Focused ultrasound can reduce symptoms of Parkinson’s disease

Focused ultrasound could help relieve symptoms in patients who are more affected by Parkinson’s disease on one side of the body than the other, according to a new study from the University of Virginia Health System.

For patients who do not respond well to medication, but who do not wish to undergo traditional brain surgery, focused ultrasound, which creates therapeutic lesions in deep brain structures, may be a good option by targeting the subthalamic nucleus. , the preferred deep brain. stimulation target to treat motor characteristics associated with Parkinson’s disease.

“This small region of the brain, the subthalamic nucleus, had a very strong and potent effect on Parkinson’s symptoms when we targeted it with precise and focused ultrasound energy,” said researcher Jeff Elias, MD, neurosurgeon at UVA Health. “The key to the final adoption of this new procedure will be to further improve the technology to ensure reliability and safety.”

He and his team released the results of their investigation into the effectiveness of focused ultrasound on Dec. 24. New England Journal of Medicine.

To test how the technology and procedure worked, Elias’ team recruited 40 patients with clearly asymmetric Parkinson’s disease who was not fully controlled with drugs and who were not eligible for surgery. of deep brain stimulation in their study. They randomly assigned the group – at a 2 to 1 ratio – to undergo a subthalamotomy with focused ultrasound on the side opposite to their major motor signs or a sham procedure – 27 underwent focused ultrasound and 13 received surgery fictitious.

After the procedure, the team compared the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor score at baseline and after four months for the two groups. The scores, which ranged from 0 to 44 with higher scores indicating worse disease, focused on the differences between the most affected side of the body when the patient was not taking medication.

Based on their assessment, among the patients who received a focused ultrasound, their MDS-UPDRS scores dropped from 19.9 at baseline to 9.9 after 4 months. The control group saw a much smaller change, only decreasing from 18.7 to 17.1. The overall difference between the groups was 8.1, the team said.

Along with the improvement in the score, some patients experienced adverse events including impaired voluntary movement, weakness on the treated side, speech disturbances, facial weakness, and difficulty walking. Most of these cases cleared up over time.

Even with these improvements, said Binit Shah, MD, assistant professor of neurology at AVU, more research is needed with a large group of patients over a longer period.

“Parkinson’s disease affects patients more than just tremors,” he said. “The current FDA approval for focused ultrasound in Parkinson’s disease only treats tremors. Targeting this new area allows us to improve tremors, but also to achieve more overall benefits for our patients than we were previously able to achieve.