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Meta-Analysis
. 2024 Oct;45(10):4687-4698.
doi: 10.1007/s10072-024-07617-2. Epub 2024 Jun 6.

Safety and efficacy of unilateral focused ultrasound pallidotomy on motor complications in Parkinson's disease (PD): a systematic review and meta-analysis

Abdallah Abbas  1 , Malak A Hassan  2 , Rahma Sameh Shaheen  3 , Amna Hussein  4 , Mostafa Hossam El Din Moawad  5   6 , Mostafa Meshref  7 , Ahmed M Raslan  8
Affiliations
Meta-Analysis

Safety and efficacy of unilateral focused ultrasound pallidotomy on motor complications in Parkinson's disease (PD): a systematic review and meta-analysis

Abdallah Abbas et al. Neurol Sci. 2024 Oct.

Abstract

To systematically review and conduct a meta-analysis to evaluate the safety and efficacy of the unilateral focused ultrasound (FUS) pallidotomy on motor complications in Parkinson's disease (PD) patients. A comprehensive search strategy was implemented through August 15, 2023, and updated on February 13, 2024, across six databases, identifying studies relevant to unilateral focused ultrasound pallidotomy and PD. Eligibility criteria included observational studies, clinical trials, and case series reporting on the impact of the intervention on motor complications in PD patients. The screening and data extraction were done by two independent reviewers. Risk of bias assessment utilized appropriate tools for different study designs. Statistical analysis involved narrative synthesis and meta-analysis. Subgroup analyses and leave-one-out analyses were performed. Five studies were included in our study, involving 112 PD patients undergoing FUS pallidotomy. UPDRS-II analysis revealed a significant improvement from baseline (mean difference (MD): -3.205, 95% CI: -4.501, -1.909, P < 0.001). UPDRS-III overall change was significant (MD: -10.177, 95% CI: [-12.748, -7.606], P < 0.001). UPDRS-IV showed a significant change from baseline (MD: -5.069, 95% CI: [-5.915, -4.224], P < 0.001). UDysRS demonstrated a significant overall improvement (MD: -18.895, 95% CI: [-26.973, -10.818], P < 0.001). The effect of FUS pallidotomy on motor complications in PD patients was effective, with a significant decrease in the UPDRS and UDysRS, reflecting improvement. The incidence of adverse events (headaches, pin-site pain, difficulty walking, and sonication-related head pain) of the FUS pallidotomy was not statistically significant, indicating its safety.

Keywords: Focused ultrasound; Meta-analysis; Motor complications; Pallidotomy; Parkinson’s disease.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
Shows the PRISMA flow diagram of the search and screening for the included studies
Fig. 2
Fig. 2
Shows the analysis of UPDRS-II
Fig. 3
Fig. 3
Shows the analysis of UPDRS-III
Fig. 4
Fig. 4
Shows the analysis of UPDRS- IV
Fig. 5
Fig. 5
Shows the analysis of UDysRS
See this image and copyright information in PMC

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