Unilateral focused ultrasound subthalamotomy in early Parkinson’s disease: a pilot study

• DOI: 10.1136/jnnp-2023-331211
• Publication Date: 2023-09-06T17:20:52Z
• Authors: Raúl Martínez Fer...; Elena Natera Vill...; Rafael Rodriguez-...; Marta del Álamo; Jose A Pineda-Pardo; Ignacio Obeso; David Mata-Marín; Pasqualina Guida; Tamara Jimenez-Ca...; Diana Pérez-Bueno; Alicia Duque; Jorge U Máñez Miró; Carmen Gasca-Salas; Michele Matarazzo; Jose A Obeso
• Keywords: Movement Disorders

Background Unilateral focused ultrasound subthalamotomy (FUS-STN) improves motor features of Parkinson’s disease (PD) in moderately advanced patients. The less invasive nature FUS makes its early application PD feasible. We aim to assess the safety and efficacy unilateral FUS-STN patients with than 5 years from diagnosis (early PD). Methods Prospective, open-label study. Eligible had highly asymmetrical cardinal features. primary outcome was safety, defined as treatment-related adverse events at 6 months. Secondary outcomes included efficacy, assessed improvement Movement Disorders Society-Unified Disease Rating Scale (MDS-UPDRS), fluctuations, non-motor symptoms, daily living activities, quality life, medication patients’ impression change. Results Twelve (median age 52.0 (IQR 49.8–55.3) years, median time 3.0 (2.1–3.9) years) underwent FUS-STN. Within 2 weeks after treatment, five developed dyskinesia on treated side, all resolved levodopa dose adjustment. One patient mild contralateral weakness which fully 4 weeks. dystonic foot another hand dystonia. latter impaired gait became functionally disabling initially. Both cases were well controlled botulinum toxin injections. off-medication MDS-UPDRS score for side improved 12 months by 68.7% (from 14.5 4.0, p=0.002), total 49.0% 26.5 13.0, p=0.002). Eleven (92%) reported global treatment. Conclusion may be safe effective treat manifestations PD. A larger confirmatory trial is warranted. Trial registration number NCT04692116