Two‐year follow‐up results of magnetic resonance imaging‐guided focused ultrasound unilateral pallidotomy for Parkinson’s disease

Abstract

AbstractBackgroundPosteroventral 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.AimTo investigate the long‐term efficacy and safety of MRgFUS unilateral GPi pallidotomy for PD.MethodsThis 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.ResultsAlthough 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.ConclusionThe efficacy of MRgFUS unilateral GPi pallidotomy differed in each patient and might depend on the natural course of PD. No safety issues were observed.