Unilateral Pallidal Ultrasound Ablation Beneficial in Parkinson Disease

THURSDAY, March 2, 2023 (HealthDay News) -- For patients with Parkinson disease, unilateral pallidal ultrasound ablation yields greater improved motor function or reduced dyskinesia, according to a study published in the Feb. 23 issue of the New England Journal of Medicine.

Vibhor Krishna, M.D., from the University of North Carolina in Chapel Hill, and colleagues randomly assigned patients with Parkinson disease and dyskinesias or motor fluctuations and motor impairment in the off-medication state to undergo focused ultrasound ablation opposite the most symptomatic side of the body or a sham procedure in a 3:1 ratio (69 and 25 patients, respectively). The primary outcome, which was assessed in 65 and 22 patients, respectively, was a response at three months, defined as a decrease of at least 3 points from baseline either in the score on the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, part III (MDS-UPDRS III) in the off-medication state or in the score of the Unified Dyskinesia Rating Scale (UDysRS) in the on-medication state.

The researchers found that 69 and 32 percent of patients in the active-treatment and control groups, respectively, had a response. Of the patients in the active-treatment group with a response, 19, eight, and 18 met the MDS-UPDRS III criterion only, the UDysRS criterion only, and both, respectively. Thirty of the 39 patients in the active-treatment group who had a response at three months and were assessed at 12 months continued to have a response.

"Unilateral focused ultrasound treatment to the internal segment of the globus pallidus significantly reduced levodopa-induced dyskinesia and the motor severity score opposite to the treated side at three months," the authors write.

Several authors disclosed financial ties to medical device companies, including Insightec, which funded the study.

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