Stereotactic and Functional Neurosurgery最新文献

{"title":"Global Research Trends in the Surgical Management of Spasticity: A Systematic Review and Bibliometric Analysis.","authors":"Giorgio Mantovani, Corentin Dauleac, Michele Alessandro Cavallo, Patrick Mertens","doi":"10.1159/000552654","DOIUrl":"10.1159/000552654","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical interventions remain a cornerstone in the multidisciplinary management of spasticity. While historically centered on pediatric cerebral palsy, the field has expanded with emerging techniques and shifting epidemiological patterns. Despite this evolution, no bibliometric study has analyzed the scientific landscape of surgical spasticity treatment. This study provides a comprehensive bibliometric analysis of global research trends, identifying historical milestones, emerging techniques, and leading institutions.</p><p><strong>Methods: </strong>A systematic search of the Scopus database was conducted using a tailored query to retrieve English-language articles on surgical interventions for spasticity. Data were analyzed using bibliometric software to assess publication trends, citation metrics, keyword evolution, and network relationships among authors, institutions, and countries.</p><p><strong>Results: </strong>A total of 1,049 articles published between 1980 and 2024 were included. The most cited works focused on intrathecal baclofen therapy and selective dorsal rhizotomy. Recent years show growing interest in peripheral procedures such as selective neurotomies and nerve transfers, while central techniques such as DREZotomy and deep brain stimulation display declining trends. Although most publications target pediatric populations, studies involving adult patients are increasing, reflecting the rise of acquired spasticity. Most articles were published in high-impact journals, yet randomized controlled trials remain scarce.</p><p><strong>Conclusion: </strong>This study highlights a progressive shift toward more tailored, peripheral, and neuromodulatory approaches, particularly in adult care. Future research should prioritize comparative trials and the integration of combined neuro-orthopedic strategies, supported by international collaboration and methodological standardization.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frameless Intraoperative CT-Guided Deep Brain Stimulation: A Multi-Institutional Analysis of Stereotactic Accuracy and Operative Metrics.","authors":"Matthan Tharakan, Kishore Balasubramanian, Rohan Aggarwal, Kiana Prather, Helen Shi, Ellen L Air, Brian Dalm, Arjun Khanna, Ryan Kochanski, Paul S Larson, Nader Pouratian, Andrew K Conner","doi":"10.1159/000553285","DOIUrl":"10.1159/000553285","url":null,"abstract":"<p><strong>Introduction: </strong>MRI-guided stereotaxy provides high accuracy but is limited by the need for an interventional/intraoperative MRI environment and associated workflow complexity. ClearPoint Software v3.0 extends an established stereotactic workflow to a conventional operating room using intraoperative CT (iCT) imaging. We aimed to evaluate stereotactic accuracy and operative metrics of the ClearPoint frameless iCT image-guided system for deep brain stimulation (DBS) lead implantation.</p><p><strong>Methods: </strong>We performed a multicenter retrospective review of consecutive DBS lead placement procedures supported by ClearPoint Neuro Navigation System Software Version 3.0 across 7 sites during a limited market release (February 1, 2025-May 1, 2025). Primary outcomes were radial targeting error (distance between planned trajectory endpoint and final device tip position in X-Y) and operative duration (skin incision to closure).</p><p><strong>Results: </strong>Twenty-three procedures were analyzed. Median age was 67 years (range 32-89). Most cases were bilateral (87%, n = 20). Targets included subthalamic nucleus (39%, n = 9), ventral intermediate nucleus (39%, n = 9), and globus pallidus internus (22%, n = 5). Targeting accuracy was high, with median radial error of 0.20 mm on the left (range 0-1.60) and 0.20 mm on the right (range 0-1.0). Median operative duration was 127 min (range 69-225). Median intraoperative scans were 6, and procedures required a median of 2 adjustments per side.</p><p><strong>Conclusion: </strong>In this first multi-institution report of ClearPoint Software v3.0 for DBS lead placement, the frameless iCT workflow demonstrated consistent submillimeter accuracy with favorable operative metrics in a standard operating room setting.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Deep Brain Stimulation Surgery in the United States.","authors":"Derrick Chatad, Michael Melhem, Abigail Abraham Teshome, Carl Porto, Mazen Taman, Athar N Malik","doi":"10.1159/000551581","DOIUrl":"10.1159/000551581","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) procedures vary by use of microelectrode recording (MER) and by unilateral or bilateral implantation. Our goal was to quantify national, regional, and state-level trends in total procedures, MER utilization, and unilateral vs. bilateral electrode implantation.