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Takaomi Taira - One of the best experts on this subject based on the ideXlab platform.
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correlation between fractional anisotropy changes in the targeted ventral intermediate nucleus and clinical outcome after transcranial mr guided focused ultrasound Thalamotomy for essential tremor results of a pilot study
Journal of Neurosurgery, 2020Co-Authors: Hiroki Hori, Takaomi Taira, Toshio Yamaguchi, Yoshiyuki Konishi, Yoshihiro MuragakiAbstract:OBJECTIVE This study evaluated changes of fractional anisotropy (FA) in the ventral intermediate nucleus (VIM) of the thalamus after transcranial MR-guided focused ultrasound (TcMRgFUS) Thalamotomy and their associations with clinical outcome. METHODS Clinical and radiological data of 12 patients with medically refractory essential tremor (mean age 76.5 years) who underwent TcMRgFUS Thalamotomy with VIM targeting were analyzed retrospectively. The Clinical Rating Scale for Tremor (CRST) score was calculated before and at 1 year after treatment. Measurements of the relative FA (rFA) values, defined as ratio of the FA value in the targeted VIM to the FA value in the contralateral VIM, were performed before Thalamotomy, and 1 day and 1 year thereafter. RESULTS TcMRgFUS Thalamotomy was well tolerated and no long-term complications were noted. At 1-year follow-up, 8 patients demonstrated relief of tremor (improvement group), whereas in 4 others persistent tremor was noted (recurrence group). In the entire cohort, mean rFA values in the targeted VIM before treatment, and at 1 day and 1 year after treatment, were 1.12 ± 0.15, 0.44 ± 0.13, and 0.82 ± 0.22, respectively (p < 0.001). rFA values were consistently higher in the recurrence group compared with the improvement group, and the difference reached statistical significance at 1 day (p < 0.05) and 1 year (p < 0.01) after treatment. There was a statistically significant (p < 0.01) positive correlation between rFA values in the targeted VIM at 1 day after Thalamotomy and CRST score at 1 year after treatment. Receiver operating characteristic curve analysis revealed that the optimal cutoff value of rFA at 1 day after Thalamotomy for prediction of symptomatic improvement at 1-year follow-up is 0.54. CONCLUSIONS TcMRgFUS Thalamotomy results in significant decrease of rFA in the targeted VIM, at both 1 day and 1 year after treatment. Relative FA values at 1 day after treatment showed significant correlation with CRST score at 1-year follow-up. Therefore, FA may be considered a possible imaging biomarker for early prediction of clinical outcome after TcMRgFUS Thalamotomy for essential tremor.
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a single case of mri guided focused ultrasound ventro oral Thalamotomy for musician s dystonia
Journal of Neurosurgery, 2019Co-Authors: Shiro Horisawa, Hiroki Hori, Toshio Yamaguchi, Yoshiyuki Konishi, Masatake Sumi, Keiichi Abe, Takaomi TairaAbstract:Musician's dystonia (MD) is a type of focal hand dystonia that develops only while playing musical instruments and interferes with skilled and fine movements. Lesioning of the ventro-oral (Vo) nucleus of the thalamus (Vo-Thalamotomy) using radiofrequency can cause dramatic improvement in MD symptoms. Focused ultrasound (FUS) can make intracranial focal lesions without an incision. The authors used MRI-guided FUS (MRgFUS) to create a lesion on the Vo nucleus to treat a patient with MD. Tubiana's MD scale (TMDS) was used to evaluate the condition of musical play ranging from 1 to 5 (1: worst, 5: best). The patient was a 35-year-old right-handed man with involuntary flexion of the right second, third, and fourth fingers, which occurred while playing a classical guitar. Immediately after therapeutic sonications of FUS Vo-Thalamotomy, there was dramatic improvement in the MD symptoms. The TMDS scores before; at 0 and 1 week after; and at 1, 3, 6, and 12 months after MRgFUS Vo-Thalamotomy were 1, 4, 4, 5, 5, 5, and 5, respectively. No complications were observed. Focused ultrasound Vo-Thalamotomy can be an effective treatment for MD.
