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Unilateral radiofrequency subthalamotomy has been shown to improve the cardinal features of Parkinson’s disease (PD).1 However, this approach has not been widely employed because most surgical candidates require bilateral treatment such as deep brain stimulation. Here, we evaluated to what extent the therapeutic impact of unilateral radiofrequency subthalamotomy on the treated body side is maintained years after surgery. This is particularly relevant nowadays because of the newly developed technique of MRI-guided high-intensity focused ultrasound (MRIgFUS). This has been shown to effectively improve essential and parkinsonian tremor by thalamotomy2 and all cardinal features of PD in asymmetrical patients by subthalamotomy.3
Patients and methods
See table 1 for demographic characteristics of the sample (n=7). All patients were recruited and operated on in the Centro Internacional de Restauración Neurologica (CIREN), Havana (Cuba), between 2008 and 2010. Details of the surgical procedure and clinical evaluation have been given previously.1 The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III (Motor Part) was used for scoring. The specific impact of the lesion was evaluated by assessing the motor MDS-UPDRS score of the cardinal motor features for each body side (ie, 3.3 item for rigidity; 3.4–3.8 for bradykinesia and 3.15–3.17 for tremor). Patients were examined in the off medication state (12–18 hours of drug withdrawal) and subsequently re-evaluated after taking their usual levodopa dose. The same neurologists evaluated the patients reported here throughout the study period.
Contributors YR, NP, JM, RMF and JAO analysed the clinical data. YR, RMF and JAO participated in the writing of the first draft of the manuscript. JAO is responsible for the whole content of the article. All authors planned the study, collected the clinical data and have read and agreed with the last version of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval Institutional (CIREN) scientific ethics committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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