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Abstract #0491

Smaller MRgFUS lesions that overlap patient-fit normative VIM—Precentral tracts improve Quality-of-Life outcomes in Essential Tremor

Yosef Chodakiewitz1, David Arnold Purger1, Alan Rehn Wang1, Daniel Barbosa1, Lior Lev Tov1, Anjali Datta1, Rachelle Bitton1, Jennifer McNab1, Vivek Buch1, and Pejman Ghanouni1
1Stanford University, Stanford, CA, United States


While Focused-Ultrasound thalamotomy has proven effective at reducing tremor, traditional targeting methods can be suboptimal at balancing primary tremor-reduction outcomes against undesired side-effects. The traditional “canonical” technique involves an indirect method which applies a non-individualized stereotactic coordinate atlas towards identifying the presumed approximate location of VIM thalamus, the ablation target; the canonical lesion is empirically grown in size based-on dynamic intraoperative feedback from an awake patient, until the surgeon judges that an appropriate balance of tremor-reduction and side-effect risk has been achieved. We propose optimized methods to define and monitor the ideal anatomical ablation for optimized tremor-reduction/Quality-of-Life balancing.

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