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Lacertid and amphisbaenian lizards are two squamate reptile lineages very divergent morphologically. In fact, adaptation to burrowing deeply modified amphisbaenian worm-like body. Lacertids instead have a typical reptile morphology with a long tail and four well-developed limbs. Despite so different in appearance, they are evolutionarily very close as evidenced by molecular phylogenetic approaches. Consistently, a slow-evolving satellite DNA (IMO-TaqI) described in lacertid lizards was isolated from the genome of the amphisbaenian Trogonophis wiegmanni too. Comparison with lacertid repeats evidenced great similarity, highlighting that molecular characters appeared very suitable especially when morphology is subjected to strong selective pressures.

BackgroundGender differences in the access to advanced therapies for Parkinson’s disease (PD) are poorly investigated.ObjectiveThe objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD.DesignRetrospective study.MethodsData from patients with consistent access to the Parkinson’s and Movement Disorder Center of L’Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included.ResultsOut of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, p-value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, p-value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, p-value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, p-value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, p-value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; p-value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, p-value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, p-value = 0.505).ConclusionThe predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation.

The recent revision of Italian legislation on nature conservation has highlighted the pressing necessity of elucidating the native distribution range of managed species. A recent study by Antognazza et al. (Current and Historical Genetic Variability of Native Brown Trout Populations in a Southern Alpine Ecosystem: Implications for Future Management. Fishes 2023, 8, 411) provides insights into the native status of brown trout in the Lombardy Prealps, northern Italy, and advocates urgent conservation measures. However, the possible effect of historical and recent anthropogenic impacts was dismissed in the paper. Here, we present how human-mediated activities plausibly might contribute to the observed distribution of population genetic variation, considering both the available literature and ongoing “Mediterranean trout” stocking activities in the region. Implementing management strategies without clear scientific evidence poses significant risks to native biodiversity conservation.

IntroductionEssential tremor (ET) and Parkinson’s Disease (PD) are debilitating neurodegenerative disorders characterized by tremor as a predominant symptom, significantly impacting patients’ quality of life. Magnetic Resonance-guided Focused Ultrasound (MRgFUS) Thalamotomy is an innovative therapeutic option for the treatment of unilateral medically refractory tremor with fewer adverse effects compared to traditional surgical interventions. A recent CE approval allows appropriate patients to have their second side treated.ObjectiveThe objective of this systematic review was to analyze available current knowledge about the use of MRgFUS for the treatment of bilateral ET and PD related tremor, to identify the effectiveness and the risks associated with bilateral treatment.MethodsEligible studies were identified by searching published studies in PubMed and Scopus databases from May 2014 to January 2024 and by identifying ongoing studies registered on the clinicaltrials.gov website. Data were summarized by considering the following information topics: the number of patients involved, the selected lesion target, the assessment tool used to evaluate clinical changes, the observed improvement, the reported side effects, and the time interval between the two treatments. The study was registered in PROSPERO (ID: CRD42024513178).ResultsNine studies were eligible for this review, 7 for ET and 2 for PD. The involved population included a variable number of patients, ranging from 1 to 11 subjects for ET and from 10 to 15 subjects for PD. The main lesional targets were the ventral intermediate nucleus of the thalamus, the pallidothalamic tract and the cerebellothalamic tract bilaterally. All studies investigated the tremor relief through the Clinical Rating Scale for Tremor (CRST) in patients with ET, and through the Unified Parkinson’s Disease Rating Scale (UPDRS) in patients with PD. A variable degree of improvement was observed, with all patients expressing overall satisfaction with the bilateral treatment. Adverse events were mild and transient, primarily involving gait disturbances, dysarthria, and ataxia. A standardized protocol for administering the two consecutive treatments was not identifiable; typically, the timing of the second treatment was delayed by at least 6 months.ConclusionAvailable evidence supports the effectiveness and safety of staged bilateral MRgFUS treatments for ET and PD-related tremor.

