Science

A new way to use the ultrasound machine. Scientists try to treat Parkinson’s disease with ultrasound

Patients with Parkinson’s disease have significantly improved tremors, mobility and other physical symptoms after undergoing a minimally invasive procedure using focused ultrasound, according to a new study.

The clinical trial, conducted by researchers at the University of Maryland School of Medicine, included 94 patients with Parkinson’s disease who were randomly assigned to undergo focused ultrasound to target an area on one side of the brain or to undergo a sham procedure. Nearly 70 percent of patients in the treatment group were considered successful after three months of follow-up, compared to 32 percent in the control group who had an inactive procedure without focused ultrasound.

Two-thirds of those who initially responded to focused ultrasound treatment continued to have a successful response to treatment a year later, writes News Medical .

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These results are very promising and doctors are now offering Parkinson’s patients a new form of therapy to treat their symptoms. There is no surgical procedure in this method, which means there is no risk of serious infection or cerebral hemorrhage.

About a million Americans suffer from Parkinson’s disease, a neurodegenerative disease that affects brain cells or neurons in a specific dopamine-producing area of ​​the brain. Symptoms include shaking, stiffness, and difficulty with balance and coordination. Other treatments for Parkinson’s include drugs and deep brain stimulation (DBS) with surgically implanted electrodes. Medicines can cause involuntary erratic movements called dyskinesia as doses are increased to control symptoms. Usually offered when medications don’t help, DBS involves brain surgery in which electrodes are inserted through two small holes in the skull. The procedure carries a small risk of serious side effects, including cerebral hemorrhage and infection.

“Our study will help clinicians and patients make informed decisions when considering this new treatment to help better manage symptoms,” said study co-author Paul Fishman, MD, a professor of neurology at UMSO and a neurologist at UMMC. “But it’s important for patients to understand that none of the currently available treatments will cure Parkinson’s completely.”

Focused ultrasound is a non-surgical procedure performed without anesthesia or hospital stay. Patients who remain fully conscious lie in a magnetic resonance imaging (MRI) scanner wearing a helmet with a sensor. Ultrasonic energy is directed through the skull into the globus pallidus, a structure deep in the brain that helps control regular voluntary movements.

MRI images provide doctors with a real-time temperature map of the treated area to pinpoint the target and apply a high enough temperature to irradiate it. During the procedure, the patient is conscious and provides feedback, which allows doctors to monitor the direct effects of tissue irradiation and make adjustments if necessary.

“Focused ultrasound is only approved to treat one side of the brain in patients with Parkinson’s disease, so it may currently be more appropriate for patients with symptoms predominantly on one side,” said study co-author Vibhor Krishna, MD. professor of neurosurgery at the University of North Carolina, Chapel Hill.

Patients in the study with moderate Parkinson’s disease who did not respond well to medications received one session of focused ultrasound on the side of their brain that controlled the side of their body where symptoms were more severe. The study was designed as a crossover trial in which 25 patients in the control group were offered active treatment three months after the sham procedure; 20 out of 25 opted for focused ultrasound treatment and experienced the same benefits as the initial treatment group.

Participants in the treatment group had an immediate improvement of at least three points on the standard score—a measure of tremor, walking ability, and leg and arm stiffness—compared to a 0.3 point improvement in the control group. They also experienced relief from the side effects of their Parkinson’s medications. They were evaluated again at three months and at 12 months. Patients will continue to be followed up for five years to assess how long treatment lasts and disease progression.

Dr. Eisenberg and colleagues are currently conducting clinical trials of the device on both sides of the brain, using focused ultrasound treatments in two sessions six months apart. “We’ve had promising results so far,” Dr. Eisenberg said.

“We are on the verge of a breakthrough in focused ultrasound as ongoing research evaluates treatments in various areas of the brain affected by Parkinson’s disease, such as the subthalamic nucleus, which controls movement regulation,” said Mark T. Gladwin, MD. “The researchers also are studying how focused ultrasound can be used to temporarily open the blood-brain barrier to help experimental Parkinson’s treatments, such as immunotherapy, more easily enter the brain.”

Focus has previously written about a cough medicine that can treat Parkinson’s disease . A landmark phase 3 clinical trial is starting in the UK to test whether a common cough medicine can be used to treat Parkinson’s disease.

 

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