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Safety and Efficacy of Magnetic Resonance-guided Focused Ultrasound in the Treatment of Parkinson's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Friday, May 3, 2024

Presenting Author(s)

Nour Shaheen

Medical student
Alexandria Faculty of Medicine
Alexandria, EG

Co-Author(s)

YB

Yarema Bezchlibnyk, n/a

Neurosurgeon
Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Tampa, Florida, United States
BD

Brian Dalm, n/a

Neurosurgeon
Department of Neurosurgery, Ohio State University, Columbus, OH, United States
OF

Oliver Flouty, n/a

Neurosurgeon
Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, USA, United States
JJ

Jennifer Jain, n/a

Neurologist
Department of Neurology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA, United States
Mohammad A. Nour El Dine, n/a (he/him/his)

Neurosurgeon
Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Tampa, Florida, United States
AS

Ahmed Shaheen, n/a

Medical student
Alexandria Faculty of Medicine, United States
TZ

Theresa Zesiewicz, n/a

Neurologist
Department of Neurology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Tampa, Florida, United States

Introduction: Magnetic resonance-guided focused ultrasound (MRgFUS) is a promising treatment option for Parkinson’s disease (PD); however, its efficacy and safety have not yet been fully evaluated.

Methods: In this review, we aimed to assess the efficacy and safety of MRgFUS for PD through a comprehensive search of PubMed, Scopus, and Web of Science databases using a specific search strategy according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We utilized Risk of Bias (RoB) 2 tool to evaluate the risk of bias and performed statistical analysis using R software.

Results: The primary outcome measure, Motor Examination (UPDRS III), demonstrated statistically significant difference between the FUS and sham groups, with a standardized mean difference (SMD) of 3.80 (95% CI: 1.44, 6.15). Analysis of secondary outcomes showed that FUS was effective in improving Motor Experiences of Daily Living (UPDRS II), with an SMD of 3.61 (95% CI: 2.27, 4.95). FUS also reduced Motor Complications (UPDRS IV), with an SMD of 5.77 (95% CI: 0.68, 10.86). However, FUS did not show significant effect on Levodopa Equivalent Daily Dose (LEDD) or the PDQ-39 score. We identified a significantly higher risk of gait disturbance in the FUS group during adverse events assessment.

Conclusion : FUS is an emerging and highly promising therapeutic approach for PD. However, it is essential to note that certain adverse effects have been reported alongside these positive outcomes. To confirm the efficacy and safety of MRgFUS for PD, further randomized controlled trials with large sample sizes are warranted.