Unilateral Magnetic Resonance–Guided Focused Ultrasound Lesion of the Subthalamic Nucleus in Parkinson's Disease: A Prospective Study

Laura Armengou-Garcia, Carlos A. Sanchez-Catasus, Iciar Aviles-Olmos, Adolfo Jiménez-Huete, Genoveva Montoya-Murillo, Arantza Gorospe, Antonio Martin-Bastida, Lain Hermes Gonzalez-Quarante, Jorge Guridi, Maria C. Rodriguez-Oroz*

*Corresponding author voor dit werk

    OnderzoeksoutputAcademicpeer review

    2 Citaten (Scopus)

    Samenvatting

    Background: Unilateral subthalamic nucleus (STN) ablation using magnetic resonance–guided focused ultrasound (MRgFUS) is being explored as a new treatment for asymmetric Parkinson's disease (PD). Objectives: The aims were to study the efficacy and safety of this treatment in asymmetric PD patients and to characterize the lesions. Methods: This prospective, single-center, open-label study evaluated asymmetric PD patients at 6 (n = 20) and 12 months (n = 12) after MRgFUS lesion of the STN. The primary outcome was the change in the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Part III (MDS-UPDRS III), score in off medication on 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 with the motor outcomes. Results: On the treated side, the MDS-UPDRS III score (mean difference = 13.8) and the scores in rigidity, bradykinesia, and tremor improved (P < 0.001) throughout the follow-up compared to baseline (at 6 months: rigidity mean difference = 2.8, improvement: 83.5%; bradykinesia mean difference = 6.0, improvement: 69.4%; tremor mean difference = 4.7, improvement: 91.5%). One patient had severe weakness in the treated hemibody, 1 had moderate dyskinesia, and 1 was in moderate confusional state that became mild (weakness) or completely resolved (dyskinesia and confusional state) at 6 months. The rest of the AEs were mild. We observed no clinically relevant changes in cognitive–neuropsychological tests. The percentage of ablation of the STN correlated with the improvement in the total MDS-UPDRS III and contralateral tremor scores (P < 0.05). Conclusion: Unilateral MRgFUS lesion of the STN resulted in a significant motor improvement. We observed no persistent severe AEs, although mild, mostly transient AEs were frequent.

    Originele taal-2English
    Pagina's (van-tot)2230-2241
    Aantal pagina's12
    TijdschriftMovement Disorders
    Volume39
    Nummer van het tijdschrift12
    Vroegere onlinedatum18-sep.-2024
    DOI's
    StatusPublished - dec.-2024

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