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• W4367296750 abstract "<h3>Objective:</h3> To report outcomes of MRI guided focused ultrasound (MRgFUS) unilateral ventral intermediate nucleus (VIM) thalamotomy in tremor-predominant Parkinson’s disease (PD) patients at a single institution. <h3>Background:</h3> MRgFUS thalamotomy of the VIM is an emerging non-invasive therapy approved for tremor-predominant PD. There are limited data on treatment outcomes and adverse effects from MRgFUS for PD. In select patients, MRgFUS can be a surgical treatment option for medication refractory tremor in PD. <h3>Design/Methods:</h3> Patients with PD who underwent unilateral MRgFUS VIM thalamotomy at a single institution were included. The Unified Parkinson’s Disease Rating Scale (UPDRS), global improvement questionnaires and adverse events were assessed at baseline and the most recent follow-up visit (range 2–13.5 months). <h3>Results:</h3> Twelve patients underwent unilateral MRgFUS VIM thalamotomy. Two patients had transient improvement and subsequently went on to obtain deep brain stimulation. Ten patients (8 male) had a mean follow-up of 8.1 ± 4.1 months. The mean age at time of surgery was 74.8 ± 8.6 years (62.7–88.5). Average disease duration was 6.1 ± 4.7 years (1.7–14.8). UPDRS motor score improved from 38.5 at baseline to 33.6 (12.8%, p=0.007) and UPDRS tremor score improved from 8.1 at baseline to 4.6 (43%, p=0.005). At last follow-up 8/10 (80%) patients noted moderate-marked global improvement, 1/10 (10%) reported mild improvement and 1/10 (10%) indicated mild worsening. Adverse events included gait difficulties which typically improved or resolved by 2 months. One individual developed acute thalamic edema with significant postural instability, but had subsequent improvement prior to passing away 2 months later. Another patient died 8 months after MRgFUS which was felt unrelated to his surgery. <h3>Conclusions:</h3> Unilateral MRgFUS thalamotomy is safe and effective treatment for tremor predominant PD. Two patient deaths in our cohort were felt unrelated to the MRgFUS procedure. Short term gait difficulties are a common adverse effect, but typically resolve over time. <b>Disclosure:</b> Dr. Au has nothing to disclose. Dr. Lyons has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Dr. Lyons has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Dr. Lyons has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acorda. Dr. Lyons has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus. Dr. Lyons has a non-compensated relationship as a President with International Essential Tremor Foundation that is relevant to AAN interests or activities. Miss O’Brien has nothing to disclose. Dr. Sharma has nothing to disclose. Jennifer Cheng, MD has nothing to disclose. Dr. Kinsman has nothing to disclose. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbott. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. Dr. Pahwa has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for ACADIA. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acorda. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amneal. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cala Health. Dr. Pahwa has received personal compensation in the range of $0-$499 for serving as a Consultant for Global Kinetics. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kyowa. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sunovion. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allevion. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avion. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Insightec. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jaaz. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neuroderm. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Photopharmics. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Wren. The institution of Dr. Pahwa has received research support from Abbott. The institution of Dr. Pahwa has received research support from Abbvie. The institution of Dr. Pahwa has received research support from Biogen. The institution of Dr. Pahwa has received research support from Biohaven. The institution of Dr. Pahwa has received research support from Boston Scientific. The institution of Dr. Pahwa has received research support from EIP. The institution of Dr. Pahwa has received research support from Global Kinetics. The institution of Dr. Pahwa has received research support from Amneal. The institution of Dr. Pahwa has received research support from Neuraly. The institution of Dr. Pahwa has received research support from Parkinson Foundation. The institution of Dr. Pahwa has received research support from Pharma 2B. The institution of Dr. Pahwa has received research support from Roche. The institution of Dr. Pahwa has received research support from Sage. The institution of Dr. Pahwa has received research support from Sun Pharma. The institution of Dr. Pahwa has received research support from Theranexus. The institution of Dr. Pahwa has received research support from Theravance. The institution of Dr. Pahwa has received research support from Voyager. The institution of Dr. Pahwa has received research support from Neuroderm." @default.
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• W4367296750 date "2023-04-25" @default.
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• W4367296750 title "Efficacy and Safety of Unilateral MRgFUS Thalamotomy for Tremor-Predominant Parkinson’s Disease (P4-11.002)" @default.
• W4367296750 doi "https://doi.org/10.1212/wnl.0000000000204161" @default.
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