Parkinson's Disease

Last Updated: 20 September 2024

FDA approved for both Tremor Dominant Parkinson’s Disease and Dyskinesia

Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with symptoms secondary to Parkinson’s disease. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.

Please note that for work being done on dementia, including that which is associated with Parkinson’s disease, please see the Disease and Conditions listing for Dementia.

How it Works
Where the beams converge, focused ultrasound produces a variety of therapeutic effects enabling Parkinson’s disease to be treated without surgery. For movement disorders, the mechanism of action is ablation (thermal disruption of the tissue) that can be aimed at several different treatment targets. For the preclinical work that one day may treat the underlying causes for Parkinson’s, the mechanisms can be temporarily disrupting the blood-brain barrier (BBB), which will allow desired therapeutics the ability to enter the brain. Opening the BBB also can enable undesired materials to more easily depart from the brain.

Advantages
Currently, there is no cure for Parkinson’s and the major options for treatment of motor symptoms include drug therapy and invasive surgery (e.g. deep brain stimulation, radiofrequency lesioning).

For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost. In the long term, focused ultrasound has the potential to treat the underlying disease pathology and prevent progression and/or restore function.

Relief of Motor Symptoms

The FDA has approved the use of focused ultrasound for treatment of tremor-dominated Parkinson’s disease and Parkinson’s dyskinesia, which is a broad definition that includes a wide variety of motor complications, including motor fluctuations, involuntary extremity movement, rigidity, slow initiation of movement and other similar diseases.

Focused ultrasound has the potential to achieve symptomatic relief by making thermal lesions deep in the brain to interrupt circuits involved with tremor and dyskinesia. Symptoms and targets being assessed for treatment using focused ultrasound include:

Parkinsonian tremor – target in the thalamus (thalamotomy)
Parkinsonian dyskinesia – target in the globus pallidus (pallidotomy) or subthalamic nucleus
Parkinsonian tremor, akinesia or dyskinesia – target in the pallidothalamic tract

At this time, focused ultrasound is only being assessed to treat one side of the brain, so it will affect tremor or dyskinesia unilaterally. Studies are being organized to assess the possibility of treating patients bilaterally, and one is included below.

Focused ultrasound is non-invasive – no incisions, holes in the skull, electrodes in the brain – and therefore has reduced risk for infection and blood clots.
Precise targeting minimizes damage to non-targeted healthy brain.
Compared to deep brain stimulation, focused ultrasound is a single procedure, and does not require subsequent procedures/visits to replace batteries, repair broken wires, or adjust simulator settings. It also does not involve the collateral damage to healthy tissue or the risk of infections associated with implanting a foreign body.

Treating Underlying Pathology

Preclinical studies suggest focused ultrasound’s potential to restore function in Parkinson’s models. Focused ultrasound can temporarily open the blood-brain barrier (BBB) to improve the delivery of:

Genes, growth factors, stem cells, other neuroprotective and/or neurorestorative drugs
Anti-alpha synuclein antibodies

In October 2018, the Foundation had a multi-disciplinary workshop that aimed at using BBB opening in conjunction with potentially curative agents, to decide what research approaches have the most potential. Read the workshop summary >

Clinical Trials

There are several recent trials that assess the feasibility, safety, and preliminary efficacy of focused ultrasound to treat different symptoms of Parkinson’s.

Parkinson’s disease tremor (neuromodulation)
A clinical trial in Los Angeles is using transcranial ultrasound neuromodulation to treat patients with essential tremor.

A clinical trial in Los Angeles is using Low Intensity Focused Ultrasound Pulsation (LIFUP) to treat patients with Parkinson’s disease movement disorders.

Parkinson’s disease patients with glucocerebrosidase deficiency
This trial is recruiting patients for treatment with recombinant glucocerebrosidase to offset this deficiency. This study is only open to those who are Canadian Citizens.

Peripheral electrical stimulation with focused ultrasound on motor symptoms
This clinical trial in Canada is using non-thermal mechanisms targeting superficial and deep targets to help treat patients with movement disorders symptoms from Parkinson’s disease.

See a list of treatment sites >
See here for a list of clinical trials sites >
See here for a list of laboratory research sites >

Regulatory Approval & Reimbursement

The Exablate system manufactured by Insightec is approved in Europe and in the US for treating tremor-dominant Parkinson’s disease. In November 2021, it also earned approval in the US for treating additional movement disorders associated with Parkinson’s disease, including mobility, rigidity and dyskinesia. We recommend that patients talk with the treatment site for questions about insurance coverage under Medicare, as some treatment sites are now being reimbursed by Medicare.

