SYSTEMATIC REVIEW article
Front. Neurosci.
Sec. Translational Neuroscience
Effectiveness and Safety of Magnetic Resonance-Guided Unilateral Focused Ultrasound Subthalamotomy for Parkinson's Disease: A Systematic Review and Meta-Analysis of Prospective Studies
Provisionally accepted
- 1Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- 2North Sichuan Medical College, Nanchong, China
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Background: Patients with asymmetric, medication-refractory Parkinson's disease (PD) often continue to experience disabling motor symptoms despite optimized pharmacological management. Magnetic resonance-guided focused ultrasound subthalamotomy (FUS-STN) has recently emerged as a promising, non-invasive alternative for improving motor function. However, its overall clinical efficacy and long-term safety remain subjects of active investigation. Methods: We systematically searched PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov from inception to November 30, 2024. Prospective studies assessing unilateral FUS-STN in PD were included. Data were pooled using RevMan 5.3 for mean differences (MD) with 95 % confidence intervals (CI). Results: Four prospective studies (n = 69) were included. Unilateral FUS-STN significantly reduced Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), part III scores for the treated hemibody in off-medication (MD = –11.01, 95% CI [–12.23, –9.80], p < 0.001) and on-medication states (MD = –6.51, 95% CI [–7.57, –5.42], p < 0.001). MDS-UPDRS II (MD = – 3.05, p < 0.01) and 39-item Parkinson's disease questionnaire summary index (PDQ-39SI) scores (MD = –6.99, p < 0.01) also improved. Levodopa equivalent daily dose (LEDD) was reduced short-term (MD = –149.5mg, p < 0.001), though attenuated at 12 months (p = 0.09). No significant improvement was observed in MDS-UPDRS IV scores (MD = –3.29, p = 0.64). In all included studies, adverse events (AEs) were frequent during and after procedure, such as postoperative gait and speech disturbance, facial asymmetry, and dyskinesia. However, most AEs were resolved during the 6-12 months follow-up period. Conclusions: Unilateral FUS-STN may offer symptomatic benefits and a general safety profile for selected patients with asymmetric PD. Future investigations should emphasize large-scale, longitudinal, multicenter, and symptom-specific randomized controlled trials to assess the long-term benefits and risks of unilateral FUS-STN in PD patients.
Keywords: Parkinson's disease, MRgFUS, Subthalamotomy, Treatment, Meta-analysis
Received: 26 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Cheng, Luo, Xiao, Che, Zhu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shushan Zhang, susan448@163.com
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