A Systematic Review Comparing Radiofrequency versus Focused Ultrasound Pallidotomy in the Treatment of Parkinson's Disease.

IF 1.9 4区医学 Q3 NEUROIMAGING Stereotactic and Functional Neurosurgery Pub Date : 2024-08-22 DOI:10.1159/000539911

Jennifer A Guidera, Sravani Kondapavulur, Doris D Wang

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Abstract

Introduction: Focused ultrasound (FUS) pallidotomy is a promising new therapy for Parkinson's disease (PD). The efficacy, motor outcomes, and side effects of FUS pallidotomy compared to radiofrequency (RF) pallidotomy are unknown.

Methods: We performed a systematic review of the outcomes and side effect profiles of FUS versus RF pallidotomy in patients with PD.

Results: Across four RF reports and one FUS report, putative contralateral UPDRS III scores were not significantly different following RF versus FUS pallidotomy. Across 18 RF and 2 FUS reports, the mean failure rate was 14% following RF pallidotomy versus 24% following FUS pallidotomy. Across 25 RF and 3 FUS reports, cognitive deficit was significantly more prevalent following RF pallidotomy (p = 0.004).

Conclusion: At present, limited data and heterogeneity in outcome reporting challenges comparisons of FUS and RF pallidotomy efficacy and safety. Available evidence suggests FUS pallidotomy may have broadly similar efficacy and a lower risk of cognitive impairment relative to RF pallidotomy. Standardized reporting of post-lesion outcomes in future studies would improve power and rule out potential confounders of these results.

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比较射频与聚焦超声苍白球切开术治疗帕金森病的系统性综述。

简介聚焦超声（FUS）苍白球切开术是治疗帕金森病（PD）的一种前景广阔的新疗法。与射频（RF）苍白球切开术相比，聚焦超声苍白球切开术的疗效、运动结果和副作用尚不清楚：我们对 PD 患者的 FUS 苍白球切开术与射频苍白球切开术的疗效和副作用进行了系统回顾：结果：在4份RF报告和1份FUS报告中，RF与FUS苍白球切开术后的对侧UPDRS III评分无显著差异。在18份RF报告和2份FUS报告中，RF苍白球切开术的平均失败率为14%，而FUS苍白球切开术的平均失败率为24%。在25份RF和3份FUS报告中，RF苍白球切除术后认知障碍的发生率明显更高（p = 0.004）：目前，有限的数据和结果报告的异质性给 FUS 和 RF 苍白球切开术疗效和安全性的比较带来了挑战。现有证据表明，与射频苍白球切除术相比，FUS苍白球切除术的疗效大致相似，认知功能障碍的风险较低。在未来的研究中，对切除后的结果进行标准化报告将提高研究的有效性，并排除这些结果的潜在混杂因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Stereotactic and Functional Neurosurgery 医学-神经成像

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： ''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.