Preclinical Laboratory Studies

Preclinical studies suggest focused ultrasound’s potential to restore function in Parkinson’s models. Active studies are assessing focused ultrasound-induced BBB opening to improve the delivery of:

Genes, growth factors, stem cells, other neuroprotective and/or neurorestorative drugs (University of Virginia/Johns Hopkins University; University of Maryland; Columbia University; Chang Gung University in Taiwan; University of Toronto)
Anti-alpha synuclein antibodies (Columbia University; HM Puerta del Sur in Madrid/Institut Langevin in Paris)

Additional Resources

The Michael J. Fox Foundation for Parkinson’s Research
Exablate Neuro by Insightec LTD

Notable Papers

Zhang Y, Zhang H, Xu T, Liu J, Mu J, Chen R, Yang J, Wang P, Jian X. A simulation study of transcranial magnetoacoustic stimulation of the basal ganglia thalamic neural network to improve pathological beta oscillations in Parkinson’s disease. Comput Methods Programs Biomed. 2024 Sep;254:108297. doi: 10.1016/j.cmpb.2024.108297. Epub 2024 Jun 18. PMID: 38905990

Cheyuo C, Germann J, Yamamoto K, Zibly Z, Krishna V, Sarica C, Borges YFF, Vetkas A, Kalia SK, Hodaie M, Fasano A, Schwartz ML, Elias WJ, Lozano AM. Probabilistic Refinement of Focused Ultrasound Thalamotomy Targeting for Parkinson’s Disease Tremor. Mov Disord. 2024 Aug 9. doi: 10.1002/mds.29965. PMID: 39120112

Guida P, Martínez-Fernández R, Máñez-Miró JU, Del Álamo M, Foffani G, Fernández-Rodríguez B, Monje MHG, Obeso I, Obeso JA, Gasca-Salas C. Social Cognition in Parkinson’s Disease after Focused Ultrasound Subthalamotomy: A Controlled Study. Mov Disord. 2024 Aug 14. doi: 10.1002/mds.29945. PMID: 39140267

Guidera JA, Kondapavulur S, Wang DD. A Systematic Review Comparing Radiofrequency versus Focused Ultrasound Pallidotomy in the Treatment of Parkinson’s Disease. Stereotact Funct Neurosurg. 2024 Aug 22:1-18. doi: 10.1159/000539911. PMID: 39173595

Ye D, Chukwu C, Yang Y, Hu Z, Chen H. Adeno-associated virus vector delivery to the brain: Technology advancements and clinical applications. Adv Drug Deliv Rev. 2024 Aug;211:115363. doi: 10.1016/j.addr.2024.115363. Epub 2024 Jun 19. PMID: 38906479

Fura Ł, Tymkiewicz R, Kujawska T. Numerical studies on shortening the duration of HIFU ablation therapy and their experimental validation. Ultrasonics. 2024 Aug;142:107371. doi: 10.1016/j.ultras.2024.107371. Epub 2024 Jun 4. PMID: 38852549

Nishida N, Sugita Y, Sawada M, Ishimori T, Taruno Y, Otsuki K, Motoie R, Kitamura K, Yoshizaki W, Kasashima K, Sugiyama J, Yamashita M, Hanyu T, Takahashi M, Kaneko S, Toda H. Minimum and early high-energy sonication protocol of MR-guided focused ultrasound thalamotomy for low-skull density ratio patients with essential tremor and Parkinson’s disease. Neurosurg Focus. 2024 Sep 1;57(3):E4. doi: 10.3171/2024.6.FOCUS24330. PMID: 39217631

Gonzalez-Quarante LH, Gonzalez-Crespo A, Arcadi A, Macias-de-la-Corte M, Aviles-Olmos I, Sanchez-Catasus CA, Cacho-Asenjo E, Honorato-Cia C, Martinez-Simon A, Gorospe A, Martin-Bastida A, Corral-Alonso P, Rodriguez-Oroz MC, Guridi J. 3-T MR-guided focused ultrasound thalamotomy for tremor in patients with a cardiac pacemaker: case series and review of the literature. Neurosurg Focus. 2024 Sep 1;57(3):E5. doi: 10.3171/2024.6.FOCUS24171. PMID: 39217637

Phipps MA, Manuel TJ, Sigona MK, Luo H, Yang PF, Newton A, Chen LM, Grissom W, Caskey CF. Practical Targeting Errors During Optically Tracked Transcranial Focused Ultrasound Using MR-ARFI and Array- Based Steering. IEEE Trans Biomed Eng. 2024 Sep;71(9):2740-2748. doi: 10.1109/TBME.2024.3391383. Epub 2024 Aug 21. PMID: 38640051

Purrer V, Pohl E, Borger V, Weiland H, Boecker H, Schmeel FC, Wüllner U. Motor and non-motor outcome in tremor dominant Parkinson’s disease after MR-guided focused ultrasound thalamotomy. J Neurol. 2024 Jul;271(7):3731-3742. doi: 10.1007/s00415-024-12469-z. Epub 2024 May 31. PMID: 38822147

Hopfner F, Buhmann C, Classen J, Holtbernd F, Klebe S, Koschel J, Kohl Z, Paus S, Pedrosa DJ. Tips and tricks in tremor treatment. J Neural Transm (Vienna). 2024 Jul 24. doi: 10.1007/s00702-024-02806-x. PMID: 39043978

