Guidance

1 Recommendations

1 Recommendations

1.1

More research is needed on MRI-guided focused ultrasound subthalamotomy for treating Parkinson's before it can be used in the NHS.

1.2

This procedure should only be done as part of a formal research study and a research ethics committee needs to have approved its use.

What research is needed

1.3

More research in the form of suitably-powered randomised controlled trials or prospective cohort studies, and safety data from a registry, is needed on:

  • patient selection, including severity of condition and symptoms

  • the site of the lesion for this procedure

  • the technique used

  • long-term outcomes

  • safety outcomes.

Why the committee made these recommendations

There is little evidence on the efficacy and safety of this procedure, including only 1 small randomised controlled trial. The evidence suggests the procedure may reduce Parkinson's symptoms including tremor. But the evidence is short-term and comes mainly from only 1 centre. So, the benefits of this procedure are unclear.

The evidence is mostly for advanced Parkinson's in people who had not had symptoms for long. They were also younger than most people with Parkinson's having treatment in the NHS. So, it is unclear who might benefit from this procedure.

This procedure also has the potential for serious complications. So, it can only be used in research.