Category: Surgical Therapy: Parkinson's Disease
Objective: To report motor and nonmotor outcomes after unilateral MRgFUS subthalamotomy for the treatment of asymmetrical PD.
Background: The development of MRgFUS as a minimally invasive technique has revitalized ablation as a treatment for movement disorders. Recently, safety and preliminary efficacy of MRgFUS unilateral subthalamotomy for the treatment of PD have been showed by two pilot studies.
Method: 14 patients underwent unilateral MRgFUS subthalamotomy (Jan 2020-Jan 2021). 12 of them were followed for six months. Evaluations included change of MDS-UPDRS III for the treated sides in OFF (n=7) and ON states (n=5). The COVID situation forced us to do online consultations and rigidity was only evaluable in 4 patients. Clinical Global Impression of patient (CGI-P), Levodopa equivalent daily dose (LEDD) and treatment-related adverse events (AE) were also evaluated. A neuropsychological assessment was done in 5 patients before and after the treatment.
Results: At the six-month visit, the improvement in total MDS-UPDRS III score in the treated side was of 76% in OFF and 50% in ON states. The improvements for the cardinal features were as follows: tremor OFF 93% and ON 89%; bradykinesia OFF 73% and ON 51%; rigidity 90% in OFF. A trend for improvement of visual memory (p=0.04), and impairment of cognitive interference (p=0.06) were observed. There was a significant reduction of LEDD of 23% (p=0.01) between the first and the last visit. 7 patients (58.3%) presented EAs at six months, of which 6 EAs (54.5%) were mild and 4 EAs (36.3%) were moderate. The most frequent were de novo transient dyskinesia (n=4; 33.3%), all of them mild except from one patient, and weakness of the treated side (n=3; 25%). Impulsiveness (n=2; 16,7%), was also seen. 100% of patients showed a subjective clinical improvement (CGI-P 1-3).
Conclusion: Our results suggest that unilateral subthalamotomy by MRgFUS is safe and that the benefits on PD motor features are similar to what was previously reported. More studies with higher samples are needed to be more conclusive about neuropsychological assessments.
To cite this abstract in AMA style:
L. Armengou Garcia, I. Avilés Olmos, MA. Gorospe Osinalde, M. Fernández Martínez, A. Arcadi, A. Martin Bastida, G. Montoya Murillo, C. Arrondo Elizarran, P. Manrique Lara, L. González Quarante, J. Guridi Legarra, MC. Rodriguez Oroz. Safety and efficacy of unilateral subthalamotomy by magnetic resonance guided focused ultrasound (MRgFUS) in asymmetrical Parkinson’s disease (PD). [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/safety-and-efficacy-of-unilateral-subthalamotomy-by-magnetic-resonance-guided-focused-ultrasound-mrgfus-in-asymmetrical-parkinsons-disease-pd/. Accessed July 3, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/safety-and-efficacy-of-unilateral-subthalamotomy-by-magnetic-resonance-guided-focused-ultrasound-mrgfus-in-asymmetrical-parkinsons-disease-pd/