Focused ultrasound may be able to relieve symptoms for patients who are more prone to Parkinson’s disease on one side of the body than the other, according to a new study out of the University of Virginia Health System.
For patients who do not respond well to medication, but do not want to undergo traditional brain surgery, focused ultrasound, which creates therapeutic lesions in deep brain structures, may be a good option to treat. ‘focusing on the subthalamic nucleus, the deep brain preferred stimulant target for the treatment of the normal motor features associated with Parkinson’s Disease.
“This small brain region, the subthalamic nucleus, had a strong and robust effect on parkinsonian signals when we targeted it with precise, focused ultrasound energy,” said researcher Jeff Elias, MD, neurosurgeon at UVA Health. “The key to adopting this new approach is to further develop the technology to ensure reliability and safety. ”
He and his team published the results of their study into the effectiveness of targeted ultrasound on Dec. 24 New England Journal of Medicine.
To test how well the technology and approach works, Elias’ team enrolled 40 patients with Parkinson’s disease who were severely disorganized and out of control with medication and who were ill. -valid for deep brain stimulation surgery in their study. They randomly assigned the group – at a 2-to-1 ratio – to undergo a subthalamotomy with a focused on the opposite side from their main motor signals or a sham approach – 27 underwent a focused ultrasound and 13 received the sham surgery.
Following the procedure, the team compared the Parkinson’s Disease Assessment Scale (MDS-UPDRS) motor score at baseline and after four months for each group. The scores, which ranged from 0-to-44 with higher scores indicating worse disease, focused on the differences between the larger side of the body when the patient was not taking medicine.
Based on their assessment, among those patients who received 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, just down from 18.7 to 17.1. The overall difference between the groups was 8.1, the team said.
Along with the improvement of the score, some patients experienced adverse events, including weakening of voluntary movements, weakness on the treated side, speech anxiety, facial weakness, and leg anxiety. Most of these issues spread over time.
Even with these developments, said Binit Shah, MD, associate professor of neurology at UVA, more research is needed with a large group of patients over a longer period of time.
“Parkinson’s disease affects patients in more ways than just tremor,” he said. “The current FDA approval for a focused ultrasound in Parkinson’s disease is the direct treatment of tremor. By focusing on this new area we will allow better vibration but also more overall benefit for the patients that we could achieve before. “