Interventional procedure overview of MRI-guided focused ultrasound subthalamotomy for treating Parkinson's

Indications and current treatment

Parkinson's is a progressive neurodegenerative condition that damages the brain over many years. It is caused by loss of cells in the brain that produce dopamine, which help control and coordinate body movements. People with Parkinson's usually have symptoms and signs described as 'parkinsonism'. These include bradykinesia (slow movements), rigidity, rest tremor (shaking) and postural instability (loss of balance). In later stages of Parkinson's 'non-motor' symptoms develop such as depression, cognitive impairment, dementia and autonomic dysfunction. Symptoms may progress to cause significant impairments, adversely affecting quality of life and, indirectly, the quality of life of family and carers.

Drug treatments for early Parkinson's include levodopa, other dopamine agonists and monoamine oxidase B inhibitors. In later stages, other drugs may be used with levodopa (as adjuvants) to reduce the motor complications associated with prolonged levodopa use. Non-pharmacological management includes physiotherapy, occupational therapy and speech and language therapy. Invasive surgical procedures may be considered in patients refractory to medical and supportive therapies. These include deep brain stimulation and, less commonly, radiofrequency thalamotomy. Treatments may also be offered for non-motor symptoms such as sleep disturbance and depression.