Ultrasound for Parkinson's

[Theyakin]

tremor.org.uk/2016-12-09-im...

Anyone has a view on ultrasound . Seems interesting and a third of the price of dba.

Thanks

[PDConscience]

It's still a relatively new, developing technology. A PubMed abstract from last October:

“MRI guided focused ultrasound is an emerging technique that uses acoustic energy to noninvasively treat intracranial disorders. At high frequencies, it can be used to raise tissue temperatures and ablate discrete brain targets with sub-millimeter accuracy. This application is currently under investigation for a broad range of clinical applications, including brain tumors, movement disorders, and psychiatric conditions.

"“Currently, there are more than 25 focused ultrasound clinical trials publicly registered for patients with neurological disorders ranging from neuro-oncology, Parkinson’s disease, Alzheimer’s disease, obsessive-compulsive disorder, and epilepsy.”

For Parkinson's: "Various targets have been proposed for MRgFUS [MRI guided focused ultrasound] ablation to treat tremor-dominant PD in early clinical studies, including the pallidothalamic tract [18], Vim thalamus, [13, 19, 20], and GPi [21]. The optimal target in PD is unclear, and will depend on the symptomology of the patient. Recent studies in PD patients treated with MRgFUS, report clinical significant improvement in motor symptoms after treatment ranging from 61% reduction in Unified PD Rating Scale (UPDRS) motor score at 3 months for pallidothalamic tractomy [18] to 46.2% at 6 months for Vim thalamotomy [13]. However, different methodologies and outcome measures make direct comparison difficult (For detailed discussion see Schlesinger et al. [15]). Future studies will need to compare outcomes after MRgFUS ablation compared to placebo or current surgical treatment options for tremor-dominant PD. Source: ncbi.nlm.nih.gov/pmc/articl...

[Lynne1946 in reply to PDConscience]

I have consulted with 2 neurologists and both said no. If you want DBS or any other new procedure you will not be able to have it. It's a double NO.

[Theyakin in reply to Lynne1946]

Why he say no to DBS ,

My first Neuro said it was an option if needed.

I know a few people who had DBS I think on the NHS. Ultrasound as far as I know would have be paid for around 12k but not sure if available in the UK yet.

[Enidah]

My understanding is that while DBS is reversible the ultrasound treatment is not. The damage is done. That would make one want to be very sure of its efficacy!

[Lynne1946]

DBS surgery is the way to go-not ultrasound. I am having DBS surgery next month.

[Theyakin in reply to Lynne1946]

What Will DBS help with. A read the battery lasts around 10 years, so what happens after 10 years . Do you simply have a new better fitted?

Thanks

[Jebbie12]

BIG NO on the ultrasound from some very reliable sources. Basically they are putting a permanent, non-reversible lesion in your brain, burning cells. If they miscalculate the correct target, you have permanent brain damage. I wouldn't even consider it!

[JMDean]

This is actually a new way to do a very old surgery . Before DBS was available, pallidotomies and thalamotomies, in which the surgeon will place a probe launch and structures in the rain and it's actually cause a stroke were effective treatment options what other options field. The caveat is that is completely irreversible and unlike DBS, the disease progresses, there's no way to tweak the programming to enhance output . In addition, undergoing that type of surgery bilaterally seemed to have a pretty bad impact upon speech and communication. At this point, DBS is probably the gold standard for surgical interventions and one of these ablation surgeries might be possible on rare occasion . Ultrasound will eventually get there but I think most doctors would prefer to wait and as a patient, you probably want to limit your options to things that have been performed many times without significant issue than to be on the cutting edge of something that could possibly go wrong .

fun fact-Michael J Fox underwent a unilateral thalamotomy in the 90s and received some benefit from it before the disease progressed beyond its capacity to improve things. DBS for Parkinson's hadn't been approved by the FDA yet so at that time, it may have been the best option. Notably, he did not get it done bilaterally due to the precise issues speech, I presume.

[Theyakin]

google.co.uk/amp/s/www.bbc....