Objective: The aim of our study is to present the results of 20 PD patients treated with magnetic resonance guided focused ultrasound thalamotomy (MRgFUS) with the use of modern digital technologies under online supervision.

Background: MRgFUS is a FDA-approved treatment for refractory essential tremor and tremor dominant form of Parkinson’s disease (PD). Intelligent Neurosurgery Clinic in Ufa (Russia) is the first medical center adopting MRgFUS to cure movement disorders in Russia. Due to the new coronavirus epidemic, the company specialists (Insightec) were not able to be on the site to start the first treatment procedures. The decision to treat all patients remotely with the help of modern digital technology came during the collaborative work.

Method: MRgFUS therapies require difficult installation with the help of the company specialists. The new coronavirus epidemic put the limitations to start the treatment procedures. The medical center requested to start the therapies by inline supervision. One week online training was conducted. Secured VNC access was organized to the equipment, Remote Desktop Sharing, and Port Address Translation allowed the use of the working station by all participants, four videoconference cameras were installed in MRI rooms, Microsoft Teams program was used for the online communication. All 20 PD patients (13 male, 7 female), mean age 61,25±11,82 years (range, 38-81) with a mean PD duration of 7,55±6,07 years (range, 2–30) and mean stage Hean-Yar 2,45±0,96 were treated under remote collaborative work. The procedures were performed in a 1.5T MR imaging system (GE Optima 450, GE Healthcare, USA) using the ExAblate 4000 (InSightec, Israel). PD symptoms were estimated using of MDS-UPDRS scale (parts III).

Results: Patients’ data according to MDS-UPDRS changed from 41,15±15,69 to 29,53±13,69 (reduction is 28,24%) with tremor and rigidity decrease immediately after the final sonication. These effects were sustained for at least 6 months. The side effects were headache (n=7), gait disturbancy (n=2), numbness (n=4).

Conclusion: Despite the COVID infection limitations innovative digital technologies allow patients’ to have high-quality medical care. Our experience shows that even very difficult neurosurgical procedures can be performed with a good result after proper preparation and education under online supervision. Supportive teamwork from both sides is achievable.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/first-in-history-mrgfus-treatment-procedures-remote-start-and-successful-treatment-of-pd-patients-due-to-covid-19-epidemic/