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Calendar - The 20th Biennial Meeting of the World Society for Stereotactic and Functional Neurosurgery
<!doctype html> <html lang="en"> <head> <meta charset="UTF-8"> <title>Calendar - The 20th Biennial Meeting of the World Society for Stereotactic and Functional Neurosurgery</title> <meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=0"/> <meta name="description" content=""/> <meta name="author" content="CTI Meeting Technology"/> <link rel="shortcut icon" href="/images/favicon/favicon.ico"> <link rel="apple-touch-icon" sizes="180x180" href="/images/favicon/apple-touch-icon.png?v=wAdaPpJKvx"> <link rel="icon" type="image/png" sizes="32x32" href="/images/favicon/favicon-32x32.png?v=wAdaPpJKvx"> <link rel="icon" type="image/png" sizes="16x16" href="/images/favicon/favicon-16x16.png?v=wAdaPpJKvx"> <link rel="manifest" href="/images/favicon/site.webmanifest?v=wAdaPpJKvx"> <link rel="mask-icon" href="/images/favicon/safari-pinned-tab.svg?v=wAdaPpJKvx" color="#5bbad5"> <link rel="shortcut icon" href="/images/favicon/favicon.ico?v=wAdaPpJKvx"> <link 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class="view-box-header">View</span> <ul> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/session/list"><i class="fa fa-list"></i><span class="hidden-xs"> List</span></a></li> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/session/calendar"><i class="fa fa-calendar"></i><span class="hidden-xs"> Calendar</span></a></li> </ul> </div> </div> <div class="list-view list-view-list"> <div class="card item-container session open st-7-bg" data-id="124" data-streaming="no" > <div class="card-header"> <div class="label-container"><div class="labels"></div> </div> <div class="expand-labels"><i class="fa fa-angle-double-down" aria-hidden="true"></i></div> <div class="actions hidden-xs"> <button type="button" class="btn btn-default pull-left btn-open-new" data-dismiss="modal"><i class="fa fa-expand"></i></button> <button type="button" class="close" data-dismiss="modal" aria-label="Close"><i class="fa fa-times"></i></button> </div> </div> <div class="card-block"> <div class="item-expand"> <h4 class="session-title card-title"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124" class="item-expand-action expand">Oral Presentation Session 07: Radiosurgery & Lesions</a></h4> </div> <div class="details property-auto-width"> <div class="property-container internal_title"> </div> <div class="property-container internal_type"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal_date"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal_time"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal_room"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal_moderators"> <div class="info">Chair(s)</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1732" data-id="1732" class="" >Cristina Torres<small> (Spain)</small></a></li> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1726" data-id="1726" class="" >Andrey Golanov<small> (Russian Federation)</small></a></li> </ul> </div> </div> <div class="property-container internal_description"> <div class="info">Session Description</div> <div class="property">Each presenter is allocated 10 minutes: 8 min for presentation +2 min for Q&A.</div> </div> <div class="property-container cslide_SESSION_ICON"> </div> </div> <div class="additional-materials"> <ul class="nav nav-pills logged"> </ul> <div class="tab-content"> </div> </div> <div class="item-content"> <div class="card presentation" data-id="496"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">TREATMENT OF TRIGEMINAL NEURALGIA WITH RADIOSURGERY IN THE NEW ZAP-X DEVICE: THE SWISS EXPERIENCE, 2021-2024</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124">0640 - Oral Presentation Session 07: Radiosurgery & Lesions <small>(ID 124)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">03:10 PM - 03:20 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/858" data-id="858" class="" >Med. E. Taub<small> (Switzerland)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="496" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-496964761936" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-496964761936" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p><span style="color:#212121;">The ZAP-X radiosurgical device has been in use at the Swiss Neuro Radiosurgery Center in Zurich since 2021 for the treatment of trigeminal neuralgia (TN).</span></p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>From September 2021 to January 2024, 35 patients with TN were treated with the ZAP-X device. The original radiation dose of 70 Gy at the 80% isodose was reduced to 60 Gy at the 80% isodose from September 2023 onward to avoid side effects. All patients underwent close clinical follow-up.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p><span style="color:#212121;">25 of the 35 patients had idiopathic TN (ITN); 10 had TN of other types (multiple sclerosis, 7; solitary pons lesion, 1; "atypical TN", 2). 19 of the ITN patients were treated up to August 2023; 2 had had previous radiosurgery treatment and 2 did not come for follow-up. For the group of 15 ITN patients analyzed here, there were follow-up periods of 2 to 15 months. All 15 experienced relief of their TN pain (2 partial, 13 complete), and 9 were no longer taking medication for TN at the time of their last follow-up. The median latency to full pain relief was 3.9 months. These improvements came at the expense of moderate or severe sensory deficits in 5 of the 15 patients (2 moderate, 3 severe). All 3 patients with severe deficits, and one with a moderate deficit, also suffered from dysesthesia. From September 2023, a further 6 ITN patients were treated with the lower dose of 60 Gy at the 80% isodose. Their preclinical follow-up data at the time of submission of this abstract suggest effective pain relief with a lower risk of severe sensory loss and dysesthesia.