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Abstract：
OBJECTIVE: Magnetic Resonance-guided Focused Ultrasound (MRgFUS) is an emerging technique for the treatment of severe, medication-refractory tremor syndromes. We here report motor and non-motor outcomes 6 and 12 months after unilateral MRgFUS thalamotomy in tremor-dominant Parkinson\'s disease (tdPD).
METHODS: 25 patients with tdPD underwent neuropsychological evaluation including standardized questionnaires of disability, quality of life (QoL), mood, anxiety, apathy, sleep disturbances, and cognition at baseline, 6 and 12 months after MRgFUS. Motor outcome was evaluated using the Clinical Rating Scale for Tremor (CRST) and Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale (MDS-UPDRS). In addition, side effects and QoL of family caregivers were assessed.
RESULTS: 12 months after MRgFUS significant improvements were evident in the tremor subscores. Patients with concomitant rest and postural tremor showed better tremor outcomes compared to patients with predominant rest tremor. There were no differences in the non-motor assessments. No cognitive decline was observed. Side effects were mostly transient (54%) and classified as mild (62%). No changes in the caregivers\' QoL could be observed.
CONCLUSIONS: We found no changes in mood, anxiety, apathy, sleep, cognition or persistent worsening of gait disturbances after unilateral MRgFUS thalamotomy in tdPD. Concomitant postural tremors responded better to treatment than predominant rest tremors.
METHODS: 25 patients with tdPD underwent neuropsychological evaluation including standardized questionnaires of disability, quality of life (QoL), mood, anxiety, apathy, sleep disturbances, and cognition at baseline, 6 and 12 months after MRgFUS. Motor outcome was evaluated using the Clinical Rating Scale for Tremor (CRST) and Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale (MDS-UPDRS). In addition, side effects and QoL of family caregivers were assessed.
RESULTS: 12 months after MRgFUS significant improvements were evident in the tremor subscores. Patients with concomitant rest and postural tremor showed better tremor outcomes compared to patients with predominant rest tremor. There were no differences in the non-motor assessments. No cognitive decline was observed. Side effects were mostly transient (54%) and classified as mild (62%). No changes in the caregivers\' QoL could be observed.
CONCLUSIONS: We found no changes in mood, anxiety, apathy, sleep, cognition or persistent worsening of gait disturbances after unilateral MRgFUS thalamotomy in tdPD. Concomitant postural tremors responded better to treatment than predominant rest tremors.
摘要：
目的：磁共振引导聚焦超声（MRgFUS）是一种新兴的治疗方法，药物难治性震颤综合征。我们在此报告震颤性帕金森病（tdPD）单侧MRgFUS丘脑切开术后6个月和12个月的运动和非运动结果。
方法：25例tdPD患者接受了神经心理学评估，包括标准化的残疾问卷，生活质量（QoL），心情,焦虑,冷漠,睡眠障碍,和基线时的认知，MRgFUS后6个月和12个月。使用震颤临床评定量表（CRST）和运动障碍协会-帕金森病统一评定量表（MDS-UPDRS）评估运动结果。此外,评估了家庭护理人员的副作用和QoL.
结果：12个月后，MRgFUS的震颤评分明显改善。与主要休息性震颤的患者相比，伴随休息和姿势性震颤的患者表现出更好的震颤结果。非运动评估没有差异。没有观察到认知能力下降。副作用大多是短暂的(54%)，归类为轻度的(62%)。未观察到护理人员的QoL变化。
结论：我们发现情绪没有变化，焦虑,冷漠,睡眠,tdPD单侧MRgFUS丘脑切开术后认知或步态障碍持续恶化。伴随的姿势性震颤对治疗的反应比主要的休息震颤更好。
方法：25例tdPD患者接受了神经心理学评估，包括标准化的残疾问卷，生活质量（QoL），心情,焦虑,冷漠,睡眠障碍,和基线时的认知，MRgFUS后6个月和12个月。使用震颤临床评定量表（CRST）和运动障碍协会-帕金森病统一评定量表（MDS-UPDRS）评估运动结果。此外,评估了家庭护理人员的副作用和QoL.
结果：12个月后，MRgFUS的震颤评分明显改善。与主要休息性震颤的患者相比，伴随休息和姿势性震颤的患者表现出更好的震颤结果。非运动评估没有差异。没有观察到认知能力下降。副作用大多是短暂的(54%)，归类为轻度的(62%)。未观察到护理人员的QoL变化。
结论：我们发现情绪没有变化，焦虑,冷漠,睡眠,tdPD单侧MRgFUS丘脑切开术后认知或步态障碍持续恶化。伴随的姿势性震颤对治疗的反应比主要的休息震颤更好。
