Magnetic Resonance–Guided Focused Ultrasound Thalamotomy May Spare Dopaminergic Therapy in Early‐Stage Tremor‐Dominant Parkinson's Disease: A Pilot Study

• Published in: Movement disorders Vol. 37; no. 11; pp. 2289 - 2295
• Main Authors: Golfrè Andreasi, Nico, Cilia, Roberto, Romito, Luigi Michele, Bonvegna, Salvatore, Straccia, Giulia, Elia, Antonio Emanuele, Novelli, Alessio, Messina, Giuseppe, Tringali, Giovanni, Levi, Vincenzo, Devigili, Grazia, Rinaldo, Sara, Gasparini, Valentina, Grisoli, Marina, Stanziano, Mario, Ghielmetti, Francesco, Prioni, Sara, Bocchi, Elisa, Amami, Paolo, Piacentini, Sylvie Hélène Marie Jeanne, Ciceri, Elisa Francesca Maria, Bruzzone, Maria Grazia, Eleopra, Roberto
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.11.2022; Wiley Subscription Services, Inc
• Subjects: Amine oxidase (flavin-containing); Brief Report; Brief Reports; Dopamine receptors; Essential Tremor - drug therapy; Essential Tremor - surgery; Humans; Levodopa; Levodopa - therapeutic use; Magnetic Resonance Imaging - methods; Magnetic Resonance Spectroscopy; Movement disorders; MRgFUS; Neurodegenerative diseases; Parkinson Disease - drug therapy; Parkinson Disease - surgery; Parkinson's disease; Patients; Pilot Projects; thalamotomy; Thalamus - diagnostic imaging; Thalamus - surgery; Treatment Outcome; Tremor; Tremor (Muscular contraction); Tremor - drug therapy; Tremor - etiology; Tremor - surgery; Ultrasonic imaging; Ultrasound; VIM; thalamotomy; tremor; MRgFUS; Parkinson's disease; VIM
• ISSN: 0885-3185; 1531-8257; 1531-8257
• DOI: 10.1002/mds.29200

ABSTRACT Background Magnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy is a safe and effective procedure for drug‐resistant tremor in Parkinson's disease (PD). Objective The aim of this study was to demonstrate that MRgFUS ventralis intermedius thalamotomy in early‐stage tremor‐dominant PD may prevent an increase in dopaminergic medication 6 months after treatment compared with matched PD control subjects on standard medical therapy. Methods We prospectively enrolled patients with early‐stage PD who underwent MRgFUS ventralis intermedius thalamotomy (PD‐FUS) and patients treated with oral dopaminergic therapy (PD‐ODT) with a 1:2 ratio. We collected demographic and clinical data at baseline and 6 and 12 months after thalamotomy. Results We included 10 patients in the PD‐FUS group and 20 patients in the PD‐ODT group. We found a significant increase in total levodopa equivalent daily dose and levodopa plus monoamine oxidase B inhibitors dose in the PD‐ODT group 6 months after thalamotomy. Conclusions In early‐stage tremor‐dominant PD, MRgFUS thalamotomy may be useful to reduce tremor and avoid the need to increase dopaminergic medications. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society