Khu KJO, Jamora RDG, Aguilar JA, Pascual JSG, Chan KIP, Espenido TMR, Mata JL, Nievera AMP, Legaspi GD. Establishing and developing a magnetic resonance-guided focused ultrasound program in a resource-limited setting: the Philippine experience. Neurosurg Rev. 2024 Jul 30;47(1):372. doi: 10.1007/s10143-024-02624-5. PMID: 39078417

Kaplitt MG, Krishna V, Eisenberg HM, Elias WJ, Ghanouni P, Baltuch GH, Rezai A, Halpern CH, Dalm B, Fishman PS, Buch VP, Moosa S, Sarva H, Murray AM. Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor: An Open-Label Clinical Trial. JAMA Neurol. 2024 Jul 29:e242295. doi: 10.1001/jamaneurol.2024.2295. PMID: 39073822

Sheth SA, Ostrem JL, Hariz M. Bilateral Focused Ultrasound Thalamotomy for Tremor-Is It Really Safe? JAMA Neurol. 2024 Jul 29. doi: 10.1001/jamaneurol.2024.2294. PMID: 39073802

Abbas A, Hassan MA, Shaheen RS, Hussein A, Moawad MHED, Meshref M, Raslan AM. Safety and efficacy of unilateral focused ultrasound pallidotomy on motor complications in Parkinson’s disease (PD): a systematic review and meta-analysis. Neurol Sci. 2024 Jun 6. doi: 10.1007/s10072-024-07617-2. PMID: 38842771

Bruno F, Badini P, Innocenzi A, Saporito G, Catalucci A, Sucapane P, Barile A, Cesare ED, Marini C, Pistoia F, Splendiani A. Early re-emerging tremor after MRgFUS thalamotomy: case-control analysis of procedural and imaging features. Front Neurol. 2024 Jun 6;15:1356613. doi: 10.3389/fneur.2024.1356613. eCollection 2024. PMID: 38903176

Atkinson-Clement C, Alkhawashki M, Ross J, Gatica M, Zhang C, Sallet J, Kaiser M. Dynamical and individualised approach of transcranial ultrasound neuromodulation effects in non-human primates. Sci Rep. 2024 May 24;14(1):11916. doi: 10.1038/s41598-024-62562-6. PMID: 38789473

Martínez-Fernández R, Natera-Villalba E, Rodríguez-Rojas R, Del Álamo M, Pineda-Pardo JA, Obeso I, Guida P, Jiménez-Castellanos T, Pérez-Bueno D, Duque A, Mañez-Miró JU, Gasca-Salas C, Matarazzo M, Alonso-Frech F, Obeso JA. Staged Bilateral MRI-Guided Focused Ultrasound Subthalamotomy for Parkinson Disease. JAMA Neurol. 2024 May 13. doi: 10.1001/jamaneurol.2024.1220. PMID: 38739377

Wang R, Li J. Noninvasive focused ultrasound-mediated delivery of rAAV9-EGFP vectors for neuronal targeting in rats. Neuroimage. 2024 Jul 1;294:120630. doi: 10.1016/j.neuroimage.2024.120630. Epub 2024 May 11. PMID: 38740226

Pineda-Pardo JA, Martínez-Fernández R, Natera-Villalba E, Ruiz-Yanzi A, Rodríguez-Rojas R, Del Alamo M, Jiménez-Castellanos T, Matarazzo M, Gasca-Salas C, Rascol O, Obeso JA. Skull Density Ratio as Arm-Allocation Parameter for a Controlled Focused Ultrasound Trial in Parkinson’s Disease. Mov Disord Clin Pract. 2024 May 13. doi: 10.1002/mdc3.14040. PMID: 38741245

Gasca-Salas C, Pineda-Pardo JA, Del Álamo M, Jiménez T, Trompeta C, Toltsis G, Garcia-Cañamaque L, Fernández-Rodríguez B, Matarazzo M, Plaza de Las Heras I, Natera-Villalba E, Martínez-Fernández R, Duque A, Ruiz de Aguiar S, Blesa J, Rachmilevich I, Obeso JA. Nigrostriatal blood-brain barrier opening in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2024 May 17:jnnp-2023-332967. doi: 10.1136/jnnp-2023-332967. PMID: 38760152

Purrer V, Pohl E, Borger V, Weiland H, Boecker H, Schmeel FC, Wüllner U. Motor and non-motor outcome in tremor dominant Parkinson’s disease after MR-guided focused ultrasound thalamotomy. J Neurol. 2024 May 31. doi: 10.1007/s00415-024-12469-z. PMID: 38822147

Büchele F, Mahendran S, Uhl M, Freudinger C, Maric A, Heeb NS, Oertel MF, Baumann CR, Stieglitz LH. Impact of target depth on safety and efficacy outcomes in MR-guided focused ultrasound thalamotomy for tremor patients. J Neurosurg. 2024 May 1;140(5):1451-1458. doi: 10.3171/2023.8.JNS23472. PMID: 37922562

