A pivotal trial reported in the New England Journal of Medicine showed that unilateral focused ultrasound ablation targeted to the globus pallidus internus was associated with adverse neurologic effects but resulted in improved motor function or reduced dyskinesia over 3 months compared to sham in a higher percentage of Parkinson′s disease patients.

The primary outcome assessment was completed by 22 controls and 65 participants in the treatment group who suffered from movement, rigidity, or dyskinesia symptoms. The Movement Disorders Society-Unified Parkinson′s Disease Rating Scale part III (MDS-UPDRS III) criterion was met by 19 of the 45 patients in the focused ultrasound group who had a response, 8 patients met the Unified Dyskinesia Rating Scale (UDysRS) score criterion, and 18 patients met the two criteria. 

For the treated side in the off-medication state, the mean MDS-UPDRS III improvement in the focused ultrasound group was 4.9 points compared to 1.0 point in the control group. The focused ultrasound group′s mean UDysRS improvement was 2.9 points, while the control group was only 0.3.

At 3 months, compared to 7 patients (32%) in the control group, 45 patients (69%) in the focused ultrasound group showed response, exhibiting a difference of 37 % points from the control group.

The findings led to the approval of Focused ultrasound by the FDA in 2021 for advanced Parkinson′s patients with movement, rigidity, or dyskinesia symptoms.

Experts confirm that focused ultrasound effectively reduces Parkinson′s motor complications, but longer and larger trials are needed.

(Source: https://www.medpagetoday.com/neurology/parkinsonsdisease/103225)