</p><p><strong>Methods: </strong>The Centers for Medicare and Medicaid Services database was queried for patients undergoing DBS procedures from 2013 to 2023 yielding 27,846 total patients. Use of MER, unilateral vs. bilateral DBS electrode implantation, and procedure location were extracted. Data were analyzed using Shapiro-Wilk test, Pearson's Correlation Coefficient, Spearman's Correlation Coefficient, ANOVA or Kruskal-Wallis with post hoc testing, and Benjamini-Hochberg correction.</p><p><strong>Results: </strong>From 2013 to 2023, total DBS electrode implantation procedures did not change significantly. MER+ DBS was more common than MER- DBS across all years, although MER- DBS increased over time (r = 0.94) while MER+ DBS decreased over time (r = -0.75). Bilateral DBS increased (r = 0.86) over time and in 2021 became more common than unilateral DBS, which decreased over time (r = -0.73). Unilateral and bilateral MER- DBS increased (r = 0.84, 0.95), while unilateral MER+ DBS decreased (r = -0.97). All regions had an increase in MER- DBS (r = 0.96, 0.81, 0.94, 0.84, respectively). The West performed the most MER- DBS, while the South performed the most MER+ DBS. The Midwest and West had an increase in percentage of bilateral DBS (r = 0.95, 0.90, respectively). Regional changes favoring MER- DBS and bilateral electrode implantation were noticed in many states. All reported significant outcomes had p < 0.05.</p><p><strong>Conclusion: </strong>Nationally, there is a trend towards performing bilateral and MER- DBS. Recently, there are more bilateral than unilateral procedures, but MER+ is still more common than MER-. Regional differences in DBS surgery also exist. These findings have implications for the experience of patients, neurosurgical trainees, and institutions across the USA.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Fully Magnetic Resonance Imaging-Compatible, Nonelectrical System for Near-Real-Time Tremor Monitoring during Magnetic Resonance-Guided Focused Ultrasound.","authors":"Adrien Lavalley, Orane Lorton, Paul Constanthin, Vanessa Fleury, Shahan Momjian","doi":"10.1159/000552899","DOIUrl":"10.1159/000552899","url":null,"abstract":"<p><strong>Introduction: </strong>Tremor quantification during magnetic resonance-guided focused ultrasound (MRgFUS) for essential tremor remains a clinical challenge. Current methods, such as accelerometry, can still be limited by electromagnetic artifacts in certain cases, magnetic resonance imaging (MRI) incompatibility, and indirect correlation with sonication timing. We aimed to develop a fully MRI-compatible, nonelectrical system capable of continuous, electromagnetically artifact-free tremor monitoring with near-real-time frequency analysis, precisely synchronized with ultrasound delivery. The primary purpose of this tool is to assist with targeting during the verification stage by providing the tremor amplitude in situ.</p><p><strong>Methods: </strong>We designed a pneumatic device using a standard, easily available endotracheal cuff inflated to a fixed pressure, held by the patient during MRgFUS sonications. Tremor-induced pressure fluctuations were transmitted outside the MRI suite and digitized using a custom Arduino-based system. A software tool was implemented to calculate the tremor amplitude in near-real time.</p><p><strong>Results: </strong>The pressure system allowed real-time visualization of the tremor and assessment of the tremor reduction at the verification stage of 10 patients. The mean tremor reduction was 86% immediately after the end of the verification sonication, confirming the correct position of the target. All patients had a lesion at this location except one, in which the target was moved because he experienced sensory side effects.</p><p><strong>Conclusion: </strong>We designed and implemented a near-real-time pressure system for quantification of the tremor amplitude during sonications. The inexpensive and MR-compatible device is easy to implement on patients requiring MRgFUS treatments and avoid the possible loss of information between the temporary tremor reduction and the clinical evaluation.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metric Choice and Programming-Output Concordance in DBS Lead Reconstruction Robustness.","authors":"Chul Bum Cho","doi":"10.1159/000553283","DOIUrl":"10.1159/000553283","url":null,"abstract":"","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful MRgFUS VIM Thalamotomy for Essential Tremor Nearby Cavernous Malformation: Image Case Report.","authors":"Leonardo Favi Bocca, Benjamin Davidson, Benjamin Lam, Ruby Endre, Yuexi Huang, Clement Hamani, Nir Lipsman","doi":"10.1159/000553173","DOIUrl":"10.1159/000553173","url":null,"abstract":"<p><strong>Introduction: </strong>Essential tremor (ET) is the most common movement disorder, severe and refractory cases of which may benefit from neurosurgical interventions such as magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy. Cerebrovascular diseases are generally considered a contraindication for MRgFUS due to concerns of intracerebral hemorrhage; however, they are a heterogenous group of lesions, with distinct clinical behaviors. We present the first reported case of successful MRgFUS-thalamotomy for ET in a patient with a contralateral thalamic cerebral cavernous malformation (CCM).