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safety and long term efficacy of ventro oral Thalamotomy for focal hand dystonia a retrospective study of 171 patients
Neurology, 2019Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Nobuhiko Takeda, Atsushi Fukui, Tomoko Hanada, Takaomi TairaAbstract:Objective To report the safety and long-term efficacy of ventro-oral Thalamotomy for 171 consecutive patients with task-specific focal hand dystonia. Methods Between October 2003 and February 2017, 171 consecutive patients with task-specific focal hand dystonia underwent unilateral ventro-oral Thalamotomy. Etiologies included writer9s cramps (n = 92), musician9s dystonias (n = 58), and other occupational task-related dystonias (n = 21). The task-specific focal hand dystonia scale was used to evaluate patients9 neurologic conditions (range 1–5, high score indicated a better condition). The scores before surgery; at 1 week, 3 months, and 12 months postoperatively; and the last available follow-up period were determined. Postoperative complications and postoperative recurrence were also evaluated. Results The scores before surgery; at 1 week (1.72 ± 0.57, 4.33 ± 0.85 [ p p p p Conclusion Ventro-oral Thalamotomy is a feasible and reasonable treatment for patients with refractory task-specific focal hand dystonias. Prospective, randomized, and blinded studies are warranted to clarify more accurate assessment of the safety and efficacy of ventro-oral Thalamotomy for task-specific focal hand dystonia. Classification of evidence This study provides Class IV evidence that for patients with task-specific focal hand dystonia, ventro-oral Thalamotomy improves dystonia.
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A single case of MRI-guided focused ultrasound ventro-oral Thalamotomy for musician’s dystonia
Journal of Neurosurgery, 2018Co-Authors: Shiro Horisawa, Hiroki Hori, Toshio Yamaguchi, Yoshiyuki Konishi, Masatake Sumi, Takaomi TairaAbstract:Musician's dystonia (MD) is a type of focal hand dystonia that develops only while playing musical instruments and interferes with skilled and fine movements. Lesioning of the ventro-oral (Vo) nucleus of the thalamus (Vo-Thalamotomy) using radiofrequency can cause dramatic improvement in MD symptoms. Focused ultrasound (FUS) can make intracranial focal lesions without an incision. The authors used MRI-guided FUS (MRgFUS) to create a lesion on the Vo nucleus to treat a patient with MD. Tubiana's MD scale (TMDS) was used to evaluate the condition of musical play ranging from 1 to 5 (1: worst, 5: best). The patient was a 35-year-old right-handed man with involuntary flexion of the right second, third, and fourth fingers, which occurred while playing a classical guitar. Immediately after therapeutic sonications of FUS Vo-Thalamotomy, there was dramatic improvement in the MD symptoms. The TMDS scores before; at 0 and 1 week after; and at 1, 3, 6, and 12 months after MRgFUS Vo-Thalamotomy were 1, 4, 4, 5, 5, 5, and 5, respectively. No complications were observed. Focused ultrasound Vo-Thalamotomy can be an effective treatment for MD.
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neurological adverse event profile of magnetic resonance imaging guided focused ultrasound Thalamotomy for essential tremor
Movement Disorders, 2018Co-Authors: Paul S Fishman, Takaomi Taira, Jeffrey W Elias, Pejman Ghanouni, Ryder P Gwinn, Nir Lipsman, Michael L Schwartz, Jin W Chang, Vibhor Krishna, Ali R RezaiAbstract:BACKGROUND:Magnetic resonance imaging-guided focused ultrasound Thalamotomy is approved by the U.S. Food and Drug Administration for treatment of essential tremor. Although this incisionless technology creates an ablative lesion, it potentially avoids serious complications of open stereotactic surgery. OBJECTIVE:To determine the safety profile of magnetic resonance imaging-guided focused ultrasound unilateral Thalamotomy for essential tremor, including frequency, and severity of adverse events, including serious adverse events. METHODS:Analysis of safety data for magnetic resonance imaging-guided focused ultrasound Thalamotomy (186 patients, five studies). RESULTS:Procedure-related serious adverse events were very infrequent (1.6%), without intracerebral hemorrhages or infections. Adverse events were usually transient and were commonly rated as mild (79%) and rarely severe (1%). As previously reported, abnormalities in sensation and balance were the commonest Thalamotomy-related adverse events. CONCLUSION:The overall safety profile of magnetic resonance imaging-guided focused ultrasound Thalamotomy supports its role as a new option for patients with medically refractory essential tremor. © 2018 International Parkinson and Movement Disorder Society.
Shiro Horisawa - One of the best experts on this subject based on the ideXlab platform.
