The findings of a significant worldwide trial to check a high-tech, scalpel-free method to treating motion issues brought on by Parkinson’s illness have been printed within the prestigious New England Journal of Medication.
Jeff Elias, MD, pioneered using centered ultrasound for the remedy of important tremor and Parkinson’s illness. Picture Credit score: UVA Well being
UVA neurosurgeon Jeff Elias, MD, and collaborators examined the advantages and dangers of utilizing centered ultrasound to focus on an space deep throughout the mind referred to as the globus pallidus. The researchers wished to see if the centered sound waves might enhance trial members’ skill to maneuver and scale back the undesirable shaking and rigidity related to Parkinson’s.
Of the 69 sufferers who acquired the process within the randomized trial, virtually 70% responded to the remedy. Thirty-nine members who acquired the process continued to see important advantages three months later, and 30 of these assessed on the one-year mark continued to see advantages. The process, the researchers conclude, may very well be significantly helpful for sufferers who’re ineligible or unwilling to obtain deep mind stimulation, a surgical procedure that implants electrodes deep within the mind to perform the identical symptom-management targets.
The focused-ultrasound trial outcomes have been shared with the federal Meals and Drug Administration previous to publication and have been an vital consideration within the company’s determination to increase approval of the expertise for the remedy of Parkinson’s illness in 2021.
This examine is promising for sufferers with Parkinson’s illness and different neurological situations. Ultrasound was exactly centered deep contained in the mind to change one of many irregular circuits of Parkinson’s illness. However it is very important perceive that the remedy improved the neurological signs of PD and didn’t alter its course. In the end, we hope to sometime remedy PD.”
Jeff Elias, MD, UVA Neurosurgeon
About centered ultrasound
The centered ultrasound process focuses sound waves contained in the mind to disrupt defective mind circuits, like how a magnifying glass can focus mild. In contrast to deep mind stimulation, the minimally invasive process doesn’t require incisions or opening the cranium. The process is guided by magnetic resonance imaging (MRI), so medical doctors can pinpoint the precise proper spot within the mind earlier than making any everlasting modifications.
Contributors within the randomized Parkinson’s trial have been assigned to obtain both the focused-ultrasound remedy or a innocent faux – or “sham” – process. In whole, 69 acquired the precise remedy and 25 acquired the sham process. The members’ signs have been then assessed utilizing two frequent score scales, one for sufferers on remedy and one for sufferers off remedy.
Sixty-nine p.c of the process recipients improved by at the least three factors on one or each of the score scales. That is in contrast with solely 32% (seven members) within the management group. Within the management group, important enhancements have been seen solely in sufferers on remedy.
Negative effects reported by remedy recipients included bother talking, issue strolling and lack of style. The lack of style and issue strolling have been delicate and resolved on their very own. One participant continued to expertise slurred speech a 12 months after the process, the researchers report.
Elias’ pioneering analysis into using centered ultrasound for Parkinson’s is simply the most recent in his greater than decade-long effort to faucet the huge potential of the expertise. His prior work prompted the federal Meals and Drug Administration to approve centered ultrasound for the remedy of important tremor, a standard motion dysfunction, in 2018. That approval represented a turning level for the expertise and helped hint extra analysis at UVA and elsewhere.
Elias and his UVA Well being colleagues proceed to discover the various doable functions of centered ultrasound. For instance, UVA Well being final 12 months joined with the Charlottesville-based Targeted Ultrasound Basis – a longtime supporter of UVA’s centered ultrasound analysis – to launch the world’s first heart devoted particularly to combining centered ultrasound with immunotherapy to boost the physique’s skill to battle most cancers. Different potential functions embody utilizing the expertise to open the mind’s pure protecting barrier to permit, for the primary time, the focused supply of medicine for neurological ailments resembling Alzheimer’s.
UVA’s transformative work with centered ultrasound was lately highlighted all over the world by CNN’s Sanjay Gupta in a narrative that showcased a process carried out by Elias and his staff.
Concerning the analysis
The Parkinson’s analysis staff consisted of Vibhor Krishna, Paul S Fishman, Howard M Eisenberg, Michael Kaplitt, Gordon Baltuch, Jin Woo Chang, Wei‑Chieh Chang, Raul Martinez Fernandez, Marta del Alamo, Casey H Halpern, Pejman Ghanouni, Roberto Eleopra, Rees Cosgrove, Jorge Guridi, Ryder Gwinn, Pravin Khemani, Andres M. Lozano, Nathan McDannold, Alfonso Fasano, Marius Constantinescu, Ilana Schlesinger, Arif Dalvi and Elias. Elias is a marketing consultant for Insightec, the producer of the centered ultrasound expertise; a full record of the authors’ disclosures is included within the paper.
Monetary assist for the Parkinson’s trial was offered by Insightec.
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Journal reference:
Krishna, V., et al. (2023). Trial of Globus Pallidus Targeted Ultrasound Ablation in Parkinson’s Illness. New England Journal of Medication. doi.org/10.1056/nejmoa2202721.