2026 American Academy of Neurology Abstract Website

Meet Kachhadia¹, Neel Parikh², Janhavi Deshpande³, Anagha Shree⁴, Asiya Tasleema Shaik⁵, Sara S⁶, Anis Shaikh⁷, Sanjana Palakodeti⁸, Anjana Chowdary Elapolu⁹
¹Department of Neurology, Florida Atlantic University Charles E. Schmidt College Of Medicine, Florida, USA, ²Department of Neurology, ³Department of Internal Medicine, Zydus Medical College and Hospital, ⁴SGT Medical College Hospital and Research Institute, ⁵Gandhi Medical College and Hospital, ⁶Fatima Institute of Medical Sciences, ⁷Zydus Medical College and Hospita, India, ⁸Kamineni Institute of Medical Sciences, ⁹Texila American University

Objective:

This review aimed to systematically evaluate the clinical efficacy and safety of MRI guided focused ultrasound (MRgFUS) for adults with medication refractory primary dystonia and to identify key gaps in the current evidence.

Background:

Primary dystonia that does not respond to pharmacological therapy or botulinum toxin injections presents a major therapeutic challenge. Deep brain stimulation (DBS) remains the established surgical option, yet it is invasive and not suitable for all patients. MRI guided focused ultrasound is a noninvasive lesioning technique that has shown potential in other movement disorders, but its role in primary dystonia has not been clearly defined.

Design/Methods:

We systematically searched PubMed, Embase, and ClinicalTrials.gov from inception to August 2025 for studies reporting clinical outcomes of MRgFUS in adults with primary dystonia. Two reviewers independently screened studies, extracted data, and assessed quality using the ROBINS I tool and JBI checklists. Due to heterogeneity in lesion targets, outcomes, and follow up, results were synthesized narratively.

Results:

Seven studies involving 25 patients were identified. Lesion targets included thalamic nuclei (VIM, VOP, Vo) and the globus pallidus/pallidothalamic tract. Follow-up ranged from 6 to 24 months. In cervical dystonia (n=14), TWSTRS severity scores improved by 70.6%-86%. In focal hand dystonia (n=11), mean WCRS improvement was 71.4%. Adverse events were mostly mild and transient; however, persistent deficits such as dysarthria and sensory disturbance were reported, as was a symptom recurrence rate of 30% in one study.

Conclusions:

Current evidence, though limited by small sample sizes and methodological variability, suggests MRgFUS offers meaningful clinical benefit for refractory focal dystonia with an acceptable safety profile. Larger controlled studies are warranted to validate efficacy, refine optimal lesion targets, and determine long-term outcomes. MRgFUS may emerge as a non-invasive alternative to DBS for carefully selected patients. Check accurately if these statements, numbers, matches with our original version and included studies.