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Magnetic resonance imaging-guided focused ultrasound thalamotomy launch with remote telemedicine international proctorship

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Chronic Diseases and Translational Medicine 2024年第1期10卷 40-50页

作者： igor V.Buzaev Rezida M.Galimova dinara i.nabiullina Sergey N.illarioshkin Naufal Sh.Zagidullin Shamil M.Safin Department of Surgery Bashkir State Medical UniversityUfaRussia intelligent Neurosurgery Clinic Ltd.International Medical Center V.S.Buzaev memorialUfaRussia Directorate Research Center of NeurologyVolokolamskoye ShosseMoscowRussia

Background: COViD-19 limitations have hindered the implementation of new technologies by preventing proctors from coming to the *** share our first experience of magnetic resonance imaging(MRi)-guided focused ultrasound(MRgFUS)treatment with an international remote online proctorship,and develop and evaluate the methodology of remote MRgFUS ***: This single-center,nonrandomized controlled prospective study included 94 patients:27 with essential tremor(ET)and 67 with tremor-dominant Parkinson's disease(PD).The coming of proctors was impossible,so we arranged for the remote participation of proctors from the United Kingdom,Spain,and israel.A total of 38 patients(40.4%)received telemedicine-proctored treatment(proctor group)and 56 received their treatment independently(solo group).We used the Clinical Rating Scale for Tremor(CRST)for ET patients and the Unified Parkinson's Disease Rating Scale(UPDRS)Part iii for PD ***: in patients with ET,success rates were 81.8%(proctor group)and 100%(solo group)(p=0.22).CRST reduction on the treated side was 71.43%[65.83%;80.56%](proctor group)versus 60.87%[53.99;79.58](solo group)(p=0.19).None of the patients showed worsening of tremors within 1 *** patients with PD,the success rates were 92.6%(proctor group)and 100%(solo group)(p=0.08).The UPDRS Part iii improvement was 30.1%(proctor group)versus 39.9%(solo group)(p=0.003).The 1-year recurrence rate was 40%(proctor group)and 17.5%(solo group)(p=0.04).No complications were observed at 6 ***: We developed a feasible and safe methodology for telemedicine remote online-proctored MRgFUS *** significant difference was observed between the solo and developed remote proctor protocols in terms of complication rate,effect,and long-term results;however,UPDRS Part iii improvement was better in the PD solo *** study demonstrated that the MRgFUS international proctorship can be performed successfully remotely.

关键词： essential tremor MRgFUS Parkinson's disease proctor telemedicine

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