Abstract Details

Title Effectiveness and Safety of Magnetic Resonance-guided Focused Ultrasound Subthalamotomy and Pallidotomy for Parkinson’s Disease: A Systematic Review and Meta-analysis

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 13-002

Objective Magnetic resonance–guided focused ultrasound (MRgFUS) has emerged as a noninvasive alternative to deep brain stimulation (DBS) for Parkinson’s disease (PD). Although the subthalamic nucleus (STN) and globus pallidus internus (GPi) are well-established surgical targets, their relative effectiveness and safety when treated with MRgFUS have not been clearly defined.

Background

MRgFUS is a noninvasive alternative to DBS for Parkinson’s disease, but the optimal neural target and comparative outcomes remain uncertain.

Design/Methods

A systematic review and meta-analysis was conducted in accordance with PRISMA and Cochrane guidelines. CENTRAL, PubMed, Web of Science, and Scopus were searched through May 2025 for studies assessing MRgFUS targeting the STN or GPi in patients with PD. Key outcomes included motor and functional performance using the Unified Parkinson’s Disease Rating Scale (UPDRS), levodopa-equivalent daily dose (LEDD), and adverse events (AEs). Random-effects models were used to calculate pooled mean differences (MD) with 95% confidence intervals (CI).

Results Nine studies with 135 patients, including two randomized controlled trials, were included. Both STN and GPi lesioning produced significant motor improvement at 6 months. Off-medication UPDRS-III improved by –13.39 after STN and –8.09 after GPi. On-medication scores improved with STN (–7.89), while GPi showed no significant change. Functional scores (UPDRS-II) improved with both targets, whereas motor complication scores (UPDRS-IV) improved more with GPi (–5.04 vs –1.31). STN lesioning led to a significant reduction in LEDD (–100.25 mg), whereas GPi did not. Adverse event patterns differed: GPi was more commonly associated with dyskinesia, gait disturbance, and dysarthria, while STN was linked to dizziness and headaches.

Conclusions

Both STN- and GPi-targeted MRgFUS demonstrate meaningful short-term clinical benefits in Parkinson’s disease. STN lesioning appears superior in reducing dopaminergic medication requirements, whereas GPi lesioning more effectively mitigates motor complications. These findings underscore the need for head-to-head randomized trials to establish the optimal target, clarify long-term efficacy and safety.

Authors/Disclosures
Abdallah Abbas, MD PRESENTER	Dr. Abbas has nothing to disclose.
Basant Lashin, MD	Dr. Lashin has nothing to disclose.
Haneen Sabet, MD	Dr. Sabet has nothing to disclose.
Moaz E. Abouelmagd, MD	Dr. Abouelmagd has nothing to disclose.
Mahmoud T. Hefnawy, MD (Zagazig University Faculty Of Medicine)	Dr. Hefnawy has nothing to disclose.
Salma Bakr, MD	Dr. Bakr has nothing to disclose.
Mohamed A. Zanaty	Mohamed A. Zanaty has nothing to disclose.
Mohamed El Moslemani, MD	Dr. El Moslemani has nothing to disclose.
Mohamed M. Mohsen Helal	Dr. Mohsen Helal has nothing to disclose.
Ahmed Negida, MD, PhD (Virginia Commonwealth University)	Dr. Negida has nothing to disclose.
Ahmed Raslan, MD, MBBS	Mr. Raslan has nothing to disclose.

��ɫ��

��ɫ��