IntroductionIn the COGNitive in Focused UltraSound (COGNIFUS) study, we examined the 6-month cognitive outcomes of patients undergoing MRgFUS thalamotomy. This study endorsed the safety profile of the procedure in terms of cognitive functions that cannot be evaluated in real-time during the procedure unlike other aspects. The aim of the COGNIFUS Part 2 study was to investigate the cognitive trajectory of MRgFUS patients over a 1-year period, in order to confirm long-term safety and satisfaction.MethodsWe prospectively evaluated the cognitive and neurobehavioral profile of patients with essential tremor (ET) or Parkinson’s Disease (PD) related tremor undergoing MRgFUS thalamotomy at 1 year-follow-up following the treatment.ResultsThe sample consists of 50 patients (male 76%; mean age ± SD 69.0 ± 8.56; mean disease duration ± SD 12.13 ± 12.59; ET 28, PD 22 patients). A significant improvement was detected at the 1 year-follow-up assessment in anxiety and mood feelings (Hamilton Anxiety rating scale 5.66 ± 5.02 vs. 2.69 ± 3.76, p ≤

PurposeThis study aimed to identify possible prognostic factors determining early tremor relapse after Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) thalamotomy in patients with essential tremor (ET) and Parkinson’s disease (PD).MethodsNine patients (six ET and three PD) who underwent Vim MRgFUS thalamotomy in a single institution and developed early re-emergent tremor were analyzed. A control group of patients matched pairwise for sex, pathology, age, disease duration, and skull density ratio (SDR) was selected to compare the technical-procedural data and MR imaging evidence. MR imaging findings compared between groups included lesion shape and volume in multiparametric sequences, as well as Fractiona Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) values derived from Diffusion Tensor Imaging Diffusion Weighted Imaging (DTI) and Diffusion Weighted Imaging (DWI) sequences.ResultsWe did not find statistically significant differences in gender and age between the two groups. Technical and procedural parameters were also similar in both treatment groups. In MRI analysis, we found lesions of similar size but with greater caudal extension in the control group with stable outcomes compared to patients with tremor relapse.ConclusionIn our analysis of early recurrences after thalamotomy with focused ultrasound, there were neither technical and procedural differences nor prognostic factors related to lesion size or ablation temperatures. Greater caudal extension of the lesion in patients without recurrence might suggest the importance of spatial consolidation during treatment.

Abstract Obesity is the main risk factor for many non-communicable diseases. In clinical practice, unspecific markers are used for the determination of metabolic alterations and inflammation, without allowing the characterization of subjects at higher risk of complications. Circulating microRNAs represent an attractive approach for early screening to identify subjects affected by obesity more at risk of developing connected pathologies. The aim of this study was the identification of circulating free and extracellular vesicles (EVs)-embedded microRNAs able to identify obese patients at higher risk of type 2 diabetes (DM2). The expression data of circulating microRNAs derived from obese patients (OB), with DM2 (OBDM) and healthy donors were combined with clinical data, through network-based methodology implemented by weighted gene co-expression network analysis. The six circulating microRNAs overexpressed in OBDM patients were evaluated in a second group of patients, confirming the overexpression of miR-155-5p in OBDM patients. Interestingly, the combination of miR-155-5p with serum levels of IL-8, Leptin and RAGE was useful to identify OB patients most at risk of developing DM2. These results suggest that miR-155-5p is a potential circulating biomarker for DM2 and that the combination of this microRNA with other inflammatory markers in OB patients can predict the risk of developing DM2.

Abstract Medullary Thyroid Carcinoma (MTC) is a rare neuroendocrine tumour whose diagnosis includes evaluating calcitonin serum levels, which can present fluctuations unrelated to MTC. Here, we investigated circulating DNA fragmentation and methylation changes as potential biomarkers using ddPCR on cell-free DNA (cfDNA) isolated from the plasma of MTC patients. For cfDNA fragmentation analysis, we investigated the fragment size distribution of a gene family and calculated short fragment fraction (SFF). Methylation analyses evaluated the methylation levels of CG_16698623, a CG dinucleotide in the MGMT gene that we found hypermethylated in MTC tissues by analyzing public databases. The SFF ratio and methylation of CG_16698623 were significantly increased in plasma from MTC patients at diagnosis, and patients with clinical remission or stable disease at follow-up showed no significant SFF difference compared with healthy subjects. Our data support the diagnostic value of cfDNA traits that could enable better management of MTC patients.

Abstract The notion that data should be Findable, Accessible, Interoperable and Reusable, according to the FAIR Principles, has become a global norm for good data stewardship and a prerequisite for reproducibility. Nowadays, FAIR guides data policy actions and professional practices in the public and private sectors. Despite such global endorsements, however, the FAIR Principles are aspirational, remaining elusive at best, and intimidating at worst. To address the lack of practical guidance, and help with capability gaps, we developed the FAIR Cookbook, an open, online resource of hands-on recipes for “FAIR doers” in the Life Sciences. Created by researchers and data managers professionals in academia, (bio)pharmaceutical companies and information service industries, the FAIR Cookbook covers the key steps in a FAIRification journey, the levels and indicators of FAIRness, the maturity model, the technologies, the tools and the standards available, as well as the skills required, and the challenges to achieve and improve data FAIRness. Part of the ELIXIR ecosystem, and recommended by funders, the FAIR Cookbook is open to contributions of new recipes.

