Accelerated Transcranial Ultrasound Neuromodulation in Parkinson's Disease: A Pilot Study.

Autor: Samuel N; Toronto Western Hospital, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Ding MYR; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada., Sarica C; Toronto Western Hospital, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada., Darmani G; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada., Harmsen IE; Toronto Western Hospital, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Grippe T; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and The Morton & Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada., Chen X; Queen's University School of Medicine, Kingston, Ontario, Canada., Yang A; Toronto Western Hospital, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Nasrkhani N; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada., Zeng K; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada., Chen R; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and The Morton & Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada., Lozano AM; Toronto Western Hospital, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Movement disorders : official journal of the Movement Disorder Society [Mov Disord] 2023 Dec; Vol. 38 (12), pp. 2209-2216. Date of Electronic Publication: 2023 Oct 09.
DOI: 10.1002/mds.29622
Abstrakt: Objective: Low-intensity transcranial focused ultrasound (TUS) is a novel method for neuromodulation. We aimed to study the feasibility of stimulating the bilateral primary motor cortices (M1) with accelerated theta-burst TUS (a-tbTUS) on neurophysiologic and clinical outcomes in Parkinson's disease (PD).
Methods: Patients were randomly assigned to receive active or sham a-tbTUS for the first visit and the alternate condition on the second visit, at least 10 days apart. a-tbTUS was administered in three consecutive sonications at 30-minute intervals. We used an accelerated protocol to produce an additive effect of stimulation. Patients were studied in the OFF-medication state. Transcranial magnetic stimulation (TMS)-elicited motor-evoked potentials (MEPs) were used to assess motor cortical excitability before and after TUS. Clinical outcomes after a-tbTUS administration were assessed using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS)-III.
Results: A total of 20 visits were conducted in 10 PD patients. Compared to the baseline, TMS-elicited MEP amplitudes significantly increased following active but not sham sonication (P = 0.0057). MEP amplitudes were also higher following a-tbTUS than sham sonication (P = 0.0064). There were no statistically significant changes in MDS-UPDRS-III scores with active or sham a-tbTUS.
Conclusions: a-tbTUS increases motor cortex excitability and is a feasible non-invasive neuromodulation strategy in PD. Future studies should determine optimal dosing parameters and the durability of neurophysiologic and clinical outcomes in PD patients. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
(© 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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