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Two‐year follow‐up results of magnetic resonance imaging‐guided focused ultrasound unilateral pallidotomy for Parkinson’s disease
Author(s) -
Ito Hisashi,
Yamamoto Kazuaki,
Fukutake Shigeru,
Kamei Tetsumasa,
Yamaguchi Toshio,
Taira Takaomi
Publication year - 2021
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12455
Subject(s) - pallidotomy , medicine , magnetic resonance imaging , parkinson's disease , dyskinesia , rating scale , levodopa , globus pallidus , functional magnetic resonance imaging , adverse effect , refractory (planetary science) , physical medicine and rehabilitation , deep brain stimulation , disease , radiology , basal ganglia , central nervous system , psychology , developmental psychology , physics , astrobiology
Background Posteroventral globus pallidus internus (GPi) pallidotomy is one of the therapeutic options for motor fluctuations in Parkinson's disease (PD). Transcranial magnetic resonance imaging‐guided focused ultrasound (MRgFUS) is a new intervention to ablate an intracranial target. Aim To investigate the long‐term efficacy and safety of MRgFUS unilateral GPi pallidotomy for PD. Methods This was a prospective and open‐labeled study involving a single center. We enrolled 3 PD patients with medication‐refractory motor fluctuations (3 women, aged 59 to 78 years). Participants underwent MRgFUS unilateral GPi pallidotomy and were evaluated serially for 2 years using the Unified Parkinson's Disease Rating Scale (UPDRS) and Unified Dyskinesia Rating Scale (UDysRS). Additionally, we assessed safety issues during the study period. Results Although motor fluctuations improved in 2 patients, the motor function in the off‐medication state and levodopa‐induced dyskinesia (LID) exacerbated in 1 of them. In the other patient, LID improved for 2 years; however, improvement of the motor function was limited and it exacerbated. Patients developed neither serious nor delayed complications. Conclusion The efficacy of MRgFUS unilateral GPi pallidotomy differed in each patient and might depend on the natural course of PD. No safety issues were observed.