Skull factors affecting outcomes of magnetic resonance-guided focused ultrasound for patients with essential tremor

Kyung Won Chang; Yong Sook Park; Jin Woo Chang

doi:10.3349/ymj.2019.60.8.768

Skull factors affecting outcomes of magnetic resonance-guided focused ultrasound for patients with essential tremor

Kyung Won Chang, Yong Sook Park, Jin Woo Chang

Department of Neurosurgery

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

Abstract

Purpose: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has become a standard treatment for medically intractable essential tremor (ET). Skull density ratio (SDR) and skull volume in patients with ET are currently considered useful indicators of the successful application of MRgFUS. We compared the clinical outcomes of MRgFUS thalamotomy with SDR above 0.4 and 0.45. We also described patterns of SDR and skull volume in Korean patients with ET who were eligible to be screened for MRgFUS. Materials and Methods: In screening 318 ET patients, we evaluated patterns of skull density and skull volume according to age and sex. Fifty patients with ET were treated with MRgFUS. We investigated the effects of SDR and skull volume on treatment parameters and the outcomes of ET. Results: The mean SDR of the 318 ET patients was 0.45±0.11, and that for skull volume was 315.74±40.95 cm³. The male patients had a higher SDR than female patients (p=0.047). Skull volume significantly decreased with aging. SDR and skull volume exhibited a linear negative relationship. Among therapeutic parameters, maximal temperature was positively related to SDR, while sonication number was not related to either SDR or skull volume. Tremor outcome was also not related to SDR or skull volume. Conclusion: SDR varied widely from 0.11 to 0.73, and men had a higher SDR. Therapeutic parameters and clinical outcomes were not affected by SDR or skull volume.

Original language	English
Pages (from-to)	768-773
Number of pages	6
Journal	Yonsei medical journal
Volume	60
Issue number	8
DOIs	https://doi.org/10.3349/ymj.2019.60.8.768
Publication status	Published - 2019 Aug

Bibliographical note

Funding Information:
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0060). Also, the authors thank Eyal Zadicario, Itay Rachmilevitch and other employees of InSightec for their excellent technical assistance.

Funding Information:
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI19C0060). Also,

Publisher Copyright:
© Yonsei University College of Medicine 2019.

All Science Journal Classification (ASJC) codes

Medicine(all)

Access to Document

10.3349/ymj.2019.60.8.768

Cite this

@article{787fcae54fa547a48f80d409a0362b8f,

title = "Skull factors affecting outcomes of magnetic resonance-guided focused ultrasound for patients with essential tremor",

abstract = "Purpose: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has become a standard treatment for medically intractable essential tremor (ET). Skull density ratio (SDR) and skull volume in patients with ET are currently considered useful indicators of the successful application of MRgFUS. We compared the clinical outcomes of MRgFUS thalamotomy with SDR above 0.4 and 0.45. We also described patterns of SDR and skull volume in Korean patients with ET who were eligible to be screened for MRgFUS. Materials and Methods: In screening 318 ET patients, we evaluated patterns of skull density and skull volume according to age and sex. Fifty patients with ET were treated with MRgFUS. We investigated the effects of SDR and skull volume on treatment parameters and the outcomes of ET. Results: The mean SDR of the 318 ET patients was 0.45±0.11, and that for skull volume was 315.74±40.95 cm3. The male patients had a higher SDR than female patients (p=0.047). Skull volume significantly decreased with aging. SDR and skull volume exhibited a linear negative relationship. Among therapeutic parameters, maximal temperature was positively related to SDR, while sonication number was not related to either SDR or skull volume. Tremor outcome was also not related to SDR or skull volume. Conclusion: SDR varied widely from 0.11 to 0.73, and men had a higher SDR. Therapeutic parameters and clinical outcomes were not affected by SDR or skull volume.",

author = "Chang, {Kyung Won} and Park, {Yong Sook} and Chang, {Jin Woo}",

note = "Funding Information: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0060). Also, the authors thank Eyal Zadicario, Itay Rachmilevitch and other employees of InSightec for their excellent technical assistance. Funding Information: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI19C0060). Also, Publisher Copyright: {\textcopyright} Yonsei University College of Medicine 2019.",

year = "2019",

month = aug,

doi = "10.3349/ymj.2019.60.8.768",

language = "English",

volume = "60",

pages = "768--773",

journal = "Yonsei Medical Journal",

issn = "0513-5796",

publisher = "Yonsei University College of Medicine",

number = "8",

}

TY - JOUR

T1 - Skull factors affecting outcomes of magnetic resonance-guided focused ultrasound for patients with essential tremor

