The symptoms of most patients with Parkinson’s disease can be managed with drugs that increase the amount of dopamine in the brain. However, the effectiveness of these drugs decreases over time, making it difficult to control symptoms, so researchers are exploring other options to directly target the affected brain cells.
The New England Journal of Medicine published a study on the latest treatment for Parkinson’s disease, showing that people with the disease experienced significant improvement in tremors, movement, and other symptoms after exposure to Focused Ultrasound for Parkinson’s Disease. Nearly 70% of participants in the treatment group showed an improvement in symptoms after three months of follow-up, indicating that this technology is well on its way to clinical use
What is the latest treatment for Parkinson’s disease?
Focused ultrasound is the latest treatment for Parkinson’s disease, a procedure that can be used to target and destroy the cells causing motor symptoms in the brain. This technique helps patients who are highly resistant to drug therapy and those with advanced Parkinson’s.
Focused ultrasound is already an NHS-approved treatment for essential tremors in the UK, and the technology is being studied to become the primary treatment for Parkinson’s within the next five years.
How does Focused Ultrasound for Parkinson’s Disease work?
During a focused ultrasound procedure, the patient is awake, and no general anesthesia or surgical incisions are used. Doctors treating Parkinson’s and Parkinson’s sometimes use magnetic resonance imaging (MRI) to guide the ultrasound beams to the exact location needed.
Focused ultrasound usually treats symptoms immediately and does not require adjustment, programming, or additional procedures, as it is a permanent and irreversible treatment. Possible side effects may include headaches, numbness, tingling, imbalance, or gait changes, among others.
Focused ultrasound is only approved to treat one side of the brain, which means it only helps treat symptoms on one side of the body. This is because performing it on both sides of the brain may cause speech, swallowing, or memory issues. (Ongoing research evaluates the potential benefits of stimulating both sides with ultrasound and the best protocols for performing the procedure.)
Rest and stress reduction are the keys to follow-up treatment, so doctors recommend regular exercise and massage while avoiding caffeinated drinks and foods that aggravate the tremors.
The difference between focused ultrasound and Deep Brain Stimulation
Focused ultrasound and deep brain stimulation (DBS) are both procedures aimed at relieving movement symptoms in Parkinson’s disease. Focused ultrasound and DBS work on the same brain areas but in different ways. Focused ultrasound therapy is irreversible, while deep brain stimulation can be reversed by removing or turning off the device.
An important point of comparison is that focused ultrasound is a non-invasive procedure, meaning there are no incisions and no devices placed in the body, while in DBS surgery, doctors insert thin wires into the brain and a battery under the collarbone.
How does ultrasound target the brain regions responsible for tremors?
In essential tremors and Parkinson’s disease, more than 1,000 highly focused ultrasound beams are focused on a specific area of the thalamus and pallidal nucleus in the brain because the thalamus transmits motor and sensory signals. The heat generated by the ultrasound burns the targeted spot in the thalamus, and the spot burned by the focused ultrasound will surely die and not send abnormal motor signals, contributing to the treatment of motor symptoms in Parkinson’s disease.
Benefits of Focused Ultrasound for Parkinson’s Disease
This technique has many benefits that have made it a frontrunner in the treatment of Parkinson’s and essential tremor, including
- Immediate results after the procedure
- There is no need for anesthesia during the procedure
- No incisions
- Permanent treatment that doesn’t need to be repeated
- No implantation of devices inside the body
- Safety of surrounding tissues due to accurate guidance
- There is little to no risk of infection since there are no incisions
- Patients can go home on the same day of treatment
Risks and possible side effects of Focused Ultrasound for Parkinson’s Disease
The rule with any treatment is that there will be side effects, but comparing the benefits to the effects determines the treatment’s effectiveness. Side effects include the following:
- Headache
- numbness and tingling
- Some patients may feel warmth, pain, or dizziness that lasts only a few seconds during the procedure, and these effects are not felt after the procedure.
- Some cases of loss of balance or gait changes have been reported
- Currently, focused ultrasound is usually performed only on one side of the brain (unilateral) due to the harmful effects of the bilateral procedure
Most side effects have been reported as mild or moderate in severity, with symptoms usually improving within a few days or months.
Who are the ideal candidates for Focused Ultrasound for Parkinson’s Disease?
Studies have shown that this approach can benefit two main conditions: Parkinson’s disease and essential tremor.
The first studies and research proved the usefulness of this technique for treating idiopathic (essential) tremor patients by targeting certain areas of the thalamus with focused waves. Parkinson’s patients did not receive much benefit at this stage. Still, with the succession of studies, the usefulness of this technique was proven in Parkinson’s patients, primarily when the rays are directed towards the pallid nucleus region of the brain, which is also responsible for the motor signals issued from the brain to the skeletal muscles of the body.
Even for Parkinson’s patients, this technique is not suitable for everyone and is reserved for patients with specific cases of the disease with specific criteria. Some points must be met for this technology to be suitable:
- Advanced stage of Parkinson’s disease: FUS is an effective treatment for patients with advanced or moderate Parkinson’s symptoms who do not respond well to medications.
- Severe motor symptoms include tremors, muscle stiffness, difficulty moving, and an inability to control fine movements.
- Patients who are not suitable for conventional surgical treatment (such as deep brain stimulation surgery): FUS can be an alternative option for those who cannot undergo DBS surgery due to other health factors.
- Patients who do not respond to medications: FUS can be a valuable option for improving motor symptoms if the patient has intolerable side effects from drugs or does not benefit from them.
How much does Focused Ultrasound for Parkinson’s Disease cost?
The cost of Parkinson’s disease treatment with FUS in Turkey varies depending on several factors, such as the clinic or hospital, the patient’s condition, the type of FUS procedure, and whether additional care or follow-up treatments are needed.
The cost of focused ultrasound surgery (FUS) for Parkinson’s disease typically ranges from $10,000 to USD 20,000 for the entire procedure. This price often includes:
- Preoperative counseling and diagnostic imaging
- Performing the focused ultrasound technique (FUS) itself
- Post-operative care and follow-up visits
- Hospitalization (if needed)
Turkey is known for offering high-quality healthcare at more affordable prices than countries like the United States, Europe, or the United Kingdom. This is one reason why many international patients travel to Turkey for advanced medical treatments such as FUS for Parkinson’s disease.
The ongoing research into guided Focused Ultrasound for Parkinson’s Disease aims to evaluate the procedure in different brain areas that are affected by Parkinson’s disease, such as the hypothalamic nucleus and the thalamic pallidum pathway. At the same time, scientists are looking at the potential benefits and safety of targeted ultrasound for both sides and best practices for applying the procedure. Researchers are also studying how ultrasound can help other Parkinson’s treatments, such as antibodies against alpha-synuclein or gene therapies, reach the brain more easily and efficiently by temporarily opening the blood-brain barrier.
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