會議議程
講者簡介
2022/8/13 14:10-17:40 Room A Hall (第一會議室) 2F
- Plenary Session
- Time
- Topic
- Speaker
- Moderator
- 14:50~15:30
- MRI-guided Focus Ultrasound and Deep Brain Stimulation for the Treatment of Movement Disorders
- Speaker:
Takaomi Taira
- Moderator:
林祖功
- Professor Takaomi Taira
- MD, PhD
-
Professor, Head of Functional Neurosurgery
Tokyo Women's Medical University
E-mail：ttaira@twmu.ac.jp
Executive Summary：
Professor, Director of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Tokyo Women’s Medical University (TWMU), Tokyo, Japan, Past President of the World Society for Stereotactic and Functional Neurosurgery and Japan Society for Stereotactic and Functional Neurosurgery. Professor Taira’s main area of interest is Stereotactic and Functional Neurosurgery for movement disorders, including management of various types of dystonias.
Pioneering surgical thalamotomy in Japan for the last 30 years, today Professor Taira’s armamentarium for treating essential tremor includes focused ultrasound, DBS, radiotherapy and RF thalamotomy. Professor Taira commented during an interview last year at WSSFN.
Professor, Director of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Tokyo Women’s Medical University (TWMU), Tokyo, Japan, Past President of the World Society for Stereotactic and Functional Neurosurgery and Japan Society for Stereotactic and Functional Neurosurgery. Professor Taira’s main area of interest is Stereotactic and Functional Neurosurgery for movement disorders, including management of various types of dystonias.
Pioneering surgical thalamotomy in Japan for the last 30 years, today Professor Taira’s armamentarium for treating essential tremor includes focused ultrasound, DBS, radiotherapy and RF thalamotomy. Professor Taira commented during an interview last year at WSSFN.
Lecture Abstract：
Over the past 20 years, neurosurgical treatment of movement disorders progressed dramatically. This is mainly because of introduction of deep brain stimulation (DBS), though the incidence of DBS has dramatically decreased in my clinical practice, and now lesioning procedure by radiofrequency (RF) or focused ultrasound (FUS) has been dramatically increasing. This is also because of introduction of detailed computer
technology, and lesioning operation today is completely different from what they were doing before 2000. Stereotactic targets like Vim thalamus, Vo thalamus, subthalamic nucleus (STN), and internal globus pallidum (GPi) have been used for many years and their clinical efficacy is well accepted. These targets are basically classified belonging to the cerebello-thalamo-cortical pathway (CTC) and pallido-thalamo-cortical pathway (PTC). CTC is used mainly for control of tremor and PTC for parkinsonism and dystonia. In PTC, there are two outputs from GPi to the thalamus; ansa lenticular (AL) is and lenticular fasciculus (LF). AL and LF have a unique fibers course running around the STN, and unite together at the dorso-medial aspects of STN that is called Forel H area. By targeting this Forel area, we can interrupt more outputs from GPi to Vo thalamus, and we expect more robust clinical improvement. This target is far from OT and IC, and can be done even under general anesthesia. We call the operation pallidothalamic tractotomy (PTT). PTT area is well-visualized with MRI, and direct targeting is possible. Some patients may show transient sleepiness and decrease of voice volume, but there are no major complications. I will show the clinical cases and discuss about usefulness of this new target in functional neurosurgery.
Over the past 20 years, neurosurgical treatment of movement disorders progressed dramatically. This is mainly because of introduction of deep brain stimulation (DBS), though the incidence of DBS has dramatically decreased in my clinical practice, and now lesioning procedure by radiofrequency (RF) or focused ultrasound (FUS) has been dramatically increasing. This is also because of introduction of detailed computer
technology, and lesioning operation today is completely different from what they were doing before 2000. Stereotactic targets like Vim thalamus, Vo thalamus, subthalamic nucleus (STN), and internal globus pallidum (GPi) have been used for many years and their clinical efficacy is well accepted. These targets are basically classified belonging to the cerebello-thalamo-cortical pathway (CTC) and pallido-thalamo-cortical pathway (PTC). CTC is used mainly for control of tremor and PTC for parkinsonism and dystonia. In PTC, there are two outputs from GPi to the thalamus; ansa lenticular (AL) is and lenticular fasciculus (LF). AL and LF have a unique fibers course running around the STN, and unite together at the dorso-medial aspects of STN that is called Forel H area. By targeting this Forel area, we can interrupt more outputs from GPi to Vo thalamus, and we expect more robust clinical improvement. This target is far from OT and IC, and can be done even under general anesthesia. We call the operation pallidothalamic tractotomy (PTT). PTT area is well-visualized with MRI, and direct targeting is possible. Some patients may show transient sleepiness and decrease of voice volume, but there are no major complications. I will show the clinical cases and discuss about usefulness of this new target in functional neurosurgery.