AU - Chang, Kyung Won

AU - Park, Yong Sook

AU - Chang, Jin Woo

N1 - Funding Information: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0060). Also, the authors thank Eyal Zadicario, Itay Rachmilevitch and other employees of InSightec for their excellent technical assistance. Funding Information: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI19C0060). Also, Publisher Copyright: © Yonsei University College of Medicine 2019.

PY - 2019/8

Y1 - 2019/8

N2 - Purpose: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has become a standard treatment for medically intractable essential tremor (ET). Skull density ratio (SDR) and skull volume in patients with ET are currently considered useful indicators of the successful application of MRgFUS. We compared the clinical outcomes of MRgFUS thalamotomy with SDR above 0.4 and 0.45. We also described patterns of SDR and skull volume in Korean patients with ET who were eligible to be screened for MRgFUS. Materials and Methods: In screening 318 ET patients, we evaluated patterns of skull density and skull volume according to age and sex. Fifty patients with ET were treated with MRgFUS. We investigated the effects of SDR and skull volume on treatment parameters and the outcomes of ET. Results: The mean SDR of the 318 ET patients was 0.45±0.11, and that for skull volume was 315.74±40.95 cm3. The male patients had a higher SDR than female patients (p=0.047). Skull volume significantly decreased with aging. SDR and skull volume exhibited a linear negative relationship. Among therapeutic parameters, maximal temperature was positively related to SDR, while sonication number was not related to either SDR or skull volume. Tremor outcome was also not related to SDR or skull volume. Conclusion: SDR varied widely from 0.11 to 0.73, and men had a higher SDR. Therapeutic parameters and clinical outcomes were not affected by SDR or skull volume.

AB - Purpose: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has become a standard treatment for medically intractable essential tremor (ET). Skull density ratio (SDR) and skull volume in patients with ET are currently considered useful indicators of the successful application of MRgFUS. We compared the clinical outcomes of MRgFUS thalamotomy with SDR above 0.4 and 0.45. We also described patterns of SDR and skull volume in Korean patients with ET who were eligible to be screened for MRgFUS. Materials and Methods: In screening 318 ET patients, we evaluated patterns of skull density and skull volume according to age and sex. Fifty patients with ET were treated with MRgFUS. We investigated the effects of SDR and skull volume on treatment parameters and the outcomes of ET. Results: The mean SDR of the 318 ET patients was 0.45±0.11, and that for skull volume was 315.74±40.95 cm3. The male patients had a higher SDR than female patients (p=0.047). Skull volume significantly decreased with aging. SDR and skull volume exhibited a linear negative relationship. Among therapeutic parameters, maximal temperature was positively related to SDR, while sonication number was not related to either SDR or skull volume. Tremor outcome was also not related to SDR or skull volume. Conclusion: SDR varied widely from 0.11 to 0.73, and men had a higher SDR. Therapeutic parameters and clinical outcomes were not affected by SDR or skull volume.

UR - http://www.scopus.com/inward/record.url?scp=85070637209&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070637209&partnerID=8YFLogxK

U2 - 10.3349/ymj.2019.60.8.768

DO - 10.3349/ymj.2019.60.8.768

M3 - Article

C2 - 31347332

AN - SCOPUS:85070637209

SN - 0513-5796

VL - 60

SP - 768

EP - 773

JO - Yonsei Medical Journal

JF - Yonsei Medical Journal

IS - 8

ER -

Skull factors affecting outcomes of magnetic resonance-guided focused ultrasound for patients with essential tremor

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this