Caudal Zona Incerta/VOP Radiofrequency Lesioning Guided by Combined Stereotactic MRI and Microelectrode Recording for Posttraumatic Midbrain Resting-Kinetic Tremor

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorLOPEZ, William Omar Contreras
dc.contributor.authorAZEVEDO, Angelo R.
dc.contributor.authorCURY, Rubens G.
dc.contributor.authorALENCAR, Francisco
dc.contributor.authorNEVILLE, Iuri S.
dc.contributor.authorREIS, Paul R.
dc.contributor.authorNAVARRO, Jessie
dc.contributor.authorMONACO, Bernardo
dc.contributor.authorSILVA, Fabio E. Fernandes da
dc.contributor.authorTEIXEIRA, Manoel J.
dc.contributor.authorFONOFF, Erich T.
dc.date.accessioned2016-03-14T14:25:58Z
dc.date.available2016-03-14T14:25:58Z
dc.date.issued2016
dc.description.abstractOBJECTIVE: Reporting the outcome of two patients who underwent unilateral ablative stereotactic surgery to treat pharmacologic resistant posttraumatic tremor (PTT). METHODS: We present two patients (31 and 47 years old) with refractory PTT severely affecting their quality of life. Under stereotactic guidance, refined by T2-weighted magnetic resonance imaging and double-channel multi-unit microelectrode recording (MER), three sequential radiofrequency lesions were performed in the caudal zona incerta (cZi) up to the base of thalamus (VOP). Effects of cZi/VOP lesion were prospectively rated with a tremor rating scale. RESULTS: Both patients demonstrated intraoperative tremor suppression with sustained results up to 18 months follow-up, with improvement of 92% and 84%, respectively, on the tremor rating scale. Tremor improvement was associated with enhancement functionality and quality of life for the patients. The patients returned to their work after the procedure. No adverse effects were observed up to the last follow-up. CONCLUSION: Radiofrequency lesion of the cZi/VOP target was effective for posttraumatic tremor in both cases. The use of T2-weighted images and MER was found helpful in increasing the precision and safety of the procedure, because it leads the RF probe by relying on neighbor structures based on thalamus and subthalamic nucleus.
dc.description.indexMEDLINE
dc.identifier.citationWORLD NEUROSURGERY, v.86, p.316-320, 2016
dc.identifier.doi10.1016/J.WNEU.2015.09.031
dc.identifier.eissn1878-8769
dc.identifier.issn1878-8750
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/13453
dc.language.isoeng
dc.publisherELSEVIER SCIENCE INC
dc.relation.ispartofWorld Neurosurgery
dc.rightsrestrictedAccess
dc.rights.holderCopyright ELSEVIER SCIENCE INC
dc.subjectAblative radiofrequency surgery
dc.subjectDeep brain stimulation
dc.subjectDiffuse axonal injury
dc.subjectForel's fields
dc.subjectMicroelectrode recording
dc.subjectTraumatic brain injury
dc.subjectTremor
dc.subjectZona incerta
dc.subject.otherdeep brain-stimulation
dc.subject.otherposterior subthalamic area
dc.subject.otherholmes tremor
dc.subject.otherparkinsons-disease
dc.subject.othernucleus
dc.subject.otherdisorders
dc.subject.wosClinical Neurology
dc.subject.wosSurgery
dc.titleCaudal Zona Incerta/VOP Radiofrequency Lesioning Guided by Combined Stereotactic MRI and Microelectrode Recording for Posttraumatic Midbrain Resting-Kinetic Tremor
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalREIS, Paul R.:Univ Sao Paulo, Sch Med, Hosp Clin, Div Funct Neurosurg,Inst Psychiat, BR-05508 Sao Paulo, Brazil
hcfmusp.citation.scopus6
hcfmusp.contributor.author-fmusphcWILLIAM OMAR CONTRERAS LOPEZ
hcfmusp.contributor.author-fmusphcANGELO RAFAEL CUNHA DE AZEVEDO
hcfmusp.contributor.author-fmusphcRUBENS GISBERT CURY
hcfmusp.contributor.author-fmusphcFRANCISCO MARCOS ALENCAR DA SILVA
hcfmusp.contributor.author-fmusphcIURI SANTANA NEVILLE RIBEIRO
hcfmusp.contributor.author-fmusphcJESSIE MEDEIROS DE NAVARRO
hcfmusp.contributor.author-fmusphcBERNARDO ASSUMPCAO DE MONACO
hcfmusp.contributor.author-fmusphcFABIO EDUARDO FERNANDES DA SILVA
hcfmusp.contributor.author-fmusphcMANOEL JACOBSEN TEIXEIRA
hcfmusp.contributor.author-fmusphcERICH TALAMONI FONOFF
hcfmusp.description.beginpage316
hcfmusp.description.endpage320
hcfmusp.description.volume86
hcfmusp.origemWOS
hcfmusp.origem.pubmed26416091
hcfmusp.origem.scopus2-s2.0-84959374639
hcfmusp.origem.wosWOS:000369625300065
hcfmusp.publisher.cityNEW YORK
hcfmusp.publisher.countryUSA
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