</span></p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Radiosurgery with the ZAP-X device is effective against trigeminal neuralgia. The radiation dose must be chosen to minimize the risk of dysesthesia.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="298"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">SEIZURE OUTCOMES AFTER GKRS FOR LARGE VOLUME AVMS</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124">0640 - Oral Presentation Session 07: Radiosurgery & Lesions <small>(ID 124)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">03:20 PM - 03:30 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/956" data-id="956" class="" >Pavel Ivanov<small> (Russian Federation)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="298" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-298406392477" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-298406392477" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Treatment of large AVMs associated with epileptic seizures are difficult, as it should result not only in AVM obliteration but also in seizure improvement.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>We analyzed the results of Gamma Knife radiosurgery (GKRS) for large AVMs associated with seizures and treated at our Radiosurgical department over 10 years from 2013. 30 patients with neurological follow-up were selected from the database and their clinical, neurological and radiological data were summarized. The Spetzler-Martin grade was 3 for 6 AVMs, 4 for 19 AVMs and 5 for 5 AVMs. As additional treatment, 18 patients underwent AVM embolization before GKRS, 4 – after GKRS and 8 patients were treated only with GKRS. Volume-staged GKRS were done for 19 patients: 2 stages for 9 AVMs, 3 stages for 8 AVMs and 4 stages for 1 and 5 stages for 1. The time interval between radiosurgical stages was 1 year. The prescribed irradiation volume for radiosurgery varied from 1.3 to 5.2 cm<sup>3</sup>. The marginal dose was between 20 to 24 Gy, prescribed at 50% isodose. After GKRS patients underwent regular radiological (MRI and CA) and neurological follow-ups. The mean follow-up time after GKRS was 90 months (median 93, from 35 to 128 months).</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>Among patients who had embolization before GKRS: 11 patients achieved seizure-free status after GKRS and 5 of them were no longer required AEDs; 5 patients achieved a decrease in seizure frequency following GKRS and 2 of them were free from AEDs; 2 patients had seizure-free status for 4 and 8 years after GKRS, but then seizures re-appeared following ischemic stroke and severe stress. Among 4 patients who underwent embolization after GKRS, 2 achieved seizure-free status without AEDs and 2 had no improvement in seizures with AEDs. Among patients who received only GKRS, 5 patients were seizure-free (3 without AEDs), 2 patients had a decrease in seizure frequency (one without AEDs) and 1 had no improvement in seizure status.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Gamma Knife radiosurgery offered an improvement in seizure status, associated with large AVMs and thus may be considered a favorable treatment strategy, even performed in a volume-staged mode.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="483"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">VIM LESIONS IN RADIOSURGERY AND FOCUSED ULTRASOUND: ASSESSMENT OF THE ACCURACY OF TWO TARGETING MODELS BASED ON MACHINE LEARNING.</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124">0640 - Oral Presentation Session 07: Radiosurgery & Lesions <small>(ID 124)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">03:30 PM - 03:40 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1294" data-id="1294" class="" >Emmanuel Cuny<small> (France)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="483" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-4831285104828" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-4831285104828" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Targeting the ventro-intermediate nucleus (VIM) remains a challenge for lesioning techniques such as radiosurgery (RS) or MR-guided focused ultrasound (MRgFUS). Are the lesioning targets equivalent to those used in DBS?</p> <p>To evaluate the ideal target locations, we examined the localization of lesions in the ventro-intermediate nucleus (VIM) in successfully treated tremor patients (considered our gold standard) and compared it with predictions generated by machine learning.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>A specific prediction model of the VIM target in RS was generated from a database of patients successfully treated in Marseille using support vector machine regression.</p> <p>A second specific prediction model of DBS active contact placement in the VIM developed by RebrAIn® was used.</p> <p>External validation of these two models was performed by selecting two new series of patients after effective left VIM lesion.</p> <p>Twelve patients successfully treated with RS in Marseille (France) and 15 patients successfully treated with MRgFUS in Pampelona (Spain) were selected to Ievaluate the accuracy of two targets : the target obtained by the DBS algorithme and the target obtained using the newly developed RS model. Both targets were compared in terms of lesion center position and lesion diameter.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>The mean distance between the RS model target and the center of the RS lesion was 1.8±0.47 mm and between the DBS model target and the center of the RS lesion was 3.4±1.05 mm for a mean RS lesion diameter of 5.28±1.01 mm.