Hori H, Taira T, Abe K, Hori T. A novel high-precision fiber tractography for nuclear localization in transcranial magnetic resonance-guided focused ultrasound surgery: a pilot study. J Neurosurg. 2024 May 1;140(5):1471-1481. doi: 10.3171/2023.8.JNS231459. PMID: 37948701

Kyle K, Peters J, Jonker B, Barnett Y, Maamary J, Barnett M, Maller J, Wang C, Tisch S. Magnetic Resonance-Guided Focused Ultrasound for Treatment of Essential Tremor: Ventral Intermediate Nucleus Ablation Alone or Additional Posterior Subthalamic Area Lesioning? Mov Disord Clin Pract. 2024 May;11(5):504-514. doi: 10.1002/mdc3.14005. Epub 2024 Mar 12. PMID: 38469997

Ciocca M, Jameel A, Yousif N, Patel N, Smith J, Akgun S, Jones B, Gedroyc W, Nandi D, Tai Y, Seemungal BM, Bain P. Illusions of Self-Motion during Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Tremor. Ann Neurol. 2024 May 6. doi: 10.1002/ana.26945. PMID: 38709569

Natera-Villalba E, Ruiz-Yanzi MA, Gasca-Salas C, Matarazzo M, Martínez-Fernández R. MR-guided focused ultrasound in movement disorders and beyond: Lessons learned and new frontiers. Parkinsonism Relat Disord. 2024 May;122:106040. doi: 10.1016/j.parkreldis.2024.106040. Epub 2024 Feb 12. PMID: 38378311

Mascotte-Cruz JU, Vera A, Leija L, Lopez-Salas FE, Gradzielski M, Koetz J, Gatica-García B, Rodríguez-Oviedo CP, Valenzuela-Arzeta IE, Escobedo L, Reyes-Corona D, Gutierrez-Castillo ME, Maldonado-Berny M, Espadas-Alvarez AJ, Orozco-Barrios CE, Martinez-Fong D. Focused ultrasound on the substantia nigra enables safe neurotensin-polyplex nanoparticle-mediated gene delivery to dopaminergic neurons intranasally and by blood circulation. Discov Nano. 2024 Apr 2;19(1):60. doi: 10.1186/s11671-024-04005-9. PMID: 38564106

Onder H. Recurrence of Parkinson’s Disease Tremor after Focused Ultrasound Thalamotomy? Mov Disord. 2024 Apr;39(4):758-759. doi: 10.1002/mds.29751. PMID: 38661050

Mueller JM, Chiu LT, Lynn F, Lewis RG, Patel S, Wodziak M, Patel N, Sani S. Magnetic Resonance-Guided Focused Ultrasound without Anesthesiologist Support. Stereotact Funct Neurosurg. 2024 Apr 24:1-10. doi: 10.1159/000537695. PMID: 38657586

Morabito R, Cammaroto S, Militi A, Smorto C, Anfuso C, Lavano A, Tomasello F, Di Lorenzo G, Brigandì A, Sorbera C, Bonanno L, Ielo A, Vatrano M, Marino S, Cacciola A, Cerasa A, Quartarone A. The Role of Treatment-Related Parameters and Brain Morphology in the Lesion Volume of Magnetic-Resonance-Guided Focused Ultrasound Thalamotomy in Patients with Tremor-Dominant Neurological Conditions. Bioengineering (Basel). 2024 Apr 12;11(4):373. doi: 10.3390/bioengineering11040373. PMID: 38671794

Kadowaki M, Sugiyama K, Nozaki T, Yamasaki T, Namba H, Shimizu M, Kurozumi K. Scalp Nerve Block Alleviates Headaches Associated With Sonication During Transcranial Magnetic Resonance-Guided Focused Ultrasound. Neurosurgery. 2024 Apr 30. doi: 10.1227/neu.0000000000002962. PMID: 38687082

Feltrin FS, White A, O’Suilleabhain P, Mckenzie L, Pride L, Shah BR. First High Intensity Focused Ultrasound Thalamotomy in a Patient with Cerebral Aneurysms. Mov Disord Clin Pract. 2024 Jan 29. doi: 10.1002/mdc3.13989. PMID: 38284308

Alonto AHD, Jamora RDG. A scoping review on the diagnosis and treatment of X-linked dystonia-parkinsonism. Parkinsonism Relat Disord. 2024 Feb;119:105949. doi: 10.1016/j.parkreldis.2023.105949. Epub 2023 Nov 30. PMID: 38072720

Gurgone S, De Salvo S, Bonanno L, Muscarà N, Acri G, Caridi F, Paladini G, Borzelli D, Brigandì A, La Torre D, Sorbera C, Anfuso C, Di Lorenzo G, Venuti V, D’Avella A, Marino S. Changes in cerebral cortex activity during a simple motor task after MRgFUS treatment in patients affected by essential tremor and Parkinson’s disease: a pilot study using functional NIRS. Phys Med Biol. 2023 Dec 15. doi: 10.1088/1361-6560/ad164e. PMID: 38100845