The fin whale Balaenoptera physalus is a large rorqual species occurring worldwide, mainly in temperate and subpolar zones. In contrast to many baleen whales, not all the fin whale populations show the same model of migration. In fact, migratory behaviours of this latter species range from long seasonal migration between high and low latitudes to a complete non-migratory behaviour. A resident fin whale population was described in the Mediterranean Sea, which is also frequented by North Atlantic individuals entering through the Strait of Gibraltar in winter to feed. Between 2020 and 2021 three individuals initially identified as fin whales died along the Tyrrhenian coasts (Mediterranean Sea, Italy). Their mitochondrial DNA control region (mtDNA CR) was analysed and compared to fin whale haplotypes previously described in North Atlantic Ocean and Mediterranean Sea to identify their geographical origin. Our results show that two individuals most likely belong to the Mediterranean fin whale population, while an individual was recognised as a putative fin-blue whale hybrid (Balaenoptera physalus x Balaenoptera musculus) with a North Atlantic origin. The discovery of the first fin-blue whale hybrid in the Mediterranean Sea was confirmed by the analysis of a biparentally inherited marker, the α-lactalbumin (α-lac) nuclear gene, demonstrating that the morphological analysis alone does not allow to correctly identify hybrids, especially if intermediate characters of both parental species are not clearly distinguishable.

Two mitochondrial genes (cytochrome oxidase I and cytochrome b) were examined to compare an isolated population of the Italian minnow in the central Apennines to other populations in the species’ range (Po plain) and other European minnow species. Both mitochondrial markers showed a new haplotype, fixed in a sample of 30 specimens, never observed in the main species distribution range, and ostensibly divergent from other Italian minnow haplotypes. The result suggests a long history of isolation, probably preceding the Holocene retreat northwards of the Po River. This relict population is now at serious extinction risk owing to habitat loss and predation by alien trout restocked into the wild for recreational fishing purposes.

Abstract Background Melanoma is the deadliest form of skin cancer and metastatic disease is associated with a significant survival rate drop. There is an urgent need for consistent tumor biomarkers to scale precision medicine and reduce cancer mortality. Here, we aimed to identify a melanoma-specific circulating microRNA signature and assess its value as a diagnostic tool. Methods The study consisted of a discovery phase and two validation phases. Circulating plasma extracellular vesicles (pEV) associated microRNA profiles were obtained from a discovery cohort of metastatic melanoma patients and normal subjects as controls. A pEV-microRNA signature was obtained using a LASSO penalized logistic regression model. The pEV-microRNA signature was subsequently validated both in a publicly available dataset and in an independent internal cohort. Results We identified and validated in three independent cohorts a panel of melanoma-specific circulating microRNAs that showed high accuracy in differentiating melanoma patients from healthy subjects with an area under the curve (AUC) of 1.00, 0.94 and 0.75 respectively. Investigation of the function of the pEV-microRNA signature evidenced their possible immune suppressive role in melanoma patients. Conclusions We demonstrate that a blood test based on circulating microRNAs can non-invasively detect melanoma, offering a novel diagnostic tool for improving standard care. Moreover, we revealed an immune suppressive role for melanoma pEV-microRNAs.

Abstract The Adriatic brook lamprey, Lampetra zanandreai Vladykov 1955, was described from northeastern Italy. Its distribution is thought to include left tributaries of the River Po and the river basins of the Adriatic Sea from the River Po to the River Isonzo/Soča in Italy, Switzerland and Slovenia. It also shows a geographically isolated distribution in the Potenza River on the Adriatic slope in Central Italy. Lampetra from the Neretva River system in Croatia and Bosnia and Herzegovina and the Morača River system in Montenegro that were previously identified as L. zanandreai were recently described as a new species Lampetra soljani Tutman, Freyhof, Dulčić, Glamuzina & Geiger 2017 based on morphological data and a genetic distance between the two species of roughly 2.5% in the DNA barcoding gene cytochrome oxidase I (COI). Since DNA barcodes for L. zanandreai are only available for one population from the upper Po River in northwestern Italy, we generated additional COI nucleotide sequence data of this species from Switzerland, northeastern and central Italy comprising near topotypic material and obtained GenBank sequences of the species from Slovenia to better assess the evolutionary history of the two brook lamprey species in the river basins of the Adriatic Sea. Our data show a low sequence divergence of