</p> <p>The mean distance between the RS model target and the center of the MRgFUS lesion was 1.37mm ±0.3mm, and between the DBS model target and the center of the MRgFUS lesion was in the same range as in RS patients, with an MRgFUS lesion diameter of 4.9±1.3mm.</p> <p>All RS model targets are within the lesion for both RS and MRgFUS patient series. The DBS model targets are more medial (x-axis) and inferior (z-axis) than the RS model.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p><span>The more medial and inferior location of the DBS prediction model highlights the fact that the learning process takes into account patients who have greatly improved by selecting the deeper active contact of leads that are closest to the PSA. </span></p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="362"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">PROBABILISTIC MAPPING OF LESION LOCATIONS IN BILATERAL FOCUSED ULTRASOUND THALAMOTOMIES</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124">0640 - Oral Presentation Session 07: Radiosurgery & Lesions <small>(ID 124)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">03:40 PM - 03:50 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/808" data-id="808" class="" >Can Sarica<small> (Turkey)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="362" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-362951308743" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-362951308743" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Bilateral focused ultrasound thalamotomies for essential tremor (ET) patients have gained regulatory approval in various countries, marking a recent addition to neurosurgeon's arsenal. Nevertheless, the need for symmetrical lesioning to achieve an optimal outcome requires further clarification. The potential necessity of asymmetrical lesioning, aimed at preventing the exacerbation of complications from initial surgeries, raises uncertainty about its impact on clinical efficacy. The aim of this study is to evaluate lesion symmetry in a bilateral thalamotomy ET cohort, identifying and comparing spatial lesion locations with the highest clinical efficacy in both hemispheres to assess the potential requirement for symmetrical lesioning.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>The CRST sub-scores for both sides at baselines and latest follow-up were reviewed. Lesions from the day-zero MRI of each surgery were segmented, and probabilistic maps of efficacy, as per literature methods<sup>1</sup>, were generated. All right-sided lesions were flipped to left for visualization. All patients received initial treatment for their dominant hands, with intentional placement of second lesions 1mm superior to the first-side.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>Nineteen ET patients who underwent bilateral thalamotomies, with an average follow-up of 21±13 months after 2<sup>nd</sup>surgery, were identified. Mean scores on the dominant side improved from 19.8±1.7 to 7.5±3.3, reflecting a 61% improvement, while non-dominant scores improved from 20.3±4.4 to 9.4±5.5, showing a 52% improvement. Thresholded probabilistic maps, showing a minimum 10% improvement, confirm the spatial superiority of lesions from the second surgery over the first, supporting the intentional asymmetrical lesioning. Thresholding at a 60% improvement revealed that the 'sweet spots' were dispersed along the length of the VIM near the VC junction, occupying distinct spatial locations.</p> <p><img src="https://s3.eu-central-1.amazonaws.com/eu-cpaper-prod/mediafiles/wssfn_24/0000000362/000158.png" alt="figure.png" title="figure.png" thumbnail="large"/></p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Non-overlapping sweet spots suggest the presence of multiple sweet spots within VIM rather than a single spot, supporting a "sweet tract" hypothesis. Symmetrical lesioning is not imperative for high efficacy in second-side surgeries; instead, emphasis is placed on accurate lesion placement. The study will be updated with complication maps during the congress.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="318"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">NON-SELECTIVE LUMBOSACRAL VENTRAL-DORSAL RHIZOTOMY FOR MANAGEMENT OF LOWER-LIMB HYPERTONIA IN NON-AMBULATORY CHILDREN WITH CEREBRAL PALSY</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124">0640 - Oral Presentation Session 07: Radiosurgery & Lesions <small>(ID 124)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">03:50 PM - 04:00 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1012" data-id="1012" class="" >Sanaa Abdelmageed<small> (United States of America)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="318" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-3181608852928" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-3181608852928" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Children with cerebral palsy (CP) often suffer from medically refractory hypertonia, for which there are surgical therapies including neuromodulation and rhizotomy. Traditional surgical treatment for medically refractory mixed hypertonia or dystonia includes intrathecal baclofen pumps (ITBP) and selective dorsal rhizotomy (SDR). A non-selective lumbosacral VDR (ventral and dorsal roots lesioned by 80-90%) has the potential to address the limitations of traditional surgical treatment options. We identified a cohort to highlight our institutional safety and efficacy using non-selective lumbosacral VDR for palliative tone management in non-ambulatory patients with highly involved CP.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Retrospective analysis was performed for patients that underwent lumbosacral VDR between 2022-2023. Demographic factors, clinical variables, and operative characteristics were collected.