First use of MRI-guided focused ultrasound to treat patients with essential tremor in Russia
- 作者: Galimova R.1,2, Nabiullina D.2, Illarioshkin S.3, Safin S.1, Sidorova Y.2, Akhmadeeva G.1,2, Mukhamadeeva N.1,2, Zagidullin N.1, Kachemaeva O.1,2, Krekotin D.2, Buzaev I.1,2
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隶属关系:
- Bashkir State Medical University
- Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
- Research Center of Neurology
- 期: 卷 16, 编号 2 (2022)
- 页面: 5-14
- 栏目: Original articles
- URL: https://journals.rcsi.science/2075-5473/article/view/124044
- DOI: https://doi.org/10.54101/ACEN.2022.2.1
- ID: 124044
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Introduction. Treatment with MRI-guided focused ultrasound (MRgFUS) is a new, non-invasive surgical technique for treating extrapyramidal movement disorders. This article presents the first use of MRgFUS in Russia for treating patients with essential tremor (ET).
Materials and methods. Patients (n = 26; 17 men and 9 women) aged 21–82 years (median age 46.0 years) and with severe and refractory ET, underwent MRgFUS thalamotomy (ExAblate 4000, Insightec). One side was treated in 22 patients (left thalamus in 18 and right thalamus in 6), both sides were treated concurrently in two patients, and both sides were treated consecutively in two patients. Tremor was assessed using the Clinical Rating Scale for Tremor (CRST). Because international clinical specialists could not visit Russia due to the COVID-19 pandemic, MRgFUS was performed via telehealth on May 5, 2020, in a world first.
Results. A satisfactory result was achieved in 25 (96%) out of 26 patients. CRST scores improved by 64.7% on the side of the operation, by 10.2% on the control side, and by 37.5% overall. Intraoperative side effects included headache during sonication (42.3%), vertigo (15.4%), nausea (11.5%), vomiting (7.7%), numbness (3.8%), ataxia (3.8%), and pathological response to cold exposure (3.8%). The symptoms resolved immediately after surgery. Unstable gait was noted in five patients, which completely resolved two weeks after surgery. Median postoperative follow-up duration was 109 days [53; 231], with a maximum of 625 days. No relapses (if the hyperkinesia had completely disappeared) or increased tremor (if reduced after surgery) were observed.
Conclusion. The efficacy of MRgFUS for ET was 96%, with no long-term complications. Both bilateral concurrent and bilateral consecutive MRgFUS thalamotomy is possible, but its efficacy and safety should be assessed in a randomized study. In a world first, MRgFUS was successfully implemented using telehealth.
作者简介
Rezida Galimova
Bashkir State Medical University; Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: rezida@galimova.com
ORCID iD: 0000-0003-2758-0351
Cand. Sci. (Med.), Department of neurosurgery, Chief, neurosurgeon
俄罗斯联邦, Ufa; 450059, Ufa, Richard Zorge str., 17/4Dinara Nabiullina
Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: nabiullina.dinara@yandex.ru
ORCID iD: 0000-0003-2570-3709
neurologist
俄罗斯联邦, 450059, Ufa, Richard Zorge str., 17/4Sergey Illarioshkin
Research Center of Neurology
Email: snillario@gmail.com
ORCID iD: 0000-0002-2704-6282
D.Sci. (Med.), Prof., Academician of the RAS, Deputy Director
俄罗斯联邦, MoscowShamil Safin
Bashkir State Medical University
Email: safinsh@mail.ru
ORCID iD: 0000-0002-0100-6100
D. Sci. (Med.), Prof., Head, Department of neurosurgery
俄罗斯联邦, UfaYulia Sidorova
Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: yuliasi.ufa@gmail.com
ORCID iD: 0000-0002-0992-0239
neurologist
俄罗斯联邦, 450059, Ufa, Richard Zorge str., 17/4Gulnara Akhmadeeva
Bashkir State Medical University; Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: nevrolog.ufa@gmail.com
ORCID iD: 0000-0001-5516-0587
Cand. Sci (Med.), Department of neurology, neurologist
俄罗斯联邦, Ufa; 450059, Ufa, Richard Zorge str., 17/4Nailya Mukhamadeeva
Bashkir State Medical University; Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: ishtu2013@yandex.ru
ORCID iD: 0000-0001-5158-2707
cardiologist
俄罗斯联邦, Ufa; 450059, Ufa, Richard Zorge str., 17/4Naufal Zagidullin
Bashkir State Medical University
Email: znaufal@mail.ru
ORCID iD: 0000-0003-2386-6707
D. Sci. (Med.), Prof., Head, Department of internal diseases
俄罗斯联邦, UfaOlga Kachemaeva
Bashkir State Medical University; Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: olga.kachemaeva@gmail.com
ORCID iD: 0000-0001-9949-9582
Cand. Sci. (Med.), Associate Professor, Department of neurology, neurologist
俄罗斯联邦, Ufa; 450059, Ufa, Richard Zorge str., 17/4Dmitriy Krekotin
Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
Email: krekotin@yandex.ru
ORCID iD: 0000-0002-2215-7178
Assistant, Department of MRI
俄罗斯联邦, 450059, Ufa, Richard Zorge str., 17/4Igor Buzaev
Bashkir State Medical University; Intelligent Neurosurgery Clinic, International Medical Center V.S. Buzaev Memorial
编辑信件的主要联系方式.
Email: igor@buzaev.com
ORCID iD: 0000-0003-0511-9345
D. Sci. (Med.), Prof., Surgery department, cardiovascular surgeon
俄罗斯联邦, Ufa; 450059, Ufa, Richard Zorge str., 17/4参考
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