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Morabito R, Cammaroto S, Militi A, Smorto C, Anfuso C, Lavano A, Tomasello F, Di Lorenzo G, Brigandì A, Sorbera C, Bonanno L, Ielo A, Vatrano M, Marino S, Cacciola A, Cerasa A, Quartarone A. The Role of Treatment-Related Parameters and Brain Morphology in the Lesion Volume of Magnetic-Resonance-Guided Focused Ultrasound Thalamotomy in Patients with Tremor-Dominant Neurological Conditions. Bioengineering (Basel) 2024; 11:373. [PMID: 38671794 PMCID: PMC11047844 DOI: 10.3390/bioengineering11040373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
PURPOSE To determine the best predictor of lesion volume induced by magnetic resonance (MR)-guided focused ultrasound (MRgFUS) thalamotomy in patients with tremor-dominant symptoms in Parkinson's disease (PD) and essential tremor (ET) patients. METHODS Thirty-six neurological patients with medication-refractory tremor (n°19 PD; n°17 ET) were treated using a commercial MRgFUS brain system (Exablate Neuro 4000, Insightec) integrated with a 1.5 T MRI unit (Sigma HDxt; GE Medical System). Linear regression analysis was used to determine how the demographic, clinical, radiological (Fazekas scale), volumetric (total GM/WM/CSF volume, cortical thickness), and MRgFUS-related parameters [Skull Density Ratio (SDR), n° of transducer elements, n° of sonications, skull area, maximal energy delivered (watt), maximal power delivered (joule), maximal sonication time delivered, maximal mean temperature reached (T°C_max), accumulated thermal dose (ATD)] impact on ventral intermediate (VIM)-thalamotomy-related 3D volumetric lesions of necrosis and edema. RESULTS The VIM thalamotomy was clinically efficacious in improving the tremor symptoms of all the patients as measured at 1 week after treatment. Multiple regression analysis revealed that T°C_max and n° of transducer elements were the best predictors of the necrosis and edema volumes. Moreover, total WM volume also predicted the size of necrosis. CONCLUSIONS Our study provides new insights into the clinical MRgFUS procedures that can be used to forecast brain lesion size and improve treatment outcomes.
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Affiliation(s)
- Rosa Morabito
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Simona Cammaroto
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Annalisa Militi
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Chiara Smorto
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Carmelo Anfuso
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Angelo Lavano
- Mater Domini University Hospital, Magna Graecia University, 88100 Catanzaro, Italy;
| | | | - Giuseppe Di Lorenzo
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Amelia Brigandì
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Chiara Sorbera
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Lilla Bonanno
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Augusto Ielo
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | | | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
| | - Alberto Cacciola
- Brain Mapping Lab, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy;
| | - Antonio Cerasa
- S. Anna Institute, 88900 Crotone, Italy;
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Arcavacata, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (R.M.); (S.C.); (A.M.); (C.S.); (C.A.); (A.B.); (C.S.); (L.B.); (A.I.); (S.M.)
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