Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study

Publication date: Available online 5 December 2017 Source:The Lancet Neurology Author(s): Raul Martínez-Fernández, Rafael Rodríguez-Rojas, Marta del Álamo, Frida Hernández-Fernández, Jose A Pineda-Pardo, Michele Dileone, Fernando Alonso-Frech, Guglielmo Foffani, Ignacio Obeso, Carmen Gasca-Salas, Esther de Luis-Pastor, Lydia Vela, José A Obeso Background Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease. Methods This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain. Eligible participants had Parkinson's disease with markedly asymmetric parkinsonism. Patients with severe dyskinesia, history of stereotactic surgery or brain haemorrhage, a diagnosis of an unstable cardiac or psychiatric disease, or a skull density ratio of 0·3 or less were excluded. Enrolled patients underwent focused ultrasound unilateral subthalamotomy. The subthalamic nucleus was targeted by means of brain images acquired with a 3-Tesla MRI apparatus. Several sonications above the definitive ablation temperature of 55°C were delivered and adjusted according to clinical response. The primary outcomes were safety and a change i...
Source: The Lancet Neurology - Category: Neurology Source Type: research