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a single case of mri guided focused ultrasound ventro oral Thalamotomy for musician s dystonia
Journal of Neurosurgery, 2019Co-Authors: Shiro Horisawa, Hiroki Hori, Toshio Yamaguchi, Yoshiyuki Konishi, Masatake Sumi, Keiichi Abe, Takaomi TairaAbstract:Musician's dystonia (MD) is a type of focal hand dystonia that develops only while playing musical instruments and interferes with skilled and fine movements. Lesioning of the ventro-oral (Vo) nucleus of the thalamus (Vo-Thalamotomy) using radiofrequency can cause dramatic improvement in MD symptoms. Focused ultrasound (FUS) can make intracranial focal lesions without an incision. The authors used MRI-guided FUS (MRgFUS) to create a lesion on the Vo nucleus to treat a patient with MD. Tubiana's MD scale (TMDS) was used to evaluate the condition of musical play ranging from 1 to 5 (1: worst, 5: best). The patient was a 35-year-old right-handed man with involuntary flexion of the right second, third, and fourth fingers, which occurred while playing a classical guitar. Immediately after therapeutic sonications of FUS Vo-Thalamotomy, there was dramatic improvement in the MD symptoms. The TMDS scores before; at 0 and 1 week after; and at 1, 3, 6, and 12 months after MRgFUS Vo-Thalamotomy were 1, 4, 4, 5, 5, 5, and 5, respectively. No complications were observed. Focused ultrasound Vo-Thalamotomy can be an effective treatment for MD.
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safety and long term efficacy of ventro oral Thalamotomy for focal hand dystonia a retrospective study of 171 patients
Neurology, 2019Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Nobuhiko Takeda, Atsushi Fukui, Tomoko Hanada, Takaomi TairaAbstract:Objective To report the safety and long-term efficacy of ventro-oral Thalamotomy for 171 consecutive patients with task-specific focal hand dystonia. Methods Between October 2003 and February 2017, 171 consecutive patients with task-specific focal hand dystonia underwent unilateral ventro-oral Thalamotomy. Etiologies included writer9s cramps (n = 92), musician9s dystonias (n = 58), and other occupational task-related dystonias (n = 21). The task-specific focal hand dystonia scale was used to evaluate patients9 neurologic conditions (range 1–5, high score indicated a better condition). The scores before surgery; at 1 week, 3 months, and 12 months postoperatively; and the last available follow-up period were determined. Postoperative complications and postoperative recurrence were also evaluated. Results The scores before surgery; at 1 week (1.72 ± 0.57, 4.33 ± 0.85 [ p p p p Conclusion Ventro-oral Thalamotomy is a feasible and reasonable treatment for patients with refractory task-specific focal hand dystonias. Prospective, randomized, and blinded studies are warranted to clarify more accurate assessment of the safety and efficacy of ventro-oral Thalamotomy for task-specific focal hand dystonia. Classification of evidence This study provides Class IV evidence that for patients with task-specific focal hand dystonia, ventro-oral Thalamotomy improves dystonia.
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A single case of MRI-guided focused ultrasound ventro-oral Thalamotomy for musician’s dystonia
Journal of Neurosurgery, 2018Co-Authors: Shiro Horisawa, Hiroki Hori, Toshio Yamaguchi, Yoshiyuki Konishi, Masatake Sumi, Takaomi TairaAbstract:Musician's dystonia (MD) is a type of focal hand dystonia that develops only while playing musical instruments and interferes with skilled and fine movements. Lesioning of the ventro-oral (Vo) nucleus of the thalamus (Vo-Thalamotomy) using radiofrequency can cause dramatic improvement in MD symptoms. Focused ultrasound (FUS) can make intracranial focal lesions without an incision. The authors used MRI-guided FUS (MRgFUS) to create a lesion on the Vo nucleus to treat a patient with MD. Tubiana's MD scale (TMDS) was used to evaluate the condition of musical play ranging from 1 to 5 (1: worst, 5: best). The patient was a 35-year-old right-handed man with involuntary flexion of the right second, third, and fourth fingers, which occurred while playing a classical guitar. Immediately after therapeutic sonications of FUS Vo-Thalamotomy, there was dramatic improvement in the MD symptoms. The TMDS scores before; at 0 and 1 week after; and at 1, 3, 6, and 12 months after MRgFUS Vo-Thalamotomy were 1, 4, 4, 5, 5, 5, and 5, respectively. No complications were observed. Focused ultrasound Vo-Thalamotomy can be an effective treatment for MD.
