Background: Magnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy is a safe and effective procedure for drug‐resistant tremor in Parkinson's disease (PD).Objective: The aim of this study was to demonstrate that MRgFUS ventralis intermedius thalamotomy in early‐stage tremor‐dominant PD may prevent an increase in dopaminergic medication 6 months after treatment compared with matched PD control subjects on standard medical therapy.Methods: We prospectively enrolled patients with early‐stage PD who underwent MRgFUS ventralis intermedius thalamotomy (PD‐FUS) and patients treated with oral dopaminergic therapy (PD‐ODT) with a 1:2 ratio. We collected demographic and clinical data at baseline and 6 and 12 months after thalamotomy.Results: We included 10 patients in the PD‐FUS group and 20 patients in the PD‐ODT group. We found a significant increase in total levodopa equivalent daily dose and levodopa plus monoamine oxidase B inhibitors dose in the PD‐ODT group 6 months after thalamotomy.Conclusions: In early‐stage tremor‐dominant PD, MRgFUS thalamotomy may be useful to reduce tremor and avoid the need to increase dopaminergic medications. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Background: Magnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy of ventral intermediate (Vim) nucleus is useful to treat drug‐resistant tremor‐dominant Parkinson's disease (TdPD), but tremor relapse may occur. Predictors of relapse have been poorly investigated so far.Objective: The aim of this study is to evaluate the role of clinico‐demographic, procedural, and neuroradiological variables in determining clinical response, relapse, and adverse events (AEs) in TdPD after MRgFUS Vim‐thalamotomy.Methods: Fifty‐two TdPD patients who consecutively underwent unilateral MRgFUS Vim‐thalamotomy were prospectively evaluated at baseline and after 24 hours, 1 month, 6 months, and 12 months using MDS‐UPDRS‐III in off and on medication conditions. AEs were collected at each evaluation. Lesion volume was calculated at 24‐hour magnetic resonance imaging (MRI). Patients with tremor improvement 30% at 24 hours. Tremor relapse occurred in 12 patients (23%), exclusively during the first month after thalamotomy. Relapse was associated with younger age (P = 0.030) and smaller lesion volume (P = 0.030). At 1 month, 22 patients (42%) had AEs; at 6 and 12 months, AEs persisted in 19% and 6% of cases. AEs at 6 months were associated with larger lesions (P = 0.018). All AEs were mild.Conclusions: MRgFUS Vim‐thalamotomy is effective in treating tremor in TdPD. Relapse is associated with younger age and smaller lesion volume, but larger lesions make AEs more likely to persist. We suggest that a lesion volume between 145 and 220 mm³ on T1‐weighted MRI may be the therapeutic window that ensures tremor control without long‐lasting AEs. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Objective . The subthalamic nucleus (STN) is the most selected target for the placement of the Deep Brain Stimulation (DBS) electrode to treat Parkinson’s disease. Its identification is a delicate and challenging task which is based on the interpretation of the STN functional activity acquired through microelectrode recordings (MERs). Aim of this work is to explore the potentiality of a set of 25 features to build a classification model for the discrimination of MER signals belonging to the STN. Approach. We explored the use of different sets of spike-dependent and spike-independent features in combination with an ensemble trees classification algorithm on a dataset composed of 13 patients receiving bilateral DBS. We compared results from six subsets of features and two dataset conditions (with and without standardization) using performance metrics on a leave-one-patient-out validation schema. Main results. We obtained statistically better results (i.e. higher accuracy p -value = 0.003) on the RAW dataset than on the standardized one, where the selection of seven features using a minimum redundancy maximum relevance algorithm provided a mean accuracy of 94.1%, comparable with the use of the full set of features. In the same conditions, the spike-dependent features provided the lowest accuracy (86.8%), while a power density-based index was shown to be a good indicator of STN activity (92.3%). Significance. Results suggest that a small and simple set of features can be used for an efficient classification of MERs to implement an intraoperative support for clinical decision during DBS surgery.

Hip Osteoarthritis (OA) causes pain and disability. Here we evaluate abobotulinumtoxinA (Dysport^®) (AboBoNT-A) injections versus placebo as a novel treatment option to improve hip range of motion, pain and quality of life. This prospective randomized double-blind multicenter study (EudraCT # 2012-004890-25) recruited 46 outpatients with hip OA who were randomized 2:1 to the Treatment Group (TG; 31 subjects), or the Placebo Group (PG; 15 subjects). The TG received 400 U of AboBoNT-A injected into the adductor muscles, and the PG received placebo solution. The primary endpoints were the difference in Harris Hip Score (HHS) and Visual Analogic Scale for pain (VAS) at Week 4 between groups (TG vs. PG). Secondary endpoints were the change from baseline in HHS, VAS pain, Medical Research Council scale for muscle strength (MRC) and Short Form scale (SF-36) scores. In TG at Week 4, the HHS and VAS score were significantly improved compared to PG, and pairwise assessments showed significant improvements in HSS and VAS pain at each time point compared to baseline for TG. No significant changes were observed in MRC and SF-36 over time, though SF-36 showed a positive trend. There were no significant differences from baseline in the PG. No adverse events were detected in either treatment group. AboBoNT-A injections in hip OA improve range of motion and pain without any significant side effects.