Category: Parkinson's Disease: Surgical Therapy
Objective: To evaluate the efficacy and safety of MR guided focused ultrasound (MRgFUS) subthalamotomy for improving motor symptoms, medication burden, and quality of life in
Parkinson’s disease (PD).
Background: MRgFUS subthalamotomy has emerged as a minimally invasive alternative for unilateral or bilateral lesioning in patients with PD. Multiple cohorts have reported improvement in motor symptoms, though variability across studies and followup intervals remains. A pooled synthesis of outcomes can clarify the magnitude and durability of treatment effects.
Method: A systematic review of PubMedindexed clinical studies reporting pre and posttreatment outcomes of MRgFUS subthalamotomy was performed. Extracted measures included
MDSUPDRS III (OFF), MDS-UPDRS II, PDQ39, and levodopa equivalent daily dose (LEDD).Adverse events (AEs) and their proportions were also collected. Random effects and fixed effect metaanalyses were conducted across time points from 1 to 12 months.
Results: Across 5 studies (80 patients), MRgFUS subthalamotomy produced a significant improvement in MDS-UPDRS-III at all time points (MD −14.12; 95% CI −18.88 to −9.36; I2 97%) [Figure 1].MDS-UPDRS II improved (MD −3.79; 95% CI −5.03 to −2.56; I2 0%), as did PDQ39 (MD −6.70; 95% CI −9.48 to −3.92; I2 0%) [Figure 2]. LEDD decreased by −148.89 mg (95% CI −210.32 to−87.45; I2 0%) [Figure 3]. Metaregression demonstrated that time from baseline did not significantly moderate outcomes. The most common AEs were gait ataxia (p=0.4; 95% CI 0.30–0.51), dyskinesia (p=0.35; 95% CI 0.25–0.45), dysarthria (p=0.31; 95% CI 0.22–0.42), and facial asymmetry (p=0.2; 95% CI 0.12–0.30).
Conclusion: MRgFUS subthalamotomy provides consistent, clinically meaningful reductions in motor severity, disability, and medication use up to 12 months postprocedure. While generally well
tolerated, transient gait and speech disturbances remain common. Further randomized and longterm comparative studies are needed to refine patient selection and optimize safety.
Forest plot of pooled MD of motor outcomes.
Forest plot of pooled MD of PDQ-39 outcomes.
Forest plot of pooled MD of LEDD.
To cite this abstract in AMA style:
A. Achuthaprasad, J. Rissardo, J. Patino, A. Caprara, A. Mcgarry, I. Walker. Motor and Quality‑of‑Life Outcomes After MR‑Guided Focused Ultrasound Subthalamotomy for Parkinson’s Disease: A Meta‑analysis [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/motor-and-quality-of-life-outcomes-after-mr-guided-focused-ultrasound-subthalamotomy-for-parkinsons-disease-a-meta-analysis/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-and-quality-of-life-outcomes-after-mr-guided-focused-ultrasound-subthalamotomy-for-parkinsons-disease-a-meta-analysis/