Rodríguez JA, Gutiérrez MI, Vera A, Hernández DA, Gutiérrez JM, Martínez-Fong D, Leija L. Protocol to Induce the Temporary Opening of the Blood-Brain Barrier with Short-Time Focused Ultrasound in Rats. Pharmaceutics. 2023 Dec 6;15(12):2733. doi: 10.3390/pharmaceutics15122733. PMID: 38140074

Tian X, Hu R, He P, Ye J. Efficacy and safety of magnetic resonance-guided focused ultrasound for Parkinson’s disease: a systematic review and meta-analysis. Front Neurol. 2023 Dec 7;14:1301240. doi: 10.3389/fneur.2023.1301240. eCollection 2023. PMID: 38146437

Peters J, Maamary J, Kyle K, Olsen N, Jones L, Bolitho S, Barnett Y, Jonker B, Tisch S. Outcomes of Focused Ultrasound Thalamotomy in Tremor Syndromes. Mov Disord. 2023 Nov 14. doi: 10.1002/mds.29658. PMID: 37964429

Büchele F, Mahendran S, Uhl M, Freudinger C, Maric A, Heeb NS, Oertel MF, Baumann CR, Stieglitz LH. Impact of target depth on safety and efficacy outcomes in MR-guided focused ultrasound thalamotomy for tremor patients. J Neurosurg. 2023 Nov 3:1-8. doi: 10.3171/2023.8.JNS23472. PMID: 37922562

Chua MMJ, Blitz SE, Ng PR, Segar DJ, McDannold NJ, White PJ, Christie S, Hayes MT, Rolston JD, Cosgrove GR. Focused Ultrasound Thalamotomy for Tremor in Parkinson’s Disease: Outcomes in a Large, Prospective Cohort. Mov Disord. 2023 Oct;38(10):1962-1967. doi: 10.1002/mds.29569. Epub 2023 Aug 4. PMID: 37539721

Samuel N, Ding MYR, Sarica C, Darmani G, Harmsen IE, Grippe T, Chen X, Yang A, Nasrkhani N, Zeng K, Chen R, Lozano AM. Accelerated Transcranial Ultrasound Neuromodulation in Parkinson’s Disease: A Pilot Study. Mov Disord. 2023 Oct 9. doi: 10.1002/mds.29622. PMID: 37811802

Maragkos GA, Kosyakovsky J, Zhao P, Kearns KN, Rush-Evans S, Moosa S, Elias WJ. Patient-Reported Outcomes After Focused Ultrasound Thalamotomy for Tremor-Predominant Parkinson’s Disease. Neurosurgery. 2023 Oct 1;93(4):884-891. doi: 10.1227/neu.0000000000002518. Epub 2023 May 3. PMID: 37133259

Caston RM, Campbell JM, Rahimpour S, Moretti P, Alexander MD, Rolston JD. Hemorrhagic Safety of Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Tremor without Interruption of Antiplatelet or Anticoagulant Therapy. Stereotact Funct Neurosurg. 2023 Sep 8:1-5. doi: 10.1159/000533590. PMID: 37690446

Martínez Fernández R, Natera Villalba E, Rodriguez-Rojas R, Del Álamo M, Pineda-Pardo JA, Obeso I, Mata-Marín D, Guida P, Jimenez-Castellanos T, Pérez-Bueno D, Duque A, Máñez Miró JU, Gasca-Salas C, Matarazzo M, Obeso JA. Unilateral focused ultrasound subthalamotomy in early Parkinson’s disease: a pilot study. J Neurol Neurosurg Psychiatry. 2023 Sep 6:jnnp-2023-331211. doi: 10.1136/jnnp-2023-331211. PMID: 37673642

Vetkas A, Boutet A, Sarica C, Germann J, Gwun D, Yamamoto K, Jung HH, Alkhotani A, Samuel N, Lang S, Conner CR, Elias GJB, Cheyuo C, Chow C, Santyr B, Iorio-Morin C, Yang AZ, Candeias da Silva C, Fasano A, Kalia SK, Lozano AM. Successful magnetic resonance-guided focused ultrasound treatment of tremor in patients with a skull density ratio of 0.4 or less. J Neurosurg. 2023 Sep 1:1-9. doi: 10.3171/2023.6.JNS23171. PMID: 37657095

Kyle K, Maamary J, Jonker B, Peters J, Barnett Y, Barnett M, D’Souza A, Maller J, Wang C, Tisch S. Consistency is key: influence of skull density ratio distribution on the formation of clinically effective lesions and long-term tremor suppression following treatment with MR-guided focused ultrasound. J Neurosurg. 2023 Sep 1:1-9. doi: 10.3171/2023.6.JNS231153. PMID: 37657096