</p><p><strong>Case presentation: </strong>A 78-year-old male with refractory bilateral upper limb postural/action tremor consented and was planned for a left-sided ventral intermediate nucleus (VIM) MRgFUS-thalamotomy. However, brain MRI revealed a right anterior thalamic CCM measuring 1.5 cm. After careful planning, a modified treatment was still carried out by blocking ultrasound trajectories intersecting the CCM (as well as calcifications) and with increased low-medium power sonications (eight sonications targeting 50-55°C). The patient experienced no adverse effects and demonstrated significant tremor improvement, and postoperative imaging confirmed a well-defined lesion without complications.</p><p><strong>Discussion: </strong>The distinct histopathological features of CCMs, including slow flow and the absence of arterial feeders, produce a more favorable profile compared to other cerebrovascular lesions. Avoidance of direct ultrasound trajectories through the malformation, the use of conservative temperatures, and continuous clinical monitoring were critical to ensuring procedural safety and efficacy. This case demonstrates the feasibility of MRgFUS-thalamotomy in carefully selected patients with coexisting CCMs.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Brain Stimulation for Sleep-Wake Regulation: A Narrative Review.","authors":"Nathan Barbe, Audrey Kist, Aurélie Davin, Malvina Billeres, Stéphan Chabardes, Brigitte Piallat","doi":"10.1159/000552944","DOIUrl":"10.1159/000552944","url":null,"abstract":"<p><strong>Background: </strong>Sleep-wake (SW) disorders are common in numerous neurological and psychiatric conditions, yet current treatments often yield incomplete results. Given the subcortical nature of sleep regulation, intracranial stimulation, and particularly deep brain stimulation (DBS), emerges as a promising therapeutic strategy. This narrative review synthesizes preclinical and clinical evidence regarding the effects of DBS and DBS-like invasive stimulation across multiple brain regions implicated in SW control. Additionally, stimulation targeting non-SW-related targets has also shown incidental effects on sleep and wakefulness.</p><p><strong>Summary: </strong>Evidence reveals target- and frequency-dependent effects on sleep architecture and arousal, with notable translational success in Parkinson's disease and obsessive-compulsive disorder. The discussion addresses three central questions: (1) Which brain areas modulate sleep and wakefulness when stimulated? (2) How do stimulation parameters influence these outcomes? (3) What are the challenges and limitations in moving toward SW-primary indications? Despite encouraging results, variability in reported measures and outcomes underscores the need for objective, standardized sleep measures (polysomnography) and advanced targeting.</p><p><strong>Key messages: </strong>Overall, this review may assist clinicians in optimizing DBS parameters in patients experiencing SW disturbances and underscores the broader potential of invasive neuromodulation both as a therapeutic strategy and as a tool to better characterize sleep and wakefulness dynamics.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-28"},"PeriodicalIF":2.1,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Patient Pathway to Focused Ultrasound Ablation for Essential Tremor: A Mixed-Method Approach.","authors":"Nicole A Silva, Ariana Hernandez, Alok K Dwivedi, Paul Mihas, Daniel A Roque, Vibhor Krishna","doi":"10.1159/000551996","DOIUrl":"10.1159/000551996","url":null,"abstract":"<p><strong>Introduction: </strong>Focused ultrasound ablation (FUSA) is an emerging treatment for essential tremor (ET). While disparities in access to deep brain stimulation for ET have been identified, potential barriers to FUSA remains understudied.</p><p><strong>Methods: </strong>A single tertiary-care center, mixed methods study was completed of medication-refractory ET patients presenting for FUSA consultation. Baseline demographics and tremor scores were obtained. A semi-structured questionnaire and focus group discussion was implemented to estimate delays in care, quality of life (QOL) differences, and treatment barriers. Quantile regression, log normal regression, and Fisher's exact tests were used in the quantitative statistical analysis. Thematic and descriptive analyses were used for qualitative data.</p><p><strong>Results: </strong>Forty patients, with similar demographics and tremor scores, were enrolled. Patients spent nearly a decade awaiting ET diagnosis and medical treatment, followed by another 4 years before undergoing FUSA consultation. Although there were no significant differences in delays between genders, the mean number of provider contacts prior to diagnosis was significantly higher for women compared to men (7.5 vs. 0.9, p = 0.029). Those with lower socioeconomic status (≤USD 50,000) had significantly longer diagnostic (15 vs. 3.3, p = 0.056) and FUSA consultation delays (35 vs. 10.2, p = 0.015). At presentation, women reported worse QOL (70 vs. 85, p = 0.037) and overall general health status (70 vs. 85, p = 0.013) than men, with tremor significantly impacting their hobbies and leisure subscores. Women cited more hesitation and concerns regarding the surgery than men such as pre-procedure hair shave. Although men reported longer time from failure of medication therapy to FUSA consultation compared to women (4.0 vs. 2.0 years), more men ultimately underwent the procedure (10 vs. 4, p = 0.04).