An article from Dr. Jordi Rumià ArboixSenior Specialist in Neurosurgery and expert in Functional and Stereotactic Neurosurgery
The Parkinson’s disease It is the second most frequent neurodegenerative disease in people over 65 years of age, only behind Alzheimer’s disease. According to data from the Spanish Society of Neurology (SEN), Parkinson’s disease affects about 150,000 people in Spain and each year 10,000 new cases are diagnosed. In addition, due to the progressive aging of the population, it is expected that the number of patients doubles in 20 years and triple by 2050.
52% of the people affected take an average of 1 to 5 years from the appearance of the first symptom to being diagnosed and 19% wait more than 5 years to receive the definitive diagnosis, according to the SEN. The main motor symptoms They include tremor at rest, slowness of movement, rigidity, and postural instability. The non-motor symptoms They include difficulty sleeping, loss of smell, constipation, speech disturbances, swallowing problems, and low blood pressure upon standing.
Other symptoms can include mood disorders and cognitive decline, ranging from mild memory difficulties to dementia.
Parkinson’s disease is a chronic and progressive condition. As the disease progresses, patients experience varying degrees of functional disability. In this sense, Parkinson’s has a great impact on the patient’s quality of life and almost doubles their mortality. Although there is currently no cure for Parkinson’s disease, some medications or surgery can substantially improve motor symptoms and the daily quality of life of patients.
Currently, Spain is the sixth country in the Organization for Economic Cooperation and Development (OECD) with the highest number of deaths from Parkinson’s disease. In addition, it involves a very significant economic cost, which can exceed €17,000 per year per patient, a figure that will increase with the aging of the population, according to a report by the Fundación del Cerebro.
To improve the quality of life of patients, it is necessary to comprehensive health care adapted to the needs of your stage of the disease that includes physiotherapy, speech therapy, occupational therapy and psychological support. In this way, with the reduction of tremor, it also improves the quality of life of the patient by reducing medical visits and complementary therapies.
ResoFus, the new therapeutic option without incisions for tremor control
Until now, the drug treatment it was virtually the only therapy to treat motor symptoms of advanced Parkinson’s disease in patients over 70 years of age. In fact, 34% of the direct costs of this disease correspond to the purchase of drugs to improve these symptoms, according to the Fundación Cerebro, a social foundation of the SEN. On the other hand, the neurosurgical treatment usual through deep brain stimulation it is usually dismissed in many patients over 70 years of age, due to the perception of risk involved in elective cranial surgery at that age.
Currently, however, there is a new non-invasive technique: the ResoFUS thalamotomy. ResoFUS noninvasive thalamotomy allows control tremor that does not respond to medication in patients with Parkinson’s disease, without the need for open surgery. Being a closed and bloodless procedure, ResoFUS Thalamotomy is a treatment to consider in elderly people suffering from Parkinson’s disease with tremor.
The ResoFus technology combine Magnetic Resonance images with an Ultrasound emitter of high intensity to interrupt the cerebral circuit of the tremor, achieving reduce tremor by more than 80% in the majority of treated patients. Tremor treatment by ResoFus Thalamotomy does not require any incision, since the ultrasound beams reach the brain without the need for cranial opening. Being a treatment that does not require general anesthesia or cranial opening, the patient does not need to undergo surgery and recovers more quickly. The treatment is carried out in the Magnetic Resonance system.
As general anesthesia is not required, the medical team can explore the patient’s neurological status throughout the treatment. On the other hand, as the treatment is carried out in Magnetic Resonance, it allows visualize the patient’s brain throughout the procedure. The possibility of monitoring the state of the patient and visualizing his brain in real time, allows to achieve a very high level of securityreducing the risk of permanent undesirable effects due to damage to the surrounding brain.
All of this makes ResoFus thalamotomy a therapeutic option to consider in elderly patients with drug-resistant tremor. At a national and international level, it has positioned itself as a benchmark in this technology. Since 2014 they have successfully treated more than 70 national and foreign patients, becoming pioneers and experts in this technique.