Jamora RDG, Khu KJO, Sy MCC, Pascual JSG, Legaspi GD, Aguilar JA. Transcranial magnetic resonance-guided focused ultrasound pallidothalamic tractotomy for patients with X-linked dystonia-parkinsonism: a study protocol. BMC Neurol. 2023 Aug 18;23(1):306. doi: 10.1186/s12883-023-03344-x. PMID: 37596524

Wang X, Wang S, Lin J, Zhang D, Lu H, Xiong Y, Deng L, Zhang D, Bian X, Zhou J, Pan L, Lou X. Gray matter alterations in tremor-dominant Parkinson’s disease after MRgFUS thalamotomy are correlated with tremor improvement: a pilot study. Quant Imaging Med Surg. 2023 Jul 1;13(7):4415-4428. doi: 10.21037/qims-22-1403. Epub 2023 May 4. PMID: 37456281

He X, Oshino S, Hosomi K, Kanemoto M, Tani N, Kishima H. Characteristics of Pain During MRI-Guided Focused Ultrasound Thalamotomy. Neurosurgery. 2023 Aug 1;93(2):358-365. doi: 10.1227/neu.0000000000002420. Epub 2023 Mar 2. PMID: 36861986

Rabin JS, Gopinath G, McSweeney M, Scantlebury N, Rohringer CR, Sewell IJ, Abrahao A, Jones RM, Huang Y, Lam B, Hamani C, Giacobbe P, Nestor SM, Hynynen K, Schwartz ML, Lipsman N. Patient satisfaction following unilateral MR-guided focused ultrasound for tremor: Who is satisfied and who is not? Parkinsonism Relat Disord. 2023 Jul;112:105439. doi: 10.1016/j.parkreldis.2023.105439. Epub 2023 May 22. PMID: 37263158

Dahmani L, Bai Y, Li M, Ren J, Shen L, Ma J, Li H, Wei W, Li P, Wang D, Du L, Cui W, Liu H, Wang M. Focused ultrasound thalamotomy for tremor treatment impacts the cerebello–thalamo-cortical network. NPJ Parkinsons Dis. 2023 Jun 15;9(1):90. doi: 10.1038/s41531-023-00543-8. PMID: 37322044

Purrer V, Upadhyay N, Borger V, Schmeel C, Boecker H, Wüllner U. Structural and functional alterations in the gustatory network underlie taste disturbances after lesional tremor therapy with MRgFUS. J Neurol Neurosurg Psychiatry. 2023 Jun 15:jnnp-2023-331324. doi: 10.1136/jnnp-2023-331324. PMID: 37321839

Baek H, Chen J, Lockwood D, Obusez E, Poturalski M, Nagel SJ, Jones SE. Feasibility of Magnetic Resonance-Compatible Accelerometers to Monitor Tremor Fluctuations During Magnetic Resonance-Guided Focused Ultrasound Thalamotomy: Technical Note. Oper Neurosurg (Hagerstown). 2023 Jun 1;24(6):641-650. doi: 10.1227/ons.0000000000000638. Epub 2023 Feb 23. PMID: 36827201

Yamaguchi T, Nakano M, Sasanuma J, Takasaki M, Maki F, Hino S, Kaburagi M, Iijima K, Iwamuro H, Watanabe K. Cavitation with low-energy sonication during focused ultrasound thalamotomy for a patient with tremor-dominant Parkinson’s disease: a potential risk. Acta Neurochir (Wien). 2023 May;165(5):1195-1200. doi: 10.1007/s00701-023-05551-4. Epub 2023 Mar 14. PMID: 36917360

Aly AE, Sun T, Zhang Y, Li Z, Kyada M, Ma Q, Padegimas L, Sesenoglu-Laird O, Cooper MJ, McDannold NJ, Waszczak BL. Focused ultrasound enhances transgene expression of intranasal hGDNF DNA nanoparticles in the sonicated brain regions. J Control Release. 2023 May 15;358:498-509. doi: 10.1016/j.jconrel.2023.04.041. PMID: 37127076

Maragkos GA, Kosyakovsky J, Zhao P, Kearns KN, Rush-Evans S, Moosa S, Elias WJ. Patient-Reported Outcomes After Focused Ultrasound Thalamotomy for Tremor-Predominant Parkinson’s Disease. Neurosurgery. 2023 May 3. doi: 10.1227/neu.0000000000002518. PMID: 37133259

Bouthour W, Newman NJ, Biousse V. Focused Ultrasound Ablation in Parkinson’s Disease. N Engl J Med. 2023 May 11;388(19):1822. doi: 10.1056/NEJMc2303750. PMID: 37163636

Hariz M, Okun MS, Vitek JL. Focused Ultrasound Ablation in Parkinson’s Disease. N Engl J Med. 2023 May 11;388(19):1822-1823. doi: 10.1056/NEJMc2303750. PMID: 37163637

Fishman PS, Krishna V, Eisenberg HM. Focused Ultrasound Ablation in Parkinson’s Disease. Reply. N Engl J Med. 2023 May 11;388(19):1823-1824. doi: 10.1056/NEJMc2303750. PMID: 37163638

