MR-guided focused ultrasound (MRgFUS) of the ventral intermediate (VIM) nucleus of the thalamus has recently emerged as a novel treatment option for medically refractory tremor in essential tremor and tremor-dominant Parkinson’s disease. The patient’s collaboration is crucial during MRgFUS, as intraoperative testing phases are performed during which tremor severity and any eventual side effects are assessed in order to select the optimal target before permanent lesioning. Head pain is among the most frequent transient adverse event associated with sonication,1 2 and in some cases, it may become so intense to hamper the patient’s cooperation and interfere with MRgFUS.3–5 This study aimed to evaluate the intensity of head pain associated with sonication. In particular, we were interested in identifying predictive factors of high-intensity head pain as it could be a source of interference with the procedure. Furthermore, we explored eventual dissociative or post-traumatic consequences related to high-intensity pain during MRgFUS. Consecutive patients treated with unilateral MRgFUS of the VIM were enrolled. Head pain associated with sonication and pain associated with frame placement was assessed separately using a Verbal Rating Scale. The Peritraumatic Dissociative Experiences Questionnaire (see supplementary references in online supplemental file 1 6 and the Impact of Event Scale-Revised (IES-R)7 were used to assess perioperative dissociative symptoms and acute stress symptoms, respectively. Demographic, clinical and MRgFUS-related data were also collected. Patients were split into two groups according to the rating of head pain intensity during sonication: the high pain (HP) group and the low-medium pain (LMP) group. Between-group comparisons and logistic regression analysis were performed. Details on materials and methods are reported in online supplemental material S1. ### Supplementary data [jnnp-2024-333401supp001.pdf] Among 95 patients treated with monolateral MRgFUS of the VIM, 85 patients were considered for the data analysis (details on selection, demographic, clinical and MRgFUS-related features are reported in …

中文翻译：

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与 MRgFUS 相关的疼痛：仅仅是轻微的短暂不良事件？

丘脑腹侧中间核 (VIM) 的 MR 引导聚焦超声 (MRgFUS) 最近已成为治疗特发性震颤和震颤为主的帕金森病中难治性震颤的一种新治疗选择。在 MRgFUS 过程中，患者的配合至关重要，因为在术中测试阶段会评估震颤的严重程度和任何最终的副作用，以便在永久性病变之前选择最佳目标。头部疼痛是与超声处理相关的最常见的短暂不良事件之一，1 2 在某些情况下，头部疼痛可能会变得非常剧烈，从而妨碍患者的合作并干扰 MRgFUS。3–5 本研究旨在评估与超声处理相关的头部疼痛的强度用超声处理。我们特别感兴趣的是确定高强度头痛的预测因素，因为它可能是干扰手术的一个来源。此外，我们还探讨了 MRgFUS 期间与高强度疼痛相关的最终分离或创伤后后果。连续纳入接受 VIM 单侧 MRgFUS 治疗的患者。使用言语评定量表分别评估与超声处理相关的头部疼痛和与框架放置相关的疼痛。围手术期解离经历问卷（参见在线补充文件 1 6 中的补充参考文献和事件影响量表修订版 (IES-R)7 分别用于评估围手术期解离症状和急性应激症状。人口统计学、临床和 MRgFUS 相关还收集了数据。根据超声处理期间头部疼痛强度的等级将患者分为两组：高疼痛（HP）组和低中度疼痛（LMP）组进行组间比较和逻辑回归分析。有关材料和方法的详细信息，请参见在线补充材料 S1。 ### 补充数据 [jnnp-2024-333401supp001.pdf] 在接受 VIM 单侧 MRgFUS 治疗的 95 名患者中，考虑了 85 名患者进行数据分析（详细信息）选择、人口统计、临床和 MRgFUS 相关特征在……中报告