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Focused ultrasound thalamotomy, a form of noninvasive brain surgery using sound waves, improves motor function and overall quality of life for patients with drug-resistant Parkinson's disease, according to a new study from the University of Virginia (UVA). ) Medicine School.
In previous research, ultrasound has been shown to reduce tremors, a characteristic symptom of Parkinson's disease. The new study adds to these findings, showing that the procedure is also safe with respect to mood, behavior, and cognitive abilities – areas largely neglected in previous research – and that this approach tends to improve the good -being emotional and quality of life. .
"In our initial study, which examined the results of focused ultrasound surgery in Parkinson's disease, we mainly described postoperative improvements in motor symptoms, especially tremors," said Scott Sperling, Psy.D., clinical neuropsychologist with UVA.
"In this study, we extended these initial findings and showed that focused ultrasound thalamotomy was not only cognitively and mood-safe, but that patients undergoing surgery benefited from significant and significant benefits. sustainable in terms of functional disability and overall quality of life.
The Federal Food and Drug Administration has approved a targeted ultrasound for the treatment of essential tremors, the most common movement disorder. This approval came after a pioneering international study led by UVA neurosurgeon Jeff Elias, M.D.
Elias and his colleagues have since demonstrated the potential of this procedure to reduce tremors in people with drug-resistant Parkinson's disease. This technique uses focused sound waves to interrupt the defective brain circuits responsible for the uncontrollable tremors associated with the disease.
The new study included 27 adults with severe Parkinson's tremors who did not respond to the previous treatment. The participants in the study were initially divided into two groups: 20 received the procedure, while seven received a fictitious procedure, serving as a control group. (The control group members were then offered the opportunity to receive the actual procedure, and all but one did.)
After undergoing the intervention, study participants reported an improvement in quality of life at both three months and twelve months.
"After the surgery, patients significantly improved several aspects of their quality of life, including their ability to perform simple daily tasks, their emotional well-being, and the feeling of stigma that they experienced due to their tremors." Sperling said.
"Our results suggest that postoperative improvements in tremors result in very significant improvements in daily functioning and, subsequently, improvement in overall quality of life."
The study was unique in that it provided an in-depth examination of the psychological and cognitive effects of the procedure, areas to which attention had been relatively limited in previous research.
The researchers found that mood and cognition, as well as the ability to cope with daily life, ultimately had more impact on the assessment of participants' overall quality of life than the severity of their tremors or the improvement of their tremors observed after the procedure.
"One's perception of one's quality of life is shaped in many different ways," said Sperling. "Symptoms of mood and behavior, such as depression, anxiety, and apathy, often have a greater impact on quality of life than the measurable severity of the tremor."
The only cognitive decline observed in the participants was the speed with which they could name the colors, think and speak. The cause of this was unclear, although the researchers suggest that this could be the result of the natural progression of Parkinson's disease. (A targeted ultrasound is currently being tested to treat tremor associated with the disease, not its other symptoms.)
The researchers said the study was limited by its small size and the fact that participants' drug dosage varied, among other factors.
Source: University of Virginia Health System
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