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GKT Safe, Effective for Elderly with PD Tremor
Stereotact Funct Neurosurg; ePub 2017 Sep 2; Raju, et al
Gamma knife thalamotomy (GKT) is a safe and effective treatment for medically refractory Parkinson disease (PD) tremor, especially for the elderly or those not suitable for deep brain stimulation or thermal thalamotomy, a recent study found. Researchers retrospectively studied the outcomes of 33 patients who were treated with GKT over a 19-year period. 12 patients were ≥80 years. A median dose of 140 Gy (range, 130-150 Gy) was delivered to the nucleus ventralis intermedius through a single 4-mm isocenter. They scored tremor, handwriting, drawing, and ability to drink fluids. and found:
- After GKT, 31 patients (93.9%) experienced improvement in tremor.
- 23 patients (70.0%) had complete or nearly complete tremor arrest.
- 9 patients (27.2%) noted tremor arrest and resolution of impairment in writing, drawing, and ability to drink fluids.
- 1 patient (3%) improved in bradykinesia, 3 patients (9%) improved in rigidity, and 3 patients (9%) decreased their dosage of dopa after GKT.
- Tremor relief was fully maintained in the last follow-up for 96.8% of responding patients.
Raju SS, Niranjan A, Monaco III EA, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for intractable tremor-dominant Parkinson disease: A retrospective analysis. [Published online ahead of print September 2, 2017]. Stereotact Funct Neurosurg. doi:10.1159/000479236.