Background: Magnetic Resonance-guided Focused Ultrasound (MRgFUS) is an innovative therapeutical approach for medically refractory tremor. It is currently under investigation for other neurological diseases including refractory neuropathic pain (NP). Objective: The objective of this systematic review is to analyze available evidence about the effectiveness and safety profile of MRgFUS in the treatment of refractory NP. Methods: Eligible studies were identified by searching published studies in PubMed and Scopus databases from inception to December 2022 and by identifying ongoing studies registered on the clinicaltrials.gov website. The study was registered in PROSPERO (ID: CRD42021277154). Results: We found three published observational studies and nine ongoing studies. In published studies, the involved population ranged from 8 to 46 patients with overall 66 patients being included with NP or trigeminal neuralgia. The target lesion was in the posterior part of the central lateral nucleus of the thalamus, bilaterally. Outcomes were assessed at different times through the Visual Analog Scale, showing a variable degree of improvement. Adverse events were rare, mild, and transient (vertigo, paresthesias, and dysesthesias) with intracerebral bleeding being reported as major adverse event in one case only. Among ongoing studies, we found three prospective, randomized, sham-controlled, crossover trials (RCTs) and six observational studies. Inclusion criteria are previous failure of more than three pharmacological treatments and NP duration longer than 6 months. The thalamus is the main proposed target and measured outcomes are accuracy of the procedure and pain relief, with a follow-up period ranging from 1 week to 1 year. Conclusion: This systematic review suggests that, although high-quality studies are lacking, available evidence endorses the effectiveness and safety of MRgFUS in the management of NP. Ongoing RCTs will provide more robust data to understand benefits and risks of the procedure. Registration: PROSPERO (ID: CRD42021277154)

Abstract Background Pediatric low-grade gliomas (pLGGs), particularly incompletely resected supratentorial tumours, can undergo progression after surgery. However to date, there are no predictive biomarkers for progression. Here, we aimed to identify pLGG-specific microRNA signatures and evaluate their value as a prognostic tool. Methods We identified and validated supratentorial incompletey resected pLGG-specific microRNAs in independent cohorts from four European Pediatric Neuro-Oncology Centres. Results These microRNAs demonstrated high accuracy in differentiating patients with or without progression. Specifically, incompletely resected supratentorial pLGGs with disease progression showed significantly higher miR-1248 combined with lower miR-376a-3p and miR-888-5p levels than tumours without progression. A significant (p

Lacertid and amphisbaenian lizards are two squamate reptile lineages very divergent morphologically. In fact, adaptation to burrowing deeply modified amphisbaenian worm-like body. Lacertids instead have a typical reptile morphology with a long tail and four well-developed limbs. Despite so different in appearance, they are evolutionarily very close as evidenced by molecular phylogenetic approaches. Consistently, a slow-evolving satellite DNA (IMO-TaqI) described in lacertid lizards was isolated from the genome of the amphisbaenian Trogonophis wiegmanni too. Comparison with lacertid repeats evidenced great similarity, highlighting that molecular characters appeared very suitable especially when morphology is subjected to strong selective pressures. [ABSTRACT FROM AUTHOR]

Background: Gender differences in the access to advanced therapies for Parkinson's disease (PD) are poorly investigated. Objective: The objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD. Design: Retrospective study. Methods: Data from patients with consistent access to the Parkinson's and Movement Disorder Center of L'Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included. Results: Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, p -value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, p -value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, p -value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, p -value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, p -value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; p -value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, p -value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, p -value = 0.505). Conclusion: The predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation. [ABSTRACT FROM AUTHOR]

The recent revision of Italian legislation on nature conservation has highlighted the pressing necessity of elucidating the native distribution range of managed species. A recent study by Antognazza et al. (Current and Historical Genetic Variability of Native Brown Trout Populations in a Southern Alpine Ecosystem: Implications for Future Management. Fishes 2023, 8, 411) provides insights into the native status of brown trout in the Lombardy Prealps, northern Italy, and advocates urgent conservation measures. However, the possible effect of historical and recent anthropogenic impacts was dismissed in the paper. Here, we present how human-mediated activities plausibly might contribute to the observed distribution of population genetic variation, considering both the available literature and ongoing "Mediterranean trout" stocking activities in the region. Implementing management strategies without clear scientific evidence poses significant risks to native biodiversity conservation. [ABSTRACT FROM AUTHOR]

