Focused Ultrasound question

[Tdonahue5]

Does anyone have experience or data on how much difference the doctor makes in this procedure. I'm considering the procedure for right arm tremor. My local hospital has performed about 20 procedures. Is it worth seeking out a doctor that has performed a much larger number even if I have to travel to another state. What I'm trying to understand is how much is judgement and experience vs how much is formulaic

[MBAnderson]

Imho, experience is everything, because the deficits are potentially grievous. It is brain surgery after all.

[Hidden]

thalamotomy or pallidothalamic tractotomy?

[MBAnderson in reply to Hidden]

Hitting the target precisely is crucial in both because missing either target has potentially grave consequences. Missing the target in thalamotomy may carry more risk.

[Hidden in reply to MBAnderson]

How come?

[MBAnderson in reply to Hidden]

My guess is the thalamus does a lot of critically important functions whereas the PTT is a pathway between the thalamus and the pallidum.

The doctors in Switzerland emphasized the importance of staying away from the thalamus.

[Hidden in reply to MBAnderson]

Dude, that makes so much sense. Thanks for the time to explain this.

[NewHope1961]

great question

[MBAnderson]

I don't equate non invasive with non surgical. They are altering a structure deep in the brain.

[MBAnderson]

I know of a person who feels the same procedure worsened their condition. I don't know what other variable could be responsible for that except missing the target. (The equipment and procedures are identical.)

[Markbit]

Experience has a big weight! My intervention took about 2 hours. The first interventions from the same team (sonimodul) took about 8 hours with no better results. It's a big learning curve.

[MBAnderson in reply to Markbit]

Kudos to you for translating Daphne's book. A huge project.

[Trixiedee]

I’d look at the different targets in the brain first. Personally I would only opt for the pallido thalamic tract at Sonimodul as they have the most experience and are the only place that operates on both sides of the brain.

[Tdonahue5 in reply to Trixiedee]

Is anyone aware if the pallido thalamic tract is being done by any Doctors in the US?

[Trixiedee in reply to Tdonahue5]

it’s only being done as part of a clinical trial which is full.

[Tdonahue5]

Thanks to all for the responses they are helpful