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Magnetic Resonance–Guided Focused Ultrasound Thalamotomy May Spare Dopaminergic Therapy in Early‐Stage Tremor‐Dominant Parkinson's Disease: A Pilot Study
Author(s) -
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
Publication year - 2022
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.29200
Subject(s) - thalamotomy , selegiline , medicine , parkinson's disease , dopaminergic , essential tremor , levodopa , movement disorders , anesthesia , physical medicine and rehabilitation , disease , deep brain stimulation , dopamine
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