3-T MR-guided focused ultrasound thalamotomy for tremor in patients with a cardiac pacemaker: case series and review of the literature

• Published in: Neurosurgical focus Vol. 57; no. 3; p. E5
• Main Authors: Gonzalez-Quarante, Lain H, Gonzalez-Crespo, Antonio, Arcadi, Alana, Macias-de-la-Corte, Marta, Aviles-Olmos, Iciar, Sanchez-Catasus, Carlos A, Cacho-Asenjo, Elena, Honorato-Cia, Cristina, Martinez-Simon, Antonio, Gorospe, Arantza, Martin-Bastida, Antonio, Corral-Alonso, Paula, Rodriguez-Oroz, Maria C, Guridi, Jorge
• Format: Journal Article
• Language: English
• Published: United States 01-09-2024
• Subjects: Aged; Aged, 80 and over; Essential Tremor - diagnostic imaging; Essential Tremor - surgery; Female; High-Intensity Focused Ultrasound Ablation - methods; Humans; Magnetic Resonance Imaging - methods; Male; Middle Aged; Pacemaker, Artificial; Parkinson Disease - complications; Parkinson Disease - diagnostic imaging; Parkinson Disease - surgery; Thalamus - diagnostic imaging; Thalamus - surgery; Tremor - diagnostic imaging; Tremor - etiology; Tremor - surgery; thalamotomy; cardiac pacemaker; essential tremor; MRgFUS; magnetic resonance–guided focused ultrasound; Parkinson’s disease
• ISSN: 1092-0684; 1092-0684
• DOI: 10.3171/2024.6.FOCUS24171

MR-guided focused ultrasound (MRgFUS) has proven its efficacy and safety for the treatment of essential tremor (ET) and/or Parkinson's disease (PD). However, having a cardiac pacemaker has been considered an exclusion criterion for the use of MRgFUS. Only 2 patients with a cardiac pacemaker treated with MRgFUS have been previously reported, both treated using 1.5-T MRI. In this paper, the authors present their experience performing 3-T MRgFUS thalamotomy in 4 patients with an implanted cardiac pacemaker. Treatments were uneventful regarding complications or severe side effects. MRgFUS using 3-T MRI was found to be an efficient and safe treatment for ET and/or PD in patients with an MRI-compatible pacemaker.