporary adverse events These findings contribute to the growing body of literature supporting the efficacy and safety of MRgFUS as a viable treatment option for patients with medication-resistant ET.
磁共振引导聚焦超声（MRgFUS）已成为治疗药物难治性特发性震颤（ET）患者的一种创新疗法。
本回顾性观察研究旨在介绍葡萄牙首个医学中心的前五例药物难治性 ET 患者接受 MRgFUS 治疗的结果。
我们对在我们的医学中心接受单侧丘脑腹中间核（Vim）MRgFUS 切开术治疗药物难治性 ET 的前五例患者进行了回顾性图表审查。
患者的平均年龄为 65.4（26-84）岁，60%为男性。所有患者均有 ET 家族史。疾病的平均持续时间为 17.4 年（范围 10-24 年），且以右手为主。根据个人偏好，有 4 例患者在左侧进行了丘脑切开术，1 例在右侧进行了丘脑切开术。MRgFUS 丘脑切开术使震颤临床评定量表（CRST）评分降低了 62%，治疗手的 CRST 综合评分降低了 73%，均有显著改善。所有患者的功能和生活质量均有改善，提高了 52%。未观察到严重不良事件，仅在治疗过程中和治疗后出现了一些轻度和短暂的不良事件。
葡萄牙首个 MRgFUS 医学中心的初步结果显示出有前景的结果，改善了生活质量，且不良事件轻微且短暂。这些发现为越来越多的支持 MRgFUS 作为药物难治性 ET 患者可行治疗选择的有效性和安全性的文献提供了新的证据。
