Category: Surgical Therapy: Parkinson's Disease
Objective: To study the efficacy and safety of this treatment in a similar cohort of patients and to characterize the lesions.
Background: Unilateral subthalamic nucleus (STN) ablation by magnetic resonance-guided focused ultrasound (MRgFUS) seems safe and effective for asymmetric Parkinson’s disease (PD).
Method: Prospective, single-center open-label study in asymmetric PD patients evaluated at 6 (n=20) and 12 months (n=12) after MRgFUS-subthalamotomy (Table 1). The primary outcome was the change in the MDS-UPDRS-III in off-medication in the treated side and the adverse events (AEs) at 6-month follow-up. We also evaluated cognitive–neuropsychological changes, self-assessment of clinical improvement, and the correlation of the lesion volume and coordinates with the motor outcomes.
Results: The MDS-UPDRS III score and all subscores on the treated side were improved (P< 0.001) throughout the follow-up compared to baseline (reductions at 6 months: rigidity 83.5%, bradykinesia 69.4%, tremor 91.5%) (Table 2). One patient had severe weakness in the treated hemibody, one moderate dyskinesia on the treated leg, and one moderate confusional state that became mild or had disappeared at 6 months follow-up. The rest of AEs were mild and mostly transient (Table 3). We observed no clinically relevant changes in cognitive-neuropsychological tests. The percentage of ablation of the motor region of the STN correlated with the improvement in the contralateral MDS-UPDRS III, tremor, and bradykinesia scores (P<0.05) (Figure 1). All but two patients self-rated as “much improved” or “very much improved” (Figure 2).
Conclusion: Unilateral MRgFUS-subthalamotomy targeting the motor-STN resulted in a significant motor improvement. We observed no persistent severe AEs, although mild, mostly transient AEs were frequent.
To cite this abstract in AMA style:
L. Armengou-Garcia, C. Sanchez-Catasus, I. Aviles Olmos, A. Jimenez-Huete, G. Montoya Murillo, A. Gorospe Osinalde, A. Martin Bastida, L. Gonzalez-Quarante, J. Guridi Legarra, MC. Rodriguez-Oroz. Unilateral MRgFUS subthalamotomy in Parkinson’s disease: A prospective clinical study [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/unilateral-mrgfus-subthalamotomy-in-parkinsons-disease-a-prospective-clinical-study/. Accessed October 7, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/unilateral-mrgfus-subthalamotomy-in-parkinsons-disease-a-prospective-clinical-study/