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Stereotactic Thalamotomy for Hairdresser's Dystonia: A Case Series
Stereotactic and functional neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Takaomi TairaAbstract:Background: Hairdresser's dystonia is a rarely reported form of focal hand dystonia, and the clinical course and treatment remains poorly understood. Objectives: The aim of this report was to clarify the impact of Thalamotomy on hairdresser's dystonia. Methods: Four consecutive patients with hairdresser's task-specific dystonia evaluated at Tokyo Women's Medical University Hospital between 2008 and 2013 were treated with stereotactic Thalamotomy, and were recruited for this case series. Results: The mean age at the onset of symptoms was 37.25 ± 10.64 years, the median duration of symptoms was 4.25 ± 1.3 years, and the mean follow-up period was 17 ± 12.37 months. Two of the 4 patients returned to work with significant improvement following the stereotactic Thalamotomy and the beneficial effects persisted for the duration of their clinical follow-up. The other 2 patients experienced transient improvements for up to 3 months. Surgical complications included only dysarthria in 2 patients, and did not interfere with their daily activities. No patients experienced a deterioration of dystonic symptoms after Thalamotomy. Conclusion: Although the benefits of Thalamotomy remain vulnerable to incorrect or insufficient coagulation, stereotactic Thalamotomy may be a feasible and effective procedure for patients with hairdresser's dystonia.
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Pallidotomy for Writer's Cramp after Failed Thalamotomy.
Stereotactic and Functional Neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takakazu Kawamata, Nobuhiko Takeda, Yuki Takano, Takaomi TairaAbstract:Background/Aims: Although many reports have confirmed the effects of stereotactic Thalamotomy for writer's cramp, pallidotomy for writer's cramp is yet to be investigated. Methods: After a 22-year-old woman with writer's cramp had undergone stereotactic Thalamotomy twice, symptomatic relief was only temporary. Because her dystonic symptoms spread around the proximal part of the upper limb, she underwent unilateral pallidotomy 21 months after the second Thalamotomy. Results: Unilateral pallidotomy improved her dystonic symptoms without any adverse effects immediately after the surgery. During a follow-up observation of 1 year, no recurrent writer's cramp was observed. Conclusion: For writer's cramp, when symptoms cannot be improved by Thalamotomy, pallidotomy may achieve an effective outcome.
Takeshi Nakajima - One of the best experts on this subject based on the ideXlab platform.
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safety and long term efficacy of ventro oral Thalamotomy for focal hand dystonia a retrospective study of 171 patients
Neurology, 2019Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Nobuhiko Takeda, Atsushi Fukui, Tomoko Hanada, Takaomi TairaAbstract:Objective To report the safety and long-term efficacy of ventro-oral Thalamotomy for 171 consecutive patients with task-specific focal hand dystonia. Methods Between October 2003 and February 2017, 171 consecutive patients with task-specific focal hand dystonia underwent unilateral ventro-oral Thalamotomy. Etiologies included writer9s cramps (n = 92), musician9s dystonias (n = 58), and other occupational task-related dystonias (n = 21). The task-specific focal hand dystonia scale was used to evaluate patients9 neurologic conditions (range 1–5, high score indicated a better condition). The scores before surgery; at 1 week, 3 months, and 12 months postoperatively; and the last available follow-up period were determined. Postoperative complications and postoperative recurrence were also evaluated. Results The scores before surgery; at 1 week (1.72 ± 0.57, 4.33 ± 0.85 [ p p p p Conclusion Ventro-oral Thalamotomy is a feasible and reasonable treatment for patients with refractory task-specific focal hand dystonias. Prospective, randomized, and blinded studies are warranted to clarify more accurate assessment of the safety and efficacy of ventro-oral Thalamotomy for task-specific focal hand dystonia. Classification of evidence This study provides Class IV evidence that for patients with task-specific focal hand dystonia, ventro-oral Thalamotomy improves dystonia.
