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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3784

Title: What factors impact the clinical outcome of magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor?
Other Titles: 本態性振戦に対するMRIガイド下集束超音波視床破壊術の臨床転帰に影響する因子は何か。
Authors: Fukutome, Kenji
Kuga, Yoshihiro
Ohnishi, Hideyuki
Hirabayashi, Hidehiro
Nakase, Hiroyuki
Keywords: focused ultrasound
thalamotomy
essential tremor
clinical rating scale for tremor
magnetic resonance imaging guided
ventral intermediate nucleus
skull density ratio
temperature
functional neurosurgery
CRST
ET
MRgFUS
SDR
Vim
Issue Date: 1-May-2020
Publisher: American Association of Neurological Surgeons
Citation: Journal of neurosurgery Online ahead of print (2020 May 1)
Abstract: Objective: Magnetic resonance imaging-guided focused ultrasound (MRgFUS) is a novel and useful treatment for essential tremor (ET); however, the factors impacting treatment outcome are unknown. The authors conducted this study to determine the factors affecting the outcome of MRgFUS. Methods: From May 2016 through August 2017, 15 patients with ET were admitted to Ohnishi Neurological Center and treated with MRgFUS. To determine the factors impacting treatment outcome, the authors retrospectively studied correlations between the Clinical Rating Scale for Tremor (CRST) improvement rate and age, disease duration, baseline CRST score, skull density ratio (SDR), skull volume, maximum delivered energy, or maximum temperature. Results: The mean CRST score was 18.5 ± 5.8 at baseline and 4.6 ± 5.7 at 1 year. The rate of improvement in the CRST score was 80% ± 22%. Younger age and lower baseline CRST score were correlated with a higher CRST improvement rate (p = 0.025 and 0.007, respectively). To obtain a CRST improvement rate ≥ 50%, a maximum temperature ≥ 55°C was necessary. There was no correlation between SDR and CRST improvement rate (p = 0.658). A lower SDR and higher skull volume required significantly higher maximum delivered energy (p = 0.014 and 0.016, respectively). A higher maximum temperature was associated with a significantly larger lesion volume (p = 0.026). Conclusions: Younger age and lower baseline CRST score were favorable outcome factors. It is important to assess predictive factors when applying MRgFUS.
Description: 博士(医学)・乙第1468号・令和2年9月30日
©AANS 2020, except where prohibited by US copyright law.
発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.3171/2020.2.JNS192814"(※全文閲覧は学内限定)
URI: http://hdl.handle.net/10564/3784
ISSN: 00223085
Academic Degrees and number: 24601B1468
Degree-granting date: 2020-09-30
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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