Quote:
Originally Posted by lurkingforacure
1. is this primarily for tremor-dominant PWP?
2. does having this preclude you from other clinical trials down the road like DBS does?
3. what effect does this have on balance, rigidity, mood, sleep, constipation (what am I missing here?)...
4. what are the outcomes of the patient in Canada that had this done and the 7-8 patients in Korea that had this done? That would be very helpful to know!
If anyone knows, please post/share!
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lurking, sounds like they are treating patients that meet the same criteria as DBS but the person in the video sure had severe dyskinesias so maybe that is a requirement, best thing to do is contact the institution. i've read that pallidotomy(?) is widely used in CUBA where DBS is too expensive.
http://neurosurgery.mgh.harvard.edu/...al/pallidt.htm
PALLIDOTOMY
Indications for Pallidotomy
Only patients with treatment-resistant idiopathic Parkinson's disease that have clearly responded to dopamine replacement therapy in the past should be considered candidates for pallidotomy. While many of the cardinal symptoms of PD will respond to pallidotomy, the features of the disease which respond best are drug induced dyskinesias, painful dystonias, marked ON/OFF fluctuations, severe bradykinesia, and rigidity. Symptoms that may improve but do so less reliably are tremor, speech dysfunction and gait disturbance. Postural instabilitiy is rarely if ever helped. The ideal patient is young (< 50 years of age), suffers from asymmetric idiopathic PD and has severe ON/OFF fluctuations with drug induced dyskinesias. Hemidystonia is another indication for pallidotomy which appears to hold promise although the available data is limited.
http://www.fusfoundation.org/disease...nsonian-tremor
Compared to implantation of a deep brain stimulation device, focused ultrasound is a single procedure, and does not require subsequent procedures to replace batteries. It also does not involve the collateral damage to healthy tissue or the risk of blood clots and infections associated with implanting a foreign body.
http://www.parkinson.org/sites/defau...on_Therapy.pdf
Parkinson’s Disease
:
Guide to Deep Brain
Stimulation Therapy
Unlike DBS, pallidotomy should not be performed on both sides of the
brain, and this is one major limitation of this surgery. Performing two pallidotomies can
lead to permanent speech, swallowing, and cognitive problems. Patients with an existing
pallidotomy who require a second surgery will usually have a DBS placed on the opposite side of the brain.
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i think this ultrasound procedure can only be done on 1 side.