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Stereotactic Thalamotomy for Hairdresser's Dystonia: A Case Series
Stereotactic and functional neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Takaomi TairaAbstract:Background: Hairdresser's dystonia is a rarely reported form of focal hand dystonia, and the clinical course and treatment remains poorly understood. Objectives: The aim of this report was to clarify the impact of Thalamotomy on hairdresser's dystonia. Methods: Four consecutive patients with hairdresser's task-specific dystonia evaluated at Tokyo Women's Medical University Hospital between 2008 and 2013 were treated with stereotactic Thalamotomy, and were recruited for this case series. Results: The mean age at the onset of symptoms was 37.25 ± 10.64 years, the median duration of symptoms was 4.25 ± 1.3 years, and the mean follow-up period was 17 ± 12.37 months. Two of the 4 patients returned to work with significant improvement following the stereotactic Thalamotomy and the beneficial effects persisted for the duration of their clinical follow-up. The other 2 patients experienced transient improvements for up to 3 months. Surgical complications included only dysarthria in 2 patients, and did not interfere with their daily activities. No patients experienced a deterioration of dystonic symptoms after Thalamotomy. Conclusion: Although the benefits of Thalamotomy remain vulnerable to incorrect or insufficient coagulation, stereotactic Thalamotomy may be a feasible and effective procedure for patients with hairdresser's dystonia.
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Bilateral Stereotactic Thalamotomy for Bilateral Musician's Hand Dystonia
World Neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Takakazu Kawamata, Takaomi TairaAbstract:Background Focal hand dystonia in musicians, also known as musician's dystonia, is a task-specific movement disorder characterized by unwanted involuntary muscle contractions occurring only when playing a musical instrument. Case Description Case 1 was a 50-year-old female professional pianist who underwent staged bilateral ventro-oral (Vo) Thalamotomy, with an interval between the first and second surgery of 4 years. The first surgery (right Vo Thalamotomy) led to significant improvements in dystonic symptoms without any complications. Pre- and postoperative Tubiana's musician's dystonia scale (TMDS) scores were 2 and 5, respectively. The second surgery (left Vo Thalamotomy) also led to significant improvements in dystonic symptoms, with dysarthria and verbal recall disturbance resolving within 3 months. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to live-stage performances. Case 2 was a 48-year-old male clarinet repair technician who underwent staged bilateral Vo Thalamotomy, with an interval between the first and second surgery of 13 months. The first surgery (right Vo Thalamotomy) led to dramatic improvements in symptoms without any complications. Pre- and postoperative TMDS scores were 2 and 5, respectively. The second surgery (left Vo Thalamotomy) also led to significant improvements in symptoms with transient hypophonia. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to work without difficulty. Conclusions The findings in these 2 cases indicate the utility of bilateral stereotactic Vo Thalamotomy in the treatment of medically intractable musician's dystonia affecting both hands.
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long term improvement of musician s dystonia after stereotactic ventro oral Thalamotomy
Annals of Neurology, 2013Co-Authors: Shiro Horisawa, Shinichi Goto, Taku Ochiai, Takaomi Taira, Takeshi NakajimaAbstract:Objective Musician's dystonia is a task-specific movement disorder that causes twisting or repetitive abnormal finger postures and movements, which tend to occur only while playing musical instruments. Such a movement disorder will probably lead to termination of the careers of affected professional musicians. Most of the currently available treatments have yet to provide consistent and satisfactory results. We present the long-term follow-up results of ventro-oral Thalamotomy for 15 patients with musician's dystonia. Methods Between October 2003 and September 2010, 15 patients with medically intractable task-specific focal hand dystonia that occurred only while playing musical instruments underwent ventro-oral Thalamotomy. We used Tubiana's musician's dystonia scale to evaluate the patients' pre- and postoperative neurological conditions. Results All patients except 1 (93%) experienced dramatic improvement of dystonic symptoms immediately after ventro-oral Thalamotomy. The mean follow-up period was 30.8 months (range = 4–108 months). None of the patients experienced recurrence or deterioration of symptoms during the follow-up periods. Interpretation Ventro-oral Thalamotomy remarkably improved musician's dystonia, and the effect persisted for a long duration. Ann Neurol 2013;74:648–654
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Long‐term improvement of musician's dystonia after stereotactic ventro‐oral Thalamotomy
Annals of Neurology, 2013Co-Authors: Shiro Horisawa, Shinichi Goto, Taku Ochiai, Takaomi Taira, Takeshi NakajimaAbstract:Objective Musician's dystonia is a task-specific movement disorder that causes twisting or repetitive abnormal finger postures and movements, which tend to occur only while playing musical instruments. Such a movement disorder will probably lead to termination of the careers of affected professional musicians. Most of the currently available treatments have yet to provide consistent and satisfactory results. We present the long-term follow-up results of ventro-oral Thalamotomy for 15 patients with musician's dystonia. Methods Between October 2003 and September 2010, 15 patients with medically intractable task-specific focal hand dystonia that occurred only while playing musical instruments underwent ventro-oral Thalamotomy. We used Tubiana's musician's dystonia scale to evaluate the patients' pre- and postoperative neurological conditions. Results All patients except 1 (93%) experienced dramatic improvement of dystonic symptoms immediately after ventro-oral Thalamotomy. The mean follow-up period was 30.8 months (range = 4–108 months). None of the patients experienced recurrence or deterioration of symptoms during the follow-up periods. Interpretation Ventro-oral Thalamotomy remarkably improved musician's dystonia, and the effect persisted for a long duration. Ann Neurol 2013;74:648–654
Shinichi Goto - One of the best experts on this subject based on the ideXlab platform.
