Key Points
- Researchers are testing the use of low-powered focused ultrasound in a region of the brain called the zona incerta in patients with Parkinson’s.
- The 20-patient study is seeking to compare tremor reduction between this new target and the FDA-approved target.
The University of British Columbia (UBC) in Vancouver, Canada, has treated the first patient in a research study evaluating the effectiveness of low-intensity focused ultrasound (LIFU) targeting the zona incerta compared to the ventral intermediate nucleus of the thalamus (Vim) for tremor control in patients with Parkinson’s disease (PD). The Vim is an FDA-approved target for high intensity focused ultrasound treatment of essential tremor and Parkinson’s tremor. The zona incerta is a region in the brain that is responsible for coordinating complex behaviors and is known to be connected to many other areas of the brain.
About the Study
The research study, which is funded by the Foundation, aims to understand the effects of focused ultrasound in neurological networks and assess therapeutic potential of targeting the zona incerta, as opposed to the Vim, for tremor control. It is being led by Martin J. McKeown, MD, head of the Division of Neurology at UBC, Hongchae Baek, PhD, and Soojin Lee, PhD, who are experts in neurological disorders and ultrasound neuromodulation.
Using the Brainbox NeuroFUS device under neuronavigational guidance, investigators will deliver LIFU to the zona incerta and Vim regions of the brain with the intention of temporarily reducing tremors without causing permanent changes. Participants will undergo two treatments over a 1-day session, during which the team will monitor tremor reduction and analyze brain activity using functional MRI to investigate the effects of LIFU in neural networks. The researchers hope to see a temporary decrease in the patients’ tremors, as measured by accelerometers placed on the patients’ hands as well as better understand the pathophysiology of Parkinson’s tremor.
“Starting this study is a step toward addressing the unmet needs of people with Parkinson’s disease who suffer from debilitating tremors. By understanding how modulating the Vim and zona incerta regions can affect these tremors, we hope to discover new treatment options that could significantly improve patient outcomes.” said Dr. McKeown.
Why Target the Zona Incerta?
PD affects millions worldwide, with tremors being one of its most debilitating symptoms. Current treatment options, like medications and surgery, are not always effective, and some patients experience tremor recurrence. This new study seeks to evaluate whether targeting the zona incerta could provide longer-lasting tremor control with fewer side effects.
Studies involving deep brain stimulation and focused ultrasound have highlighted the zona incerta as an alternative target to the Vim, which has been the traditional target for tremor treatments. Because tremor recurrence may be higher in PD as compared with Essential Tremor, researchers theorize that targeting the zona incerta might yield better long-term results.
Focused Ultrasound for Movement Disorders
The use of focused ultrasound as a noninvasive treatment for movement disorders has gained momentum. In 2016, the U.S. Food and Drug Administration approved the use of focused ultrasound ablation for treating essential tremor in medication-resistant patients. In 2021, this approval expanded to include advanced PD symptoms, such as mobility issues, rigidity, and dyskinesia. Focused ultrasound is becoming a popular alternative to traditional treatments.
For Patients
For more information about the study, visit clinicaltrials.gov or contact UBC, in Vancouver, British Columbia, Canada. Email Juana MA Ayala Castaneda at juana.ayala@ubc.ca.