Objective: To test the effects of focused ultrasound subthalatomy on motor cortex excitability in Parkinson’s disease (PD).

Background: Short-interval intracortical inhibition (SICI), a GABAAR-mediated inhibition in human motor cortex, is reduced in PD patients and this alteration correlates with clinical impairment. Recently it was shown that focused ultrasound therapy is feasible, safe and efficient when used to induce a thalatomy in essential tremor patients. The subthalamic nucleus (STN) is considered the target of choice for the surgical treatment of PD.

Methods: We performed a study to assess bilateral cortical excitability – by means of MEP amplitude, SICI, SICF and silent period (SP) – before, 24 hours, 3 months and 6 months after focused ultrasound subthalatomy performed on the more affected hemisphere in a group of 9 clinically asymmetric PD patients. All the evaluations were performed OFF medication. We studied a group of healthy controls for the comparison of the neurophysiological parameters. 

Results: In baseline conditions, SICI and SP were significantly reduced in the more affected hemisphere compared to the less affected hemisphere and to healthy controls. After focused ultrasound subthalatomy, SICI and SP selectively increased in the more affected hemisphere, reaching values near normality: these changes were still present at 6 months after the procedure. SICI and SP were unchanged in the less affected hemisphere.

Conclusions: We showed that focused ultrasound subthalatomy, besides being safe, feasible and clinically effective, is able to restore intracortical inhibition in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/focused-ultrasound-subthalatomy-restores-intracortical-inhibition-in-pd/