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>Fourteen patients (7 female) were included. All patients underwent a T12-L2 osteoplastic laminoplasty and bilateral L1-S1 VDR. Nine patients had quadriplegic mixed hypertonia, four patients had quadriplegic spasticity, and one patient had generalized secondary dystonia. Following VDR, there was a significant decrease in both the lower extremity modified Ashworth scale (mAS), mean difference (MD) -2.77 ± 1.0 (p <0.001) and upper extremity mAS, MD -0.71 ± 0.76 (p= 0.02), postoperatively with average follow-up of three months. In the patient with generalized dystonia, the lower extremity Barry Albright Dystonia Scale (BADS) score decreased from 8 to 0 and the overall score decreased from 32 to 13. All parents noted improvement in caregiving provisions, particularly with positioning, transfers and changing. Mean daily enteral baclofen dose decreased from 47 mg preoperatively to 24.5 mg (p<0.001) postoperatively. Three patients developed wound dehiscence, two of which had concurrent infections.</p> <p><img src="https://s3.eu-central-1.amazonaws.com/eu-cpaper-prod/mediafiles/wssfn_24/0000000318/000128.jpg" alt="figure 2.jpg" title="figure 2.jpg" thumbnail="large"/></p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Lumbosacral VDR is safe, effective for tone control, and can provide quality of life improvements in patients with medically refractory lower-limb mixed hypertonia. Lumbosacral VDR can be considered for palliative tone control in non-ambulatory patients with more involved CP. Larger studies with longer follow-up are necessary to further determine safety and long-term benefits in these patients.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="195"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">INVESTIGATION OF GUSTATORY PATHWAYS USING PROBABILISTIC TRACTOGRAPHY: IMPLICATIONS FOR MR-GUIDED FOCUSED ULTRASOUND</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/124">0640 - Oral Presentation Session 07: Radiosurgery & Lesions <small>(ID 124)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Oral Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">03:10 PM - 04:10 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">04:00 PM - 04:10 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/641" data-id="641" class="" >Kazuki Sakakura<small> (United States of America)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="195" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-195244680689" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-195244680689" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Taste disturbances have been increasingly recognized as a side effect following MR-guided focused ultrasound (MRgFUS) treatment of the ventral intermediate nucleus (VIM) for essential tremor and tremor-dominant Parkinson’s disease. Given the impact of taste disturbances on patients' quality of life, addressing this issue has become a pressing concern. However, our understanding of how gustatory pathways traverse the thalamus and which regions are involved at the thalamic level remains incomplete. To address this knowledge gap, we conducted tractography of gustatory pathways using probabilistic tractography.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>We leveraged data from 20 individuals sourced from the Human Connectome Project database. We created the tractography using diffusion-weighted images with MRtrix3. The medial lemniscus (ML) was delineated using the Regions of interest (ROIs) in the dorsal brainstem, entire thalamus, and postcentral gyrus, followed by the pyramidal tract (PT) using ROIs in the cerebral peduncle, posterior limb of the internal capsule, and precentral gyrus. Subsequently, gustatory tracts were delineated using the ROIs that were placed in a sphere with a 3-mm diameter, of which the center is at coordinates 3mm medial from the intersection between the anterior edge of the ML and the inner edge of the PT (Sphere ROI), the dorsal brainstem, Brodmann area 43. Additionally, the dentato-rubro-thalamic tract (DRTT) was delineated using the Sphere ROI, dentate nucleus, red nucleus, and precentral gyrus.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>The results indicated successful delineation of the ML, PT, gustatory tract, and DRTT in all 20 subjects. Across all participants, a total of 564 gustatory tracts (14.1 per patient) were identified, anteromedial to the ML and posteromedial to the DRTT in the anterior commissure – posterior commissure plane (Figure).</p> <p><img src="https://s3.eu-central-1.amazonaws.com/eu-cpaper-prod/mediafiles/wssfn_24/0000000195/000090.jpg" alt="figure_ks1.jpg" title="figure_ks1.jpg" thumbnail="large"/></p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Our findings suggest that gustatory pathways are predominantly located anteromedial to the ML and posteromedial to the DRTT at the thalamic level. These insights highlight the importance for clinicians performing MRgFUS on the VIM to consider the gustatory pathways when selecting treatment targets.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div></div> </div> </div> </div> <div id="footer"> <div class="footer text-center"> <div class="footer_wrapper"> <i class="fa fa-chevron-up" aria-hidden="true" style="display: none;"></i> <p>Programme and Faculty are preliminary and subject to change.<br /> <b><a href="http://www.surveymonkey.com/r/MSHLPYT?c=7647_The 20th Biennial Meeting of the World Society for Stereotactic and Functional Neurosurgery_2024" target="_blank"><span>Give Feedback</span></a></b><br /> <span>© 2024 cSLIDE </span><a href="http://www.ctimeetingtech.com" target="_blank"><span>CTI MEETING TECHNOLOGY</span></a><span>. 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