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safety and long term efficacy of ventro oral Thalamotomy for focal hand dystonia a retrospective study of 171 patients
Neurology, 2019Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Nobuhiko Takeda, Atsushi Fukui, Tomoko Hanada, Takaomi TairaAbstract:Objective To report the safety and long-term efficacy of ventro-oral Thalamotomy for 171 consecutive patients with task-specific focal hand dystonia. Methods Between October 2003 and February 2017, 171 consecutive patients with task-specific focal hand dystonia underwent unilateral ventro-oral Thalamotomy. Etiologies included writer9s cramps (n = 92), musician9s dystonias (n = 58), and other occupational task-related dystonias (n = 21). The task-specific focal hand dystonia scale was used to evaluate patients9 neurologic conditions (range 1–5, high score indicated a better condition). The scores before surgery; at 1 week, 3 months, and 12 months postoperatively; and the last available follow-up period were determined. Postoperative complications and postoperative recurrence were also evaluated. Results The scores before surgery; at 1 week (1.72 ± 0.57, 4.33 ± 0.85 [ p p p p Conclusion Ventro-oral Thalamotomy is a feasible and reasonable treatment for patients with refractory task-specific focal hand dystonias. Prospective, randomized, and blinded studies are warranted to clarify more accurate assessment of the safety and efficacy of ventro-oral Thalamotomy for task-specific focal hand dystonia. Classification of evidence This study provides Class IV evidence that for patients with task-specific focal hand dystonia, ventro-oral Thalamotomy improves dystonia.
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Stereotactic Thalamotomy for Hairdresser's Dystonia: A Case Series
Stereotactic and functional neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Takaomi TairaAbstract:Background: Hairdresser's dystonia is a rarely reported form of focal hand dystonia, and the clinical course and treatment remains poorly understood. Objectives: The aim of this report was to clarify the impact of Thalamotomy on hairdresser's dystonia. Methods: Four consecutive patients with hairdresser's task-specific dystonia evaluated at Tokyo Women's Medical University Hospital between 2008 and 2013 were treated with stereotactic Thalamotomy, and were recruited for this case series. Results: The mean age at the onset of symptoms was 37.25 ± 10.64 years, the median duration of symptoms was 4.25 ± 1.3 years, and the mean follow-up period was 17 ± 12.37 months. Two of the 4 patients returned to work with significant improvement following the stereotactic Thalamotomy and the beneficial effects persisted for the duration of their clinical follow-up. The other 2 patients experienced transient improvements for up to 3 months. Surgical complications included only dysarthria in 2 patients, and did not interfere with their daily activities. No patients experienced a deterioration of dystonic symptoms after Thalamotomy. Conclusion: Although the benefits of Thalamotomy remain vulnerable to incorrect or insufficient coagulation, stereotactic Thalamotomy may be a feasible and effective procedure for patients with hairdresser's dystonia.
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Pallidotomy for Writer's Cramp after Failed Thalamotomy.
Stereotactic and Functional Neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takakazu Kawamata, Nobuhiko Takeda, Yuki Takano, Takaomi TairaAbstract:Background/Aims: Although many reports have confirmed the effects of stereotactic Thalamotomy for writer's cramp, pallidotomy for writer's cramp is yet to be investigated. Methods: After a 22-year-old woman with writer's cramp had undergone stereotactic Thalamotomy twice, symptomatic relief was only temporary. Because her dystonic symptoms spread around the proximal part of the upper limb, she underwent unilateral pallidotomy 21 months after the second Thalamotomy. Results: Unilateral pallidotomy improved her dystonic symptoms without any adverse effects immediately after the surgery. During a follow-up observation of 1 year, no recurrent writer's cramp was observed. Conclusion: For writer's cramp, when symptoms cannot be improved by Thalamotomy, pallidotomy may achieve an effective outcome.
