Unilateral Transcranial Magnetic Resonance-guided Focused Ultrasound Pallidothalamic Tractotomy in X-linked Dystonia-Parkinsonism: A Case Report

Roland Dominic G.  Jamora; Wei  Lin; Kevin Wen-Kai  Tsai; Hui-Chin  Lai; Pai-Yi  Chiu; Azalea T.  Pajo; Wei-Chieh  Chang; Takaomi  Taira

doi:10.47895/amp.vi0.3727

Roland Dominic G. Jamora Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines; 2 Movement Disorders Service, Institute for Neurosciences, St. Luke’s Medical Center, Global City, Philippines
Wei Lin Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan
Kevin Wen-Kai Tsai MR-guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan
Hui-Chin Lai MR-guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan
Pai-Yi Chiu Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Taiwan
Azalea T. Pajo Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines
Wei-Chieh Chang Department of Neurosurgery, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan
Takaomi Taira Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

DOI: https://doi.org/10.47895/amp.vi0.3727

Keywords: Focused ultrasound, pallidothalamic tractotomy, pallidothalamic tract, XDP, X-linked dystonia parkinsonism

Abstract

X-linked dystonia-parkinsonism (XDP) is an adult-onset debilitating neurodegenerative disorder presenting with
motor and nonmotor symptoms. The treatment options for XDP are limited. We described a patient with XDP who underwent a unilateral transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) pallidothalamic tractotomy with a one-year follow-up. The patient reported an immediate improvement in his pain after the procedure. Compared to baseline, there was an improvement in his scores in the dystonia (31%), parkinsonism (35.1%), and activities of daily living (71%) subscales at 1-year follow up. The overall improvement at one year was 46%. There were no adverse events noted. Additional studies with larger sample size and follow-up would be needed to document its long-term safety and efficacy.

Author Biographies

Wei Lin, Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan

Dr. Lin is with the department of Neurology of Chang Bing Show Chwan Memorial Hospital in Taiwan.

Kevin Wen-Kai Tsai, MR-guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan

Dr. Tsai is with the MR-guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital in Taiwan.

Hui-Chin Lai, MR-guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan

Ms. Lai is with the MR-guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital in Taiwan.

Pai-Yi Chiu, Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Taiwan

Dr. Chiu is with the Department of Neurology, Show Chwan Memorial Hospital in Taiwan.

Azalea T. Pajo, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines

Dr. Pajo is with the Department of Neurosciences, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

Wei-Chieh Chang, Department of Neurosurgery, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan

Dr. Chang is with the Department of Neurosurgery, Chang Bing Show Chwan Memorial Hospita in Taiwan.

Takaomi Taira, Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

Prof. Taira is with the Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan.