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Randomized Controlled Trial
. 2023 Dec;38(12):2209-2216.
doi: 10.1002/mds.29622. Epub 2023 Oct 9.

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

Nardin Samuel #  1 , Mandy Yi Rong Ding #  2 , Can Sarica #  1   2 , Ghazaleh Darmani  2 , Irene E Harmsen  1 , Talyta Grippe  2   3 , Xingyu Chen  4 , Andrew Yang  1 , Negar Nasrkhani  2 , Ke Zeng  2 , Robert Chen  2   3 , Andres M Lozano  1   2
Affiliations
Randomized Controlled Trial

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

Nardin Samuel et al. Mov Disord. 2023 Dec.

Abstract

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.

Keywords: Parkinson's disease; low-intensity focused ultrasound; non-invasive brain stimulation; transcranial magnetic stimulation.

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References

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