1Department of Neurosurgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
2Focused Ultrasound Foundation, Charlottesville, Virginia.
Neurosurg Focus. 2024 Sep 1;57(3):E3. doi: 10.3171/2024.6.FOCUS2494.
Essential tremor (ET) is the most common movement disorder globally and has negative impacts on quality of life. While medical treatments exist, approximately 50% of patients have tremor that is refractory to medication or experience intolerable medication side effects. Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is an option for these patients and while incisionless, it is still invasive, although less so than other surgical treatments such as deep brain stimulation and radiofrequency thalamotomy. Despite MRgFUS being FDA-approved since 2016, there is still no current consensus on the best approaches for targeting, imaging, and outcome measurement. A 2-day workshop held by the Focused Ultrasound Foundation in September of 2023 convened experts and critical stakeholders in the field to share their knowledge and experiences. The goals of the workshop were to determine the optimal target location within the thalamus and compare best practices for localizing the target and tracking patient outcomes. This paper summarizes the current landscape, important questions, and discussions that will help direct future treatments to improve patient care and outcomes.
特发性震颤（ET）是全球最常见的运动障碍，对生活质量有负面影响。虽然有医学治疗方法，但约 50%的患者的震颤对药物治疗有抗药性或出现无法忍受的药物副作用。对于这些患者，磁共振引导聚焦超声（MRgFUS）丘脑切开术是一种选择，虽然是非切口的，但仍具有侵入性，尽管比其他手术治疗（如深部脑刺激和射频丘脑切开术）的侵入性要小。尽管自 2016 年以来，MRgFUS 已获得 FDA 批准，但在靶向、成像和结果测量的最佳方法上仍没有共识。2023 年 9 月，聚焦超声基金会举办了为期两天的研讨会，召集了该领域的专家和关键利益相关者，分享他们的知识和经验。研讨会的目标是确定丘脑内的最佳目标位置，并比较定位目标和跟踪患者结果的最佳实践。本文总结了当前的情况、重要问题和讨论，这些将有助于指导未来的治疗方法，以改善患者的护理和结果。