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Bilateral Stereotactic Thalamotomy for Bilateral Musician's Hand Dystonia
World Neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Takakazu Kawamata, Takaomi TairaAbstract:Background Focal hand dystonia in musicians, also known as musician's dystonia, is a task-specific movement disorder characterized by unwanted involuntary muscle contractions occurring only when playing a musical instrument. Case Description Case 1 was a 50-year-old female professional pianist who underwent staged bilateral ventro-oral (Vo) Thalamotomy, with an interval between the first and second surgery of 4 years. The first surgery (right Vo Thalamotomy) led to significant improvements in dystonic symptoms without any complications. Pre- and postoperative Tubiana's musician's dystonia scale (TMDS) scores were 2 and 5, respectively. The second surgery (left Vo Thalamotomy) also led to significant improvements in dystonic symptoms, with dysarthria and verbal recall disturbance resolving within 3 months. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to live-stage performances. Case 2 was a 48-year-old male clarinet repair technician who underwent staged bilateral Vo Thalamotomy, with an interval between the first and second surgery of 13 months. The first surgery (right Vo Thalamotomy) led to dramatic improvements in symptoms without any complications. Pre- and postoperative TMDS scores were 2 and 5, respectively. The second surgery (left Vo Thalamotomy) also led to significant improvements in symptoms with transient hypophonia. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to work without difficulty. Conclusions The findings in these 2 cases indicate the utility of bilateral stereotactic Vo Thalamotomy in the treatment of medically intractable musician's dystonia affecting both hands.
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long term improvement of musician s dystonia after stereotactic ventro oral Thalamotomy
Annals of Neurology, 2013Co-Authors: Shiro Horisawa, Shinichi Goto, Taku Ochiai, Takaomi Taira, Takeshi NakajimaAbstract:Objective Musician's dystonia is a task-specific movement disorder that causes twisting or repetitive abnormal finger postures and movements, which tend to occur only while playing musical instruments. Such a movement disorder will probably lead to termination of the careers of affected professional musicians. Most of the currently available treatments have yet to provide consistent and satisfactory results. We present the long-term follow-up results of ventro-oral Thalamotomy for 15 patients with musician's dystonia. Methods Between October 2003 and September 2010, 15 patients with medically intractable task-specific focal hand dystonia that occurred only while playing musical instruments underwent ventro-oral Thalamotomy. We used Tubiana's musician's dystonia scale to evaluate the patients' pre- and postoperative neurological conditions. Results All patients except 1 (93%) experienced dramatic improvement of dystonic symptoms immediately after ventro-oral Thalamotomy. The mean follow-up period was 30.8 months (range = 4–108 months). None of the patients experienced recurrence or deterioration of symptoms during the follow-up periods. Interpretation Ventro-oral Thalamotomy remarkably improved musician's dystonia, and the effect persisted for a long duration. Ann Neurol 2013;74:648–654
Taku Ochiai - One of the best experts on this subject based on the ideXlab platform.
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safety and long term efficacy of ventro oral Thalamotomy for focal hand dystonia a retrospective study of 171 patients
Neurology, 2019Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Nobuhiko Takeda, Atsushi Fukui, Tomoko Hanada, Takaomi TairaAbstract:Objective To report the safety and long-term efficacy of ventro-oral Thalamotomy for 171 consecutive patients with task-specific focal hand dystonia. Methods Between October 2003 and February 2017, 171 consecutive patients with task-specific focal hand dystonia underwent unilateral ventro-oral Thalamotomy. Etiologies included writer9s cramps (n = 92), musician9s dystonias (n = 58), and other occupational task-related dystonias (n = 21). The task-specific focal hand dystonia scale was used to evaluate patients9 neurologic conditions (range 1–5, high score indicated a better condition). The scores before surgery; at 1 week, 3 months, and 12 months postoperatively; and the last available follow-up period were determined. Postoperative complications and postoperative recurrence were also evaluated. Results The scores before surgery; at 1 week (1.72 ± 0.57, 4.33 ± 0.85 [ p p p p Conclusion Ventro-oral Thalamotomy is a feasible and reasonable treatment for patients with refractory task-specific focal hand dystonias. Prospective, randomized, and blinded studies are warranted to clarify more accurate assessment of the safety and efficacy of ventro-oral Thalamotomy for task-specific focal hand dystonia. Classification of evidence This study provides Class IV evidence that for patients with task-specific focal hand dystonia, ventro-oral Thalamotomy improves dystonia.
