This study states that Focal hand dystonia (FHD) is an idiopathic, adult-onset disorder in most cases and manifests only while performing specific tasks.1 Writer’s cramp and musician’s dystonia are the most well-known types of FHD, both of which cause dystonic muscle contractions in hand muscles only while writing or playing musical instruments. The prevalence of this condition is 1.2–1.5 per 100,000 persons.2-4 In some specific populations, such as professional musicians or athletes, the prevalence is much higher than in the general population; approximately 1%–2% of professional musicians are affected by FHD.

The ventro-oral (Vo) nucleus is one of the main output terminators from the basal ganglia, and lesioning or stimulation of this nucleus has been reported to improve FHD.7, 8 Magnetic resonance (MR)-guided focused ultrasound (MRgFUS) thalamotomy, which allows intracranial focal lesioning without an incision, has been reported to be an effective and less invasive procedure for the treatment of tremor and Parkinson’s disease.9, 10 MRgFUS thalamotomy produces thermal lesions, similarly to radiofrequency thalamotomy, and is expected to have similar effects to radiofrequency Vo-thalamotomy on FHD. However, its efficacy for the treatment of FHD has been investigated in only two patients thus far.11, 12 Therefore, we prospectively investigated the efficacy of MRgFUS Vo-thalamotomy in 10 patients with FHD.

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