Ko TH, Lee YH, Chan L, Tsai KW, Hong CT, Lo WL. Magnetic Resonance-Guided focused ultrasound surgery for Parkinson’s disease: A mini-review and comparison between deep brain stimulation. Parkinsonism Relat Disord. 2023 May 5:105431. doi: 10.1016/j.parkreldis.2023.105431. PMID: 37164870

Blesa J, Pineda-Pardo JA, Inoue KI, Gasca-Salas C, Balzano T, Del Rey NL, Reinares-Sebastián A, Esteban-García N, Rodríguez-Rojas R, Márquez R, Ciorraga M, Del Álamo M, García-Cañamaque L, Ruiz de Aguiar S, Rachmilevitch I, Trigo-Damas I, Takada M, Obeso JA. BBB opening with focused ultrasound in nonhuman primates and Parkinson’s disease patients: Targeted AAV vector delivery and PET imaging. Sci Adv. 2023 Apr 21;9(16):eadf4888. doi: 10.1126/sciadv.adf4888. Epub 2023 Apr 19.

Martínez-Fernández R, Natera-Villalba E, Máñez Miró JU, Rodriguez-Rojas R, Marta Del Álamo M, Pineda-Pardo JÁ, Ammann C, Obeso I, Mata-Marín D, Hernández-Fernández F, Gasca-Salas C, Matarazzo M, Alonso-Frech F, Obeso JA. Prospective Long-term Follow-up of Focused Ultrasound Unilateral Subthalamotomy for Parkinson Disease. Neurology. 2023 Mar 28;100(13):e1395-e1405. doi: 10.1212/WNL.0000000000206771. Epub 2023 Jan 11.

Kiani L. Ultrasound ablation treatment for PD. Nat Rev Neurol. 2023 Apr;19(4):197. doi: 10.1038/s41582-023-00797-z.

Lu H, Wang X, Lou X. Current applications for magnetic resonance-guided focused ultrasound in the treatment of Parkinson’s disease. Chin Med J (Engl). 2023 Mar 14. doi: 10.1097/CM9.0000000000002319.

Maamary J, Peters J, Kyle K, Barnett Y, Jonker B, Tisch S. Effective Subthalamic Nucleus Deep Brain Stimulation Following MRgFUS for Tremor Dominant Parkinson’s Disease. Mov Disord Clin Pract. 2023 Jan 30;10(3):486-492. doi: 10.1002/mdc3.13662. eCollection 2023 Mar.

He X, Oshino S, Hosomi K, Kanemoto M, Tani N, Kishima H. Characteristics of Pain During MRI-Guided Focused Ultrasound Thalamotomy. Neurosurgery. 2023 Mar 2. doi: 10.1227/neu.0000000000002420.

Pirker W, Katzenschlager R, Hallett M, Poewe W. Pharmacological Treatment of Tremor in Parkinson’s Disease Revisited. J Parkinsons Dis. 2023 Feb 21. doi: 10.3233/JPD-225060.

Krishna V, Fishman PS, Eisenberg HM, Kaplitt M, Baltuch G, Chang JW, Chang WC, Martinez Fernandez R, Del Alamo M, Halpern CH, Ghanouni P, Eleopra R, Cosgrove R, Guridi J, Gwinn R, Khemani P, Lozano AM, McDannold N, Fasano A, Constantinescu M, Schlesinger I, Dalvi A, Elias WJ.Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease. N Engl J Med. 2023 Feb 23;388(8):683-693. doi: 10.1056/NEJMoa2202721.

Schrag A. Focused Ultrasound Ablation of the Globus Pallidus Internus for Parkinson’s Disease. N Engl J Med. 2023 Feb 23;388(8):759-760. doi: 10.1056/NEJMe2215506.

Yuen J, Goyal A, Kaufmann TJ, Jackson LM, Miller KJ, Klassen BT, Dhawan N, Lee KH, Lehman VT. Comparison of the impact of skull density ratio with alternative skull metrics on magnetic resonance-guided focused ultrasound thalamotomy for tremor. J Neurosurg. 2023 Jan 1;138(1):50-57. doi: 10.3171/2022.5.JNS22350.

Saporito G, Sucapane P, Ornello R, Cerone D, Bruno F, Splendiani A, Masciocchi C, Ricci A, Marini C, Sacco S, Pistoia F. Cognitive outcomes after focused ultrasound thalamotomy for tremor: Results from the COGNIFUS (COGNitive in Focused UltraSound) study. Parkinsonism Relat Disord. 2023 Jan;106:105230. doi: 10.1016/j.parkreldis.2022.105230. Epub 2022 Nov 28.

Moro E, Romito LM. Unilateral Focused Ultrasound Subthalamotomy for Parkinson Disease: Long-term Efficacy and Safety. Neurology. 2023 Jan 11:10.1212/WNL.0000000000206896. doi: 10.1212/WNL.0000000000206896.

