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

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Author information

Affiliations

  • 1. Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV 26505, USA.
      Authors
    • Petersen J 1
    • McGough J 1
    • Brandmeir C 1
    • Mahoney JJ 3rd 1, 5
    (4 authors)
  • 2. Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada  M4N 3M5.
      Authors
    • Gopinath G 2
    • Boshmaf SZ 2
    • Sewell IJ 2
    • Abrahao A 2, 3
    • Lam B 2
    • Hamani C 2, 3
    • Rohringer C 2
    • McSweeney M 2
    • Schwartz ML 2
    • Lipsman N 2, 3
    • Rabin JS 2, 3
    (11 authors)
  • 3. Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, ON, Canada  M4N 3M5.
      Authors
    • Scantlebury N 3
    • Abrahao A 2, 3
    • Hamani C 2, 3
    • Lipsman N 2, 3
    • Rabin JS 2, 3
    (5 authors)
  • 4. Jean and Paul Amos PD and Movement Disorders Program, Department of Neurology, Emory University School of Medicine, Atlanta, GA 30307, USA.
      Authors
    • Tripathi R 4
    (1 author)
  • 5. Department of Neuroscience, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV 26505, USA.
      Authors
    • Brandmeir NJ 5, 7
    • Konrad PE 5, 7
    • Mahoney JJ 3rd 1, 5
    • Rezai A 5, 7
    • Scarisbrick DM 5
    (5 authors)
    • Show all (7)

ORCIDs linked to this article

Brain Communications, 30 Aug 2024, 6(5):fcae293
https://doi.org/10.1093/braincomms/fcae293 PMID: 39291168 PMCID: PMC11406546

This article is in the Europe PMC Open access subset. Refer to the copyright information in the article for licensing details.
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Abstract 

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.

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Time: 2024/11/20 03:41:26

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Read article at publisher's site: https://doi.org/10.1093/braincomms/fcae293

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Funding 

Funders who supported this work.

Division of Neurology

    Harquail Centre for Neuromodulation

      NIGMS NIH HHS (1)

      National Institute of General Medical Sciences

        National Institutes of Health (1)

        Sandra Black Centre

          Slamen-Fast New Initiatives

            University of Toronto