Magnetic Resonance-Guided Focused Ultrasound Thalamotomy For Focal Hand Dystonia: A Pilot Study

Background: The efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for the treatment of focal hand dystonia (FHD) is not well known.Objective: We aimed to prospectively investigate the efficacy of MRgFUS thalamotomy for the treatment of FHD.Methods: We performed MRgFUS thalamotomy of the ventro-oral (Vo) nucleus in 10 patients with FHD. We evaluated the scores of the Writer's Cramp Rating Scale (WCRS, 0-30; higher scores indicating greater severity), Tubiana Musician's Dystonia Scale (TMDS, 0-5; lower scores indicating greater severity), and Arm Dystonia Disability Scale (ADDS, 0%-100%; lower scores indicating greater disability) at baseline and 3 and 12 months post-treatment.Results: WCRS, TMDS, and ADDS scores significantly improved from 6.3 +/- 2.7, 1.4 +/- 0.5, and 58.7% +/- 14.3% at baseline to 1.6 +/- 3.1 (P = 0.011), 5.0 +/- 0 (P = 0.0001), and 81.6% +/- 22.9% (P = 0.0229) at 12 months, respectively. There was one prolonged case of dysarthria at 12 months.Conclusion: We show that MRgFUS Vo-thalamotomy significantly improved FHD. (c) 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society