Stereotactic radiosurgery for tremor: systematic review

Martínez-Moreno, Nuria; Sahgal, Arjun; Salles, Antônio De; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Paddick, Ian; Régis, Jean; Ryu, Sam; Slotman, Ben J.; Martínez‐Álvarez, Roberto

doi:10.3171/2017.8.jns17749

Cited by 34 publications

(27 citation statements)

References 82 publications

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“…Более серьезные осложнения, такие как кровоизлияние в таламус, встречаются в единичных сообщениях [22,25]. Так, M. S. Okun и соавт.…”

Section: рис 1 фотография пациента (а) и магнитно-резонансная томография (б) при фиксации стереотаксической рамы рама расположена таким оunclassified

Radiosurgical treatment of medically refractory Parkinson’s tremor

Ivanov

Zubatkina

Butovskaya³

et al. 2021

Nejrohirurgiâ (Mosk.)

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Introduction. In spite of medication treatment being today the basic form of treatment for Parkinson’s disease, surgical methods may be preferable to improve symptoms of the disease. Radiosurgery is one of them, but in Russia, to date, there are no publications summarizing data about the experience of using this method throughout the country.The study objective is to evaluate the effect of radiosurgical thalamotomy (destruction of the intermediate ventral nucleus of the thalamus) on the severity of tremor in patients with Parkinson’s disease, as well as to estimate the frequency of complications of this intervention, the frequency of different variants of radiological and clinical-neurological response.Materials and methods. One hundred and one (101) patients with medically refractory Parkinson’s tremor received Gamma Knife radiosurgery in our centre over a 10‑year period, of whom 10 patients were treated bilaterally. Pre-treatment evaluation was done using tremor assessment scales and video recordings of tremor intensity. Gamma Knife radiosurgery was provided with Leksell Gamma Knife 4C and Leksell Gamma Knife Perfexion (Elekta AB, Sweden) preceded by magnetic resonance tractography the day before treatment. The same planning protocol was used for all patients, the target was ventral intermediate nucleus and the prescription dose of 130 Gy was delivered with a 4 mm isocenter. After treatment, patients were evaluated radiologically and neurologically at regular 6‑month intervals, as well as through telephone interviews and video recordings.Results. Ninety-two (92) patients were included in the analysis of the results of radiosurgical treatment. Median follow-up time after radiosurgery was 26 months, from 6 to 113 months. Tremor reduction was achieved in 76 % of the patients, 61 % of whom had almost complete tremor arrest. Decreased tremors were observed from 1 to 6 months after treatment, with a mean of 4 months. Three (3) patients experienced tremor resurgence after 3–7 years. Complications were observed in 6.5 % of patients and were transient in character. Some of the patients developed severe depression. Only 1 patient had a serious complication in the form of thalamic haemorrhage (at 22 months after treatment). Ten (10) patients who were treated bilaterally all showed considerable clinical improvement and absence of complications.Conclusion. Gamma Knife radiosurgery is a safe and effective functional neurosurgical procedure for tremor correction to improve patients’ quality of life, especially when deep brain stimulation is not accessible. Patients with severe medically refractory tremors are good candidates for Gamma Knife treatment, which showed high efficacy and a low risk of complications.

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Radiosurgical treatment of medically refractory Parkinson’s tremor

Ivanov

Zubatkina

Butovskaya³

et al. 2021

Nejrohirurgiâ (Mosk.)

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“…Since that time, the patient indications for treatment have not changed much. Currently, SRS is adopted primarily to treat benign brain tumors, arteriovenous malformations, acoustic neuromas, brain metastases, and other brain tumors, as well as trigeminal neuralgia (Table 4) [26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Indications Of Radiosurgerymentioning

confidence: 99%

The mixed era of stereotactic radiosurgery and radiotherapy

Park

2021

J Korean Ster Func Neurosurg

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“…The field's apparent hesitancy to pursue surgical intervention may be due in part to the controversial use of the highly indiscriminate prefrontal lobotomy to treat psychiatric disorders in the 1940's and 1950's, and this hesitancy has persisted despite the more accurate and discriminatory cingulotomy and capsulotomy, as they are also non-reversible and destructive lesioning procedures (20,21). Advances in many areas of neurosurgery have led to the development of new, precise procedures such as radiosurgery and neurostimulation (22,23). For example, deep brain stimulation (DBS) is a well-recognized and effective surgical intervention for the treatment of medically-refractory movement disorders (24,25).…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation for Obsessive–Compulsive Disorder: A Long Term Naturalistic Follow Up Study in a Single Institution

et al. 2020

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Introduction: Deep brain stimulation (DBS) is a proven, effective tool in the treatment of movement disorders. Expansion of indications for DBS into the realm of neuropsychiatric disorders, especially obsessive-compulsive disorder (OCD), has gained fervent interest, although data on appropriate clinical utilization remains limited. Methods: A retrospective, naturalistic study followed nine severely affected OCD patients (average YBOCs score before implantation 34.2 ± 2.5) treated with DBS of ventral capsule/ventral striatum, with average follow up of 54.8 months. Results: With chronic stimulation (years), a majority of the patients achieved significant benefits in obsessive-compulsive and depressive symptoms. Six patients experienced periods of OCD remission following implantation. Four of the six responders required more than 12 months to achieve response. Relief of major depressive symptoms occurred in four out of six patients with documented co-morbid depression. Settings required to achieve efficacy were higher than those typically utilized for movement disorders, necessitating increased impulse generator (IPG) battery demand. We found patients benefited from conversion to a rechargeable IPG to prevent serial operations for IPG replacement. For patients with rechargeable IPGs, the repetitive habit of recharging did not appear to aggravate or trigger new obsessive-compulsive behaviors or anxiety symptoms. Conclusions: Our study supports and builds upon other research suggesting that DBS for OCD in a real-world setting can be implemented successfully and provide long-term benefit for severely affected OCD patients. Optimal patient selection and DBS programming criteria are discussed. The use of rechargeable IPGs appears to be both cost effective and well-tolerated in this population.

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Stereotactic radiosurgery for tremor: systematic review

Cited by 34 publications

References 82 publications

Radiosurgical treatment of medically refractory Parkinson’s tremor

Radiosurgical treatment of medically refractory Parkinson’s tremor

The mixed era of stereotactic radiosurgery and radiotherapy

Deep Brain Stimulation for Obsessive–Compulsive Disorder: A Long Term Naturalistic Follow Up Study in a Single Institution

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