Safety and efficacy of magnetic resonance imaging-guided focused ultrasound neurosurgery for Parkinson’s disease: a systematic review

Abstract

Magnetic resonance imaging-guided focused ultrasound (MRgFUS) neurosurgery is a new option for medication-resistant Parkinson’s disease (PD), but its safety and efficacy remain elusive. This study aimed to investigate the safety and efficacy of MRgFUS for PD by systematically reviewing related literature. PubMed and EMBASE were searched to identify related studies. Inclusion criteria were (1) reported the efficacy or safety of MRgFUS for PD and (2) published in English. Exclusion criteria were (1) nonhuman study, (2) review or meta-analysis or other literature types without original data, and (3) conference abstract without full text. Data on study characteristics, treatment parameters, efficacy, and adverse events were collected. Descriptive synthesis of data was performed. Eleven studies containing 80 patients were included. Nine studies were observational studies with no controls. Two studies included a randomized and controlled phase. Most studies included tremor-dominant PD. Ten studies reported decline of UPDRS-III scores after MRgFUS, and five reported a statistically significant decline. Nine studies evaluated the quality of life (QOL). Significant improvement of QOL was reported by four studies using the 39-item Parkinson’s disease questionnaire. Four studies investigated the impact of MRgFUS on non-motor symptoms. Most tests indicated that MRgFUS had no significant effect on neuropsychological outcomes. Most adverse events were mild and transient. MRgFUS is a potential treatment for PD with satisfying efficacy and safety. Studies in this field are still limited. More studies with strict design, larger sample size, and longer follow-up are needed to further investigate its efficacy and safety for PD.

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Funding

This work was funded by the National Natural Science Foundation of China (81870999) and 135 Project of Outstanding Development of West China Hospital, Sichuan University (ZY2017307).

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YX, QH, and WW proposed the conception and design of the study. YX and QH conducted the literature search, study screening, data extraction, and quality assessment. All authors were involved in the analysis and interpretation of data. YX drafted the manuscript and all authors revised it critically under the guidance of WW. All authors have approved the final version of the manuscript to be submitted.

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Correspondence to Wei Wang.

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This study was approved by West China Hospital of Sichuan University Biomedical Research Ethics Committee.

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Xu, Y., He, Q., Wang, M. et al. Safety and efficacy of magnetic resonance imaging-guided focused ultrasound neurosurgery for Parkinson’s disease: a systematic review. Neurosurg Rev 44, 115–127 (2021). https://doi.org/10.1007/s10143-019-01216-y

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Keywords

  • Parkinson’s disease
  • Magnetic resonance imaging-guided focused ultrasound
  • Systematic review
  • Safety
  • Efficacy