Safety and Efficacy of Focused Ultrasound for Patients With Tremor-Dominant Parkinson Disease
Menna Elbadry1, Laith Shakhatreh2, Yousef Ahmed El-Ayman3, Tasabeeh Omer4, Zina Otmani5, Doaa Mashaly1, Heba T. ElSayed6, Ahmed Negida7
1October 6 university faculty of medicine, Egypt, 2Princess Basma Hospital, Irbid, Jordan, 3Zagazig University, Egypt, 4Family physician, MD, Emirates health services, Fujairah, United Arab Emirates., 5Faculty of medicine, Mouloud Mammeri university, Tizi Ouzou, Algeria, 6Tanta University, Faculty of Medicine, Egypt, 7Virginia Commonwealth University
Objective:
We aimed to compare the outcomes of Magnetic resonance-guided focused ultrasound (MRgFUS) versus sham procedure in patients with parkinson disease (PD)
Background:
Tremors are present in approximately half of PD patients. MRgFUS is a non-invasive method that may benefit tremor-dominant Parkinson's patients who are resistant to medication.
Design/Methods:
We searched Cochrane Library, PubMed, Web of Science, and Scopus until August 25, 2024. We included randomized controlled trials comparing the two procedures. The primary outcome of interest was the tremor score. Other outcomes included changes in the Unified Parkinson's Disease Rating Scale (UPDRS) and the incidence of adverse events.
Results:
Four studies were included with a total of 169 patients. MRgFUS was performed on 125 patients, while 54 patients underwent a sham procedure. The difference in tremor score between the two groups was not statistically significant (MD: 2.56, 95% CI [-0.00, 5.12], p: 0.05). Pooled studies were not homogenous (P = < 0.04, I2 = 77%). The results of the MDS-UPDRS III in the on-medication group indicated a statistically significant difference in favor of the sham group (MD: 8.87, 95% CI [6.05, 11.68], p: 0.00001). The MDS-UPDRS II results significantly favored the sham group (MD: 3.80, 95% CI [1.96, 5.64], p < 0.00001). The UPDRS IV results favored the sham group (MD: 3.58, 95% CI [1.13, 6.03], p = 0.004). pooled analysis results of the PDQ-39 questionnaire were not statistically significant (MD: -3.56, 95% CI [-10.67, 3.55], p: 0.33). The results showed that the number of cases who experienced dizziness and gait disturbance were significantly higher in the sham group (RR: 2.94, 95% CI [1.06, 8.18], p: 0.04) and (RR: 7.37, 95% CI [1.07, 51.02], p: 0.04), respectively.
Conclusions:
Although MRgFUS is a safe method,
Its efficacy is uncertain and necessitates additional research.
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