Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson's Disease - Review PPT

Original Article
Randomized Trial of Focused Ultrasound
Subthalamotomy for Parkinson’s Disease
Raúl Martínez-Fernández, M.D., Ph.D., Jorge U. Máñez-Miró, M.D., Rafael
Rodríguez-Rojas, Ph.D., Marta del Álamo, M.D., Binit B. Shah, M.D., Frida
Hernández-Fernández, M.Sc., José A. Pineda-Pardo, Ph.D., Mariana H.G.
Monje, M.D., Ph.D., Beatriz Fernández-Rodríguez, M.D., Scott A. Sperling, Psy.D.,
David Mata-Marín, M.Sc., Pasqualina Guida, M.Sc., Fernando Alonso-Frech, M.D.,
Ph.D., Ignacio Obeso, Ph.D., Carmen Gasca-Salas, M.D., Ph.D., Lydia VelaDesojo, M.D., Ph.D., W. Jeffrey Elias, M.D., and José A. Obeso, M.D., Ph.D.
N Engl J Med
Volume 383(26):2501-2513
December 24, 2020
Study Overview
• In a randomized, sham-controlled trial involving 40 patients, therapeutic
lesions on one side in the subthalamic nucleus were produced by
focused ultrasound.
• At 4 months, motor performance was better in the active-treatment
group.
• Twelve patients had neurologic deficits, many of which resolved by 12
months.
Enrollment and Follow-up of the Patients.
Martínez-Fernández R et al. N Engl J Med 2020;383:2501-2513
Clinical Outcomes of Focused Ultrasound Subthalamotomy, as Compared with a Sham
Procedure, in One Hemisphere.
Martínez-Fernández R et al. N Engl J Med 2020;383:2501-2513
Demographic and Clinical Characteristics of the Patients at Baseline.
Martínez-Fernández R et al. N Engl J Med
2020;383:2501-2513
Primary and Secondary Efficacy Outcomes, Assessed from Baseline to 4 Months (Intention-toTreat Population).
Martínez-Fernández R et al. N Engl J Med 2020;383:2501-2513
Adverse Events.
Martínez-Fernández R et al. N Engl J Med
2020;383:2501-2513
Conclusions
• Focused ultrasound subthalamotomy in one hemisphere improved motor
features of Parkinson’s disease in selected patients with asymmetric
signs.
• Adverse events included speech and gait disturbances, weakness on
the treated side, and dyskinesia.