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Abstract #4039

Is the tremor relief in Parkinson’s disease ancillary benefits during the ablation of thalamic Vim using MR guided focused ultrasound (MRgFUS)? 

Hongchae Baek1,2, Sean Nagel2, Daniel Lockwood1, Emmanuel C. Obusez1, and Stephen E. Jones1
1Imaging Institute, Cleveland Clinic, Cleveland, OH, United States, 2Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, United States


Essential tremor (ET) and tremor dominant Parkinson’s disease (PD) treatment using MRgFUS share the same therapeutic target and the thermal dose threshold to create a thalamic lesion at ViM. However, PD patients respond to treatment typically only during the last few sonications, whereas ET patients respond earlier, typically within the first few sonications. Furthermore, we confirmed that zona incerta (ZI) is commonly affected due to proximity to ViM, by using postoperative T2-weighted images fused with auto-segmented ViM and ZI, demonstrating a possible causal relationship between the lesion overlap with ZI that primarily reduces tremor reduction in PD patients.

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