</p><p><strong>Discussion: </strong>We identified a variety of socioeconomic and gender differences along the patient pathway to FUSA for ET. Although women presented with worse QOL because of their tremor, they were still less likely to undergo FUSA compared to men. Further investigation and patient-centered interventions are needed to achieve equity of care in this patient population.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-of-the-Art Imaging and Localization Assessment in Post-Operative Deep Brain Stimulation for Parkinson's Disease: A Review.","authors":"Kezia Tanesha Susanto, Brian Premchand, Kai Rui Wan, Wai-Yung Yu, Hui Ping Oh, Vincent Ern Yao Chan, Fatimah Misbaah, Rosa Qiyue So","doi":"10.1159/000553009","DOIUrl":"10.1159/000553009","url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation (DBS) is an established therapy for Parkinson's disease (PD), dependent on precise electrode placement relative to intended anatomical and functional targets. Post-operative imaging, primarily magnetic resonance imaging (MRI) and computed tomography (CT), is essential for verifying lead position, assessing surgical accuracy, and guiding stimulation programming.</p><p><strong>Summary: </strong>Most centers perform imaging within the first week after surgery, typically using CT or MRI-CT fusion to confirm electrode location and detect complications. CT offers submillimeter resolution (slice thickness 0.5-1.25 mm; voxel ∼0.5 mm) for clear electrode visualization, while MRI (particularly T1-MPRAGE, T2-FLAIR, and GRE sequences) provides superior anatomical contrast and artifact characterization.</p><p><strong>Key messages: </strong>Registration between pre- and post-operative scans remains the predominant localization technique, though automated pipelines such as Lead-DBS, Brainlab Elements™, SureTune4™ now achieve consistent precision within ±0.5-1.5 mm across platforms. This review summarizes current post-operative imaging strategies and quantitative localization techniques in DBS for PD. It discusses the advantages and limitations of each modality and outlines future directions in automation, multimodal integration, and personalized imaging pipelines for improving the accuracy, reproducibility, and clinical utility of post-operative DBS assessment.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Outcomes and Quality of Life after Unilateral MRgFUS Subthalamotomy in Parkinson's Disease.","authors":"Marina Campins-Romeu, Rebeca Conde-Sardón, Isabel Sastre-Bataller, Raquel Baviera-Muñoz, Mireya Losada-López, Carlos Morata-Martínez, María J Ibáñez-Juliá, José L León-Guijarro, Julia Pérez-García, Luis Raga-Rodríguez, Andrés M Lozano, Andrés Gutiérrez-Martín, Irene Martínez-Torres","doi":"10.1159/000552000","DOIUrl":"10.1159/000552000","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) leads to progressive motor and non-motor deficits that compromise activities of daily living (ADL) and quality of life (QoL). Although bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is highly effective, its invasiveness restricts use in certain patients. Magnetic resonance-guided focused ultrasound (MRgFUS) subthalamotomy offers a less invasive, lesion-based alternative, but evidence regarding its broader functional impact remains limited. The objective was to assess the effects of unilateral MRgFUS subthalamotomy on motor experiences of daily living (MDS-UPDRS II) and QoL (PDQ-39) in patients with PD.</p><p><strong>Methods: </strong>Thirty patients with asymmetric PD refractory to optimized dopaminergic therapy underwent unilateral MRgFUS subthalamotomy targeting the dorsolateral STN between June 2021 and June 2024. Evaluations were performed at baseline, 6 months, and 12 months using MDS-UPDRS II-III, PDQ-39, EQ-5D, and Berg Balance Scale. Primary endpoints were changes in MDS-UPDRS II and QoL; secondary outcomes included motor function (MDS UPDRS III), Levodopa Equivalent Daily Dose (LEDD), and safety.</p><p><strong>Results: </strong>Off- and on-state MDS-UPDRS II improved by 38.5% and 45.8% at 6 months (p < 0.01) and by 50% in both states at 12 months (p < 0.01). PDQ-39 ADL subdomain improved by 10.4% at 12 months (p = 0.033), while global QoL indices remained stable. Off-state motor scores improved by 35.9% (p < 0.001), with reductions in rigidity (50%), bradykinesia (52.9%), and tremor (81.7%). LEDD decreased by 22.1% (p = 0.003). Adverse events were mild and transient, including dysarthria, facial asymmetry, and gait disturbance.</p><p><strong>Conclusion: </strong>Unilateral MRgFUS subthalamotomy was associated with improvements in motor function and motor-related activities of daily living, with a favorable safety profile. These findings suggest that this approach may represent a potential less invasive therapeutic option for selected patients who are unsuitable for or unwilling to undergo DBS, although results should be interpreted with caution given the study design.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-15"},"PeriodicalIF":2.1,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}