Fabbri M, Barbosa R, Rascol O. Off-time Treatment Options for Parkinson’s Disease. Neurol Ther. 2023 Jan 12. doi: 10.1007/s40120-022-00435-8.

Blitz SE, Torre M, Chua MMJ, Christie SL, McDannold NJ, Cosgrove GR. Focused Ultrasound Thalamotomy: Correlation of Postoperative Imaging with Neuropathological Findings. Stereotact Funct Neurosurg. 2023 Jan 25:1-8. doi: 10.1159/000527269.

Chen JC, Lu MK, Chen CM, Tsai CH. Stepwise Dual-target MR-guided Focused Ultrasound in Tremor-dominant Parkinson’s Disease: a Feasibility Study. World Neurosurg. 2022 Dec 20:S1878-8750(22)01753-3. doi: 10.1016/j.wneu.2022.12.049.

Trinh D, Nash J, Goertz D, Hynynen K, Bulner S, Iqbal U, Keenan J. Microbubble drug conjugate and focused ultrasound blood brain barrier delivery of AAV-2 SIRT-3. Drug Deliv. 2022 Dec;29(1):1176-1183. doi: 10.1080/10717544.2022.2035855.

Golfrè Andreasi N, Cilia R, Romito LM, Bonvegna S, Straccia G, Elia AE, Novelli A, Messina G, Tringali G, Levi V, Devigili G, Rinaldo S, Gasparini V, Grisoli M, Stanziano M, Ghielmetti F, Prioni S, Bocchi E, Amami P, Piacentini SHMJ, Ciceri EFM, Bruzzone MG, Eleopra R. Magnetic Resonance-Guided Focused Ultrasound Thalamotomy May Spare Dopaminergic Therapy in Early-Stage Tremor-Dominant Parkinson’s Disease: A Pilot Study. Mov Disord. 2022 Nov;37(11):2289-2295. doi: 10.1002/mds.29200. Epub 2022 Aug 29.

Feng Y, An R, Zhang Y, Chen M, Wang L, Duan Y, Xing C. AHNAK-modified microbubbles for the intracranial delivery of triptolide: In-vitro and in-vivo investigations. Int J Pharm. 2022 Dec 15;629:122351. doi: 10.1016/j.ijpharm.2022.122351. Epub 2022 Oct 29.

Hvingelby VS, Pavese N. Surgical Advances in Parkinson’s Disease. Curr Neuropharmacol. 2022 Nov 21. doi: 10.2174/1570159X21666221121094343.

Zhang H, Xu M, Zhang Y, Wang X, Zhang C, He F, Song X, Chen S, Jian X, Ming D. Numerical simulation study of firing threshold of STN neuron stimulated by focused ultrasound. IEEE Trans Biomed Eng. 2022 Oct 28;PP. doi: 10.1109/TBME.2022.3217831.

Pineda-Pardo JA, Gasca-Salas C, Fernández-Rodríguez B, Rodríguez-Rojas R, Del Álamo M, Obeso I, Hernández-Fernández F, Trompeta C, Martínez-Fernández R, Matarazzo M, Mata-Marín D, Guida P, Duque A, Albillo D, Plaza de Las Heras I, Montero JI, Foffani G, Toltsis G, Rachmilevitch I, Blesa J, Obeso JA. Striatal Blood-Brain Barrier Opening in Parkinson’s Disease Dementia: A Pilot Exploratory Study. Mov Disord. 2022 Oct;37(10):2057-2065. doi: 10.1002/mds.29134. Epub 2022 Jun 28.

Kim E, Van Reet J, Kim HC, Kowsari K, Yoo SS. High Incidence of Intracerebral Hemorrhaging Associated with the Application of Low-Intensity Focused Ultrasound Following Acute Cerebrovascular Injury by Intracortical Injection. Pharmaceutics. 2022 Oct 6;14(10):2120. doi: 10.3390/pharmaceutics14102120.

Deuschl G, Antonini A, Costa J, Śmiłowska K, Berg D, Corvol JC, Fabbrini G, Ferreira J, Foltynie T, Mir P, Schrag A, Seppi K, Taba P, Ruzicka E, Selikhova M, Henschke N, Villanueva G, Moro E. European Academy of Neurology/Movement Disorder Society – European Section guideline on the treatment of Parkinson’s disease: I. Invasive therapies. Eur J Neurol. 2022 Sep;29(9):2580-2595. doi: 10.1111/ene.15386. Epub 2022 Jul 6.

Meng Y, Pople CB, Huang Y, Jones RM, Ottoy J, Goubran M, Oliveira LM, Davidson B, Lawrence LSP, Lau AZ, Bethune A, Maralani P, Abrahao A, Hamani C, Hynynen K, Kalia SK, Lipsman N, Kalia LV. Putaminal Recombinant Glucocerebrosidase Delivery with Magnetic Resonance-Guided Focused Ultrasound in Parkinson’s Disease: A Phase I Study. Mov Disord. 2022 Sep 11. doi: 10.1002/mds.29190.

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