Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease

RESULTS

Of 94 patients, 69 were assigned to undergo ultrasound ablation (active treatment) and 25 to undergo the sham procedure (control); 65 patients and 22 patients, respectively, completed the primary-outcome assessment. In the active-treatment group, 45 patients (69%) had a response, as compared with 7 (32%) in the control group (difference, 37 percentage points; 95% confidence interval, 15 to 60; P=0.003). Of the patients in the active-treatment group who had a response, 19 met the MDS-UPDRS III criterion only, 8 met the UDysRS criterion only, and 18 met both criteria. Results for secondary outcomes were generally in the same direction as those for the primary outcome. Of the 39 patients in the active-treatment group who had had a response at 3 months and who were assessed at 12 months, 30 continued to have a response. Pallidotomy-related adverse events in the active-treatment group included dysarthria, gait disturbance, loss of taste, visual disturbance, and facial weakness.

CONCLUSIONS

Unilateral pallidal ultrasound ablation resulted in a higher percentage of patients who had improved motor function or reduced dyskinesia than a sham procedure over a period of 3 months but was associated with adverse events. Longer and larger trials are required to determine the effect and safety of this technique in persons with Parkinson’s disease. (Funded by Insightec; ClinicalTrials.gov number, NCT03319485. )

nejm.org/doi/10.1056/NEJMoa...

[MBAnderson]

It would be interesting to know if the results varied by location. That is, did more of the adverse events occur in the same place?

Hitting the target precisely seems to be determinative. Is every doctor equally skilled?

[Awyn]

Thank you for sharing!

We were sent this related Medical Express article yesterday from a close friend/ toxicologist and are now trying to get a copy of the full journal research article in preparation for discussing with my husband’s neurologist.

“Parkinson's disease patients experience significant reduction in symptoms with non-surgical focused ultrasound treatment” Feb. 22, 2023: medicalxpress.com/news/2023...

The short video expose included in this article provides some helpful context.

youtu.be/Ceg7R3sw7Qs(Not working as expected?)

This treatment looks very promising, especially for those suffering with dyskinesia.

[MBAnderson in reply to Awyn]

Which way are you leaning?

[Awyn in reply to MBAnderson]

Not exactly leaning just yet. …cautiously optimistic. We are still trying to get a copy of the full report.

Because my husband has chronic lymphocytic leukemia in addition to PD, we always run things like this by his team of medical and integrative specialists. He meets with his oncologist on Monday (convenient timing) and his neurologist in 4 weeks.

Meanwhile, we are very interested in what others here in the community are learning….feeling about it. So how are you “leaning”?

[JMSL]

Interested & hopeful! Interesting that the ablation was done to the globus pallidus, not to the PTT where Sonimodul Clinic in Switzerland is having success.

[Awyn]

I have received a copy of the full journal report in the form of a PDF and am happy to share it if someone can tell me how to post a document.