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Evaluate the Safety and Effectiveness of Staged Bilateral Exablate Ablation of the Pallidothalamic Tract (PTT) for the Treatment of the Motor Complications of Parkinson's Disease (PD).
Full description
This study is a prospective, open label, single-arm, multi-center clinical trial to establish the safety and effectiveness of bilateral PTTractotomy for the treatment of motor complications in patients with bilateral idiopathic Parkinson's Disease. A maximum of 50 subjects will be treated at up to 10 sites.
Subjects will undergo an Exablate index procedure targeting the PTT and will be seen at 1-week,1-, 3-, and 6- months post treatment. At the 6-month visit, subjects will be evaluated for an Exablate procedure on the other side.
Enrollment
Sex
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Volunteers
Inclusion criteria
Exclusion criteria
Subject where there is suspicion that Parkinsonian symptoms are a side effect from neuroleptic medications.
Subject with significant cognitive impairment as determined by the neuropsychologist.
Subject has other central neurodegenerative disease suspected on neurological examination. These include: multisystem atrophy, progressive supranuclear palsy, corticobasal syndrome, dementia with Lewy bodies, and Alzheimer's disease.
Subject with unstable psychiatric disease, defined as active uncontrolled depressive symptoms, psychosis, delusions, hallucinations, or suicidal ideation
Women of childbearing potential who are pregnant or lactating
Subjects exhibiting any behavior(s) consistent with ethanol or substance abuse
Subject with unstable cardiac status or severe hypertension including:
Subject with history of abnormal bleeding, hemorrhage, or coagulopathy including:
Subject with risk factors for intraoperative or postoperative bleeding as indicated by: platelet count less than 100,000 per cubic millimeter; a documented clinical coagulopathy; or INR coagulation studies exceeding the institution's laboratory standard.
History of intracranial hemorrhage, multiple strokes, or a stroke within past 6 months
Subjects with intracranial aneurysms requiring treatment or arterial venous malformations (AVMs) requiring treatment
Subject is receiving anticoagulant (e.g., warfarin) or antiplatelet (e.g., aspirin) therapy within one week of focused ultrasound procedure or drugs known to increase risk or hemorrhage (e.g., Avastin) within one month of focused ultrasound procedure.
Subject with severely impaired renal function with estimated glomerular filtration rate <30 mL/min/1.73m2 (or per local standards should that be more restrictive) and/or who is on dialysis.
Subjects with a history of seizures within the past year.
Subject with an intracranial brain tumor
Subjects with life-threatening systemic disease that include and not limited to the following will be excluded from the study participation: HIV, liver failure, blood dyscrasias, etc.
Any illness that in the investigator's opinion preclude participation in this study.
Subject with standard contraindications for MR imaging such as implanted metallic devices
Subject who had prior deep brain stimulation of the basal ganglia or thalamus.
Subjects who are unable to tolerate the required prolonged stationary supine position during treatment.
Subject who is participating in another clinical investigation with an active treatment arm in the last 30 days.
Subject who is unable to communicate with the investigator and staff.
Primary purpose
Allocation
Interventional model
Masking
50 participants in 1 patient group
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Data sourced from clinicaltrials.gov
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