Abstract Systemic sclerosis (SSc) is an uncommon autoimmune disease. Aim of the study was to detect the occult cardiac involvement in asymptomatic SSc patients of recent onset (indicative of a more aggressive disease) with unenhanced Cardiac Magnetic Resonance (CMR). Our historical prospective study included naïve SSc patients of recent onset. Modified Rodnan Skin Score (mRSS) and Scleroderma Clinical Trial Consortium Damage Index (SCTC-DI) were calculated. Cardiac volumes and global myocardial strain were assessed and also compared with healthy group values. Pericardial involvement was further recorded. Thirty-one patients met inclusion criteria (54 ± 12 years; 1 M). Mean duration of disease was 6.8 years. All patients showed preserved systolic function. Higher incidence of pericardial involvement was founded in patients with disease accrual damage (OR: 9.6, p-value 0.01). Radial and longitudinal strain values resulted significantly different between healthy and SSc patients. GRS and GLS showed an independent predictive validity on damage accrual (HR: 1.22 and 1.47, respectively). Best C-index for disease progression was reached when strain values and pericardial evaluation were added to conventional risk factors (0.97, p-value: 0.0001). Strain analysis by CMR-TT may show a high capability both in identifying early cardiac involvement and stratifying its clinical aggressiveness, regardless of the standard damage indices and CMR contrast-dependent biomarker.

Profiling event visitors has attracted increasing interest in tourism literature. However, in event visitors' segmentation, psychographic characteristics such as perceptions and satisfaction should be more emphasized by research. To fill this gap, our study aims at segmenting event visitors according to their overall perception of the exhibition, the perceived quality of the exhibition and their relationship with photography in terms of expertise. The study was based on a sample of 455 visitors of the photo exhibition “Sensational Umbria” by Steve McCurry (Perugia, Italy, 2014-2015), which was analyzed through a latent class approach. Results provide evidence of two different typologies of visitors: pragmatic and expert, who are differently affected by their level of expertise in photography and that are not convergent in evaluations about the exhibition. Theoretical and managerial implications, along with avenues for future research, are discussed. Negli studi in ambito turistico è emerso un crescente interesse verso la profilazione dei visitatori di eventi culturali. Tra le variabili di segmentazione utilizzate comunemente, le caratteristiche psicografiche – come le percezioni e la soddisfazione dei visitatori – dovrebbero essere maggiormente analizzate, sia dal punto di vista concettuale che empirico. Per colmare questa lacuna, il presente studio si propone di segmentare i visitatori di un evento in base alla loro percezione complessiva della mostra, alla qualità percepita della mostra e al rapporto dei visitatori con la fotografia. Lo studio si è basato su un campione di 455 visitatori della mostra fotografica di Steve McCurry “Sensational Umbria” (Perugia, Italia, 2014-2015), attraverso i modelli a classe latente. I risultati evidenziano due diverse tipologie di visitatori: pragmatici ed esperti, che risentono in modo diverso del loro livello di competenza nella fotografia e che non sono convergenti nelle valutazioni sulla mostra. Infine, il lavoro discute le implicazioni teoriche e manageriali e le prospettive di ricerca future.

Abstract To analyze and compare direct and indirect targeting of the Vim for MRgFUS thalamotomy. We retrospectively evaluated 21 patients who underwent unilateral MRgFUS Vim ablation and required targeting repositioning during the procedures. For each patient, in the three spatial coordinates, we recorded: (i) indirect coordinates; (ii) the coordinates where we clinically observed tremor reduction during the verification stage sonications; (iii) direct coordinates, measured on the dentatorubrothalamic tract (DRTT) at the after postprocessing of DTI data. The agreement between direct and indirect coordinates compared to clinically effective coordinates was evaluated through the Bland–Altman test and intraclass correlation coefficient. The median absolute percentage error was also calculated. Compared to indirect targeting, direct targeting showed inferior error values on the RL and AP coordinates (0.019 vs. 0.079 and 0.207 vs. 0.221, respectively) and higher error values on the SI coordinates (0.263 vs. 0.021). The agreement between measurements was higher for tractography along the AP and SI planes and lower along the RL planes. Indirect atlas-based targeting represents a valid approach for MRgFUS thalamotomy. The direct tractography approach is a valuable aid in assessing the possible deviation of the error in cases where no immediate clinical response is achieved.