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

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    Outcome measures

    MDS-UPDRSis a comprehensive 50 question assessment of both motor and non-motor symptoms and complications associated with Parkinson's. It is used to evaluate various aspects of Parkinson's, monitor progression and response to medications and provide a clinical endpoint in studies. The MDS-UPDRS has 4 sections. These are completed by the person with Parkinson's and their carers, and also by the clinician:

    • Part 1: non-motor experiences of daily living

    • Part 2: motor experiences of daily living

    • Part 3: motor examination

    • Part 4: motor complications.

    MDS–UPDRS part 1 and 2

    Non-motor symptoms and autonomy in functional daily living activities were assessed with parts 1 and 2 of the MDS–UPDRS (scores range from 0 to 52, with higher scores indicating a worse state/greater disability).

    MDS-UPDRS motor score 3

    Motor symptoms were assessed with MDS–UPDRS part 3 (scores range from 0 to 44, with higher scores indicating a worse condition). A change of 30% in the motor score of MDS–UPDRS is considered clinically meaningful. The scale includes subitems for rigidity, akinesia and tremor (scores range from 0 to 8, from 0 to 20, and from 0 to 16, respectively, with higher scores indicating greater severity in all cases). Tremor score can also be derived from the Clinical Rating Scale, which ranges from 0 to 32 for tremor in the hand.

    General motor condition is assessed with total MDS–UPDRS 3 (score ranges from 0 to 132 and includes scores for both the treated and untreated body sides and axial features, with higher scores indicating worse parkinsonism).

    MDS–UPDRS 4

    Motor complicationswere assessed with MDS–UPDRS 4 with scores ranging from 0 to 24 (score 0 to 4 for each item) and with the UDRS (scores ranging from 0 to 104, with a high score indicating frequent and disabling motor complications/dyskinesia). The dyskinesia rating scale has 3 parts: an on-dyskinesia patient questionnaire (scored 0 to 44), an off-dystonia patient questionnaire (scored 0 to 16) and an objective, videotaped evaluation to determine the presence and impact of dyskinesia or dystonia during the performance of different tasks such as communication, dressing, drinking from a glass and walking (scored 0 to 44).

    Quality of life

    Evaluated using the PDQ-39SI with scores ranging from 0 to 100, with a higher score indicating a worse quality of life.

    Patients' Global Impression of Change (P-GIC) and Clinician's Global Impression of Change (C-GIC)

    Scores ranging from 1 (very much improved) to 7 (very much worsened).