Cognitive outcomes following unilateral magnetic resonance-guided focused ultrasound thalamotomy for essential tremor: findings from two cohorts

被引：3

作者：

Petersen, Julie ^{[1
,2
]}

McGough, Josh ^{[1
]}

Gopinath, Georgia ^{[3
]}

Scantlebury, Nadia ^{[4
]}

Tripathi, Richa ^{[5
]}

Brandmeir, Cheryl ^{[1
]}

Boshmaf, Silina Z. ^{[3
]}

Brandmeir, Nicholas J. ^{[6
,7
]}

Sewell, Isabella J. ^{[3
]}

Konrad, Peter E. ^{[6
,7
]}

Abrahao, Agessandro ^{[3
,4
,8
]}

Murray, Ann ^{[9
]}

Lam, Benjamin ^{[3
,8
]}

Ranjan, Manish ^{[7
]}

Hamani, Clement ^{[3
,4
,10
]}

Frey, Jessica ^{[9
]}

Rohringer, Camryn ^{[3
]}

McSweeney, Melissa ^{[3
]}

Mahoney III, James J. ^{[1
,6
,11
]}

Schwartz, Michael L. ^{[3
,10
]}

Rezai, Ali ^{[6
,7
]}

Lipsman, Nir ^{[3
,4
,10
,12
]}

Scarisbrick, David M. ^{[6
,11
]}

Rabin, Jennifer S. ^{[3
,4
,13
]}

机构：

[1] West Virginia Univ, Sch Med, Rockefeller Neurosci Inst, Morgantown, WV 26505 USA

[2] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Psychiat, Boston, MA 02215 USA

[3] Sunnybrook Res Inst, Hurvitz Brain Sci Program, Toronto, ON M4N 3M5, Canada

[4] Sunnybrook Res Inst, Harquail Ctr Neuromodulat, Toronto, ON M4N 3M5, Canada

[5] Emory Univ, Jean & Paul Amos PD & Movement Disorders Program, Sch Med, Dept Neurol, Atlanta, GA 30307 USA

[6] West Virginia Univ, Sch Med, Rockefeller Neurosci Inst, Dept Neurosci, Morgantown, WV 26505 USA

[7] West Virginia Univ, Rockefeller Neurosci Inst, Sch Med, Dept Neurosurg, Morgantown, WV 26505 USA

[8] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med, Div Neurol, Toronto, ON M4N 3M5, Canada

[9] West Virginia Univ, Rockefeller Neurosci Inst, Sch Med, Dept Neurol, Morgantown, WV 26505 USA

[10] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Surg, Div Neurosurg, Toronto, ON M4N 3M5, Canada

[11] West Virginia Univ, Sch Med, Rockefeller Neurosci Inst, Dept Behav Med & Psychiat, Morgantown, WV 26505 USA

[12] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Psychiat, Toronto, ON M4N 3M5, Canada

[13] Univ Toronto, Rehabil Sci Inst, Toronto, ON M5G 1V7, Canada

来源：

BRAIN COMMUNICATIONS | 2024年 / 6卷 / 05期

基金：

美国国家卫生研究院;

关键词：

magnetic resonance-guided focused ultrasound; cognition; thalamotomy; essential tremor; neuropsychology; QUALITY-OF-LIFE; THALAMIC-STIMULATION; VARIABILITY;

D O I：

10.1093/braincomms/fcae293

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Magnetic resonance-guided, focused ultrasound thalamotomy is a neurosurgical treatment for refractory essential tremor. This study examined cognitive outcomes following unilateral magnetic resonance-guided, focused ultrasound thalamotomy, targeting the ventral intermediate nucleus of the thalamus for essential tremor. The research was conducted at two sites: Sunnybrook Research Institute in Toronto, Canada, and West Virginia University School of Medicine Rockefeller Neuroscience Institute in West Virginia, USA. The study focused on cognitive changes at both the group and individual levels. Patients with refractory essential tremor completed cognitive testing before and after magnetic resonance-guided, focused ultrasound thalamotomy at both sites. The cognitive testing assessed domains of attention, processing speed, working memory, executive function, language and learning/memory. Postoperative changes in cognition were examined using paired t-tests and Wilcoxon signed-rank tests, as appropriate. Reliable change indices were calculated to assess clinically significant changes at the individual level. A total of 33 patients from Toronto and 22 patients from West Virginia were included. Following magnetic resonance-guided, focused ultrasound thalamotomy, there was a significant reduction in tremor severity in both cohorts. At the group level, there were no significant declines in postoperative cognitive performance in either cohort. The reliable change analyses revealed some variability at the individual level, with most patients maintaining stable performance or showing improvement. Taken together, the results from these two independent cohorts demonstrate that unilateral magnetic resonance-guided, focused ultrasound thalamotomy significantly reduces tremor severity without negatively impacting cognition at both the group and individual levels, highlighting the cognitive safety of magnetic resonance-guided focused ultrasound thalamotomy for essential tremor.

引用

页数：10

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