Imperial College London
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Dr Yen F Tai

Faculty of Medicine, Department of Brain Sciences

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3311 1182yen.tai

 
 
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Location

 

Department of NeurologyCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Jameel:2021:10.1080/02688697.2021.1958150,
author = {Jameel, A and Gedroyc, W and Nandi, D and Jones, B and Kirmi, O and Molloy, S and Tai, Y and Charlesworth, G and Bain, P},
doi = {10.1080/02688697.2021.1958150},
journal = {British Journal of Neurosurgery},
pages = {241--250},
title = {Double lesion MRgFUS treatment of essential tremor targeting the thalamus and posterior sub-thalamic area: preliminary study with two year follow-up},
url = {http://dx.doi.org/10.1080/02688697.2021.1958150},
volume = {36},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundMR-guided focused ultrasound (MRgFUS) is an effective treatment for essential tremor (ET). However, the optimal intracranial target sites remain to be determined.ObjectiveTo assess MRgFUS induced sequential lesions in (anterior-VIM/VOP nuclei) the thalamus and then posterior subthalamic area (PSA) performed during the same procedure for alleviating ET.Methods14 patients had unilateral MRgFUS lesions placed in anterior-VIM/VOP then PSA. Bain-Findley Spirals were collected during MRgFUS from the treated arm (BFS-TA) and throughout the study from the treated (BFS-TA) and non-treated (BFS-NTA) arms and scored by blinded assessors. Although, the primary outcome was change in the BFS-TA from baseline to 12 months we have highlighted the 24-month data. Secondary outcomes included the Clinical Rating Scale for Tremor (CRST), Quality of Life for ET (QUEST) and PHQ-9 depression scores.ResultsThe mean improvement in the BFS-TA from baseline to 24 months was 41.1% (p < 0.001) whilst BFS-NTA worsened by 8.8% (p < 0.001). Intra-operative BFS scores from the targeted arm showed a mean 27.9% (p < 0.001) decrease after anterior-VIM/VOP ablation and an additional 30.1% (p < 0.001) reduction from post anterior-VIM/VOP to post-PSA ablation. Mean improvements at 24 month follow-up in the CRST-parts A, B and C were 60.7%, 30.4% and 65.6% respectively and 37.8% in QUEST-tremor score (all p < 0.05). Unilateral tremor severity scores decreased in the treated arm (UETTS-TA) 72.9% (p = 0.001) and non-treated arm (UETTS-NTA) 30.5% (p = 0.003). At 24 months residual adverse effects were slight unsteadiness (n = 1) and mild hemi-chorea (n = 1).ConclusionUnilateral anterior-VIM/VOP and PSA MRgFUS significantly diminished contralateral arm tremor with improvements in arm function, tremor related disability and quality of life, with an acceptable adv
AU  - Jameel,A
AU  - Gedroyc,W
AU  - Nandi,D
AU  - Jones,B
AU  - Kirmi,O
AU  - Molloy,S
AU  - Tai,Y
AU  - Charlesworth,G
AU  - Bain,P
DO  - 10.1080/02688697.2021.1958150
EP  - 250
PY  - 2021///
SN  - 0268-8697
SP  - 241
TI  - Double lesion MRgFUS treatment of essential tremor targeting the thalamus and posterior sub-thalamic area: preliminary study with two year follow-up
T2  - British Journal of Neurosurgery
UR  - http://dx.doi.org/10.1080/02688697.2021.1958150
UR  - https://www.tandfonline.com/doi/full/10.1080/02688697.2021.1958150
UR  - http://hdl.handle.net/10044/1/91090
VL  - 36
ER  -
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