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Stereotactic Thalamotomy for Hairdresser's Dystonia: A Case Series
Stereotactic and functional neurosurgery, 2016Co-Authors: Shiro Horisawa, Shinichi Goto, Takeshi Nakajima, Taku Ochiai, Takakazu Kawamata, Takaomi TairaAbstract:Background: Hairdresser's dystonia is a rarely reported form of focal hand dystonia, and the clinical course and treatment remains poorly understood. Objectives: The aim of this report was to clarify the impact of Thalamotomy on hairdresser's dystonia. Methods: Four consecutive patients with hairdresser's task-specific dystonia evaluated at Tokyo Women's Medical University Hospital between 2008 and 2013 were treated with stereotactic Thalamotomy, and were recruited for this case series. Results: The mean age at the onset of symptoms was 37.25 ± 10.64 years, the median duration of symptoms was 4.25 ± 1.3 years, and the mean follow-up period was 17 ± 12.37 months. Two of the 4 patients returned to work with significant improvement following the stereotactic Thalamotomy and the beneficial effects persisted for the duration of their clinical follow-up. The other 2 patients experienced transient improvements for up to 3 months. Surgical complications included only dysarthria in 2 patients, and did not interfere with their daily activities. No patients experienced a deterioration of dystonic symptoms after Thalamotomy. Conclusion: Although the benefits of Thalamotomy remain vulnerable to incorrect or insufficient coagulation, stereotactic Thalamotomy may be a feasible and effective procedure for patients with hairdresser's dystonia.
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long term improvement of musician s dystonia after stereotactic ventro oral Thalamotomy
Annals of Neurology, 2013Co-Authors: Shiro Horisawa, Shinichi Goto, Taku Ochiai, Takaomi Taira, Takeshi NakajimaAbstract:Objective Musician's dystonia is a task-specific movement disorder that causes twisting or repetitive abnormal finger postures and movements, which tend to occur only while playing musical instruments. Such a movement disorder will probably lead to termination of the careers of affected professional musicians. Most of the currently available treatments have yet to provide consistent and satisfactory results. We present the long-term follow-up results of ventro-oral Thalamotomy for 15 patients with musician's dystonia. Methods Between October 2003 and September 2010, 15 patients with medically intractable task-specific focal hand dystonia that occurred only while playing musical instruments underwent ventro-oral Thalamotomy. We used Tubiana's musician's dystonia scale to evaluate the patients' pre- and postoperative neurological conditions. Results All patients except 1 (93%) experienced dramatic improvement of dystonic symptoms immediately after ventro-oral Thalamotomy. The mean follow-up period was 30.8 months (range = 4–108 months). None of the patients experienced recurrence or deterioration of symptoms during the follow-up periods. Interpretation Ventro-oral Thalamotomy remarkably improved musician's dystonia, and the effect persisted for a long duration. Ann Neurol 2013;74:648–654
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Long‐term improvement of musician's dystonia after stereotactic ventro‐oral Thalamotomy
Annals of Neurology, 2013Co-Authors: Shiro Horisawa, Shinichi Goto, Taku Ochiai, Takaomi Taira, Takeshi NakajimaAbstract:Objective Musician's dystonia is a task-specific movement disorder that causes twisting or repetitive abnormal finger postures and movements, which tend to occur only while playing musical instruments. Such a movement disorder will probably lead to termination of the careers of affected professional musicians. Most of the currently available treatments have yet to provide consistent and satisfactory results. We present the long-term follow-up results of ventro-oral Thalamotomy for 15 patients with musician's dystonia. Methods Between October 2003 and September 2010, 15 patients with medically intractable task-specific focal hand dystonia that occurred only while playing musical instruments underwent ventro-oral Thalamotomy. We used Tubiana's musician's dystonia scale to evaluate the patients' pre- and postoperative neurological conditions. Results All patients except 1 (93%) experienced dramatic improvement of dystonic symptoms immediately after ventro-oral Thalamotomy. The mean follow-up period was 30.8 months (range = 4–108 months). None of the patients experienced recurrence or deterioration of symptoms during the follow-up periods. Interpretation Ventro-oral Thalamotomy remarkably improved musician's dystonia, and the effect persisted for a long duration. Ann Neurol 2013;74:648–654
