Department of Neurological Surgery, UCSF, San Francisco, California, USA,
Medical Scientist Training Program, UCSF, San Francisco, California, USA,
Stereotact Funct Neurosurg. 2024;102(5):325-342. doi: 10.1159/000539911. Epub 2024 Aug 22.
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.
We performed a systematic review of the outcomes and side effect profiles of FUS versus RF pallidotomy in patients with PD.
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).
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.
聚焦超声（FUS）苍白球切开术是一种有前途的治疗帕金森病（PD）的新方法。与射频（RF）苍白球切开术相比，FUS 苍白球切开术的疗效、运动结果和副作用尚不清楚。
我们对 FUS 与 RF 苍白球切开术治疗 PD 患者的疗效和副作用进行了系统评价。
在 4 项 RF 报告和 1 项 FUS 报告中，RF 与 FUS 苍白球切开术后的假定对侧 UPDRS III 评分无显著差异。在 18 项 RF 和 2 项 FUS 报告中，RF 苍白球切开术后的平均失败率为 14%，而 FUS 苍白球切开术后为 24%。在 25 项 RF 和 3 项 FUS 报告中，RF 苍白球切开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使得比较 FUS 和 RF 苍白球切开术的疗效和安全性具有挑战性。现有证据表明，与 RF 苍白球切开术相比，FUS 苍白球切开术可能具有相似的疗效和较低的认知障碍风险。在未来的研究中，标准化报告损伤后结果将提高研究的效能，并排除这些结果的潜在混杂因素。
