ExAblate Pallidotomy for Medically-Refractory Dyskinesia Symptoms or Motor Fluctuations of Advanced Parkinson's Disease

NCT ID: NCT03319485

Last Updated: 2026-01-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

92 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-09

Study Completion Date

2026-08-31

Brief Summary

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Evaluate the safety and efficacy of unilateral focused ultrasound pallidotomy using the ExAblate 4000 System in the management of dyskinesia symptoms or motor fluctuations for medication refractory, advanced idiopathic Parkinson's disease.

Detailed Description

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The goal of this prospective, two-arm, sham-controlled, randomized, multi-center pivotal study is to evaluate the safety and efficacy of unilateral focused ultrasound pallidotomy using the ExAblate 4000 System in the management of dyskinesia symptoms or motor fluctuations for medication refractory, advanced idiopathic Parkinson's disease.

Conditions

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Parkinson Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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ExAblate Pallidotomy

ExAblate treatment for Advanced Idiopathic Parkinson's Disease

Group Type EXPERIMENTAL

ExAblate Pallidotomy

Intervention Type DEVICE

ExAblate Pallidotomy for Parkinson's Disease

Sham ExAblate Pallidotomy

Sham (fake) treatment

Group Type SHAM_COMPARATOR

Sham ExAblate Pallidotomy

Intervention Type DEVICE

ExAblate MRgFUS Sham Procedure

Interventions

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ExAblate Pallidotomy

ExAblate Pallidotomy for Parkinson's Disease

Intervention Type DEVICE

Sham ExAblate Pallidotomy

ExAblate MRgFUS Sham Procedure

Intervention Type DEVICE

Other Intervention Names

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MRgFUS Pallidotomy

Eligibility Criteria

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Inclusion Criteria

1. Men and women, age 30 years and older.
2. Subjects who are able and willing to give informed consent and able to attend all study visits through 12 Months.
3. Subjects with a diagnosis of idiopathic PD by UK Brain Bank Criteria as confirmed by a movement disorder neurologist at the site.
4. Levodopa responsive as defined by at least a 30% reduction in MDS-UPDRS motor subscale in the ON vs OFF medication state.
5. MDS-UPDRS score of ≥ 20 in the meds OFF condition OR Motor complications of PD on optimum medical treatment .
6. Subjects should be on a stable dose of all PD medications for 30 days prior to study entry as determined by medical records.
7. Subject is able to communicate sensations during the ExAblate procedure.
8. Subjects on stable antidepressant medications for at least 3 months

Exclusion Criteria

1. Hoehn and Yahr stage in the ON medication state of 3 or greater.
2. Presence of 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.
3. Any suspicion that Parkinsonian symptoms are a side effect from neuroleptic medications.
4. Subjects who have had deep brain stimulation or a prior stereotactic ablation of the basal ganglia.
5. Presence of significant cognitive impairment using MMSE ≤ 24.
6. Unstable psychiatric disease, defined as active uncontrolled depressive symptoms, psychosis, delusions, hallucinations, or suicidal ideation.
7. Subjects with an active alcohol or drug dependency or history of drug/alcohol abuse within the past year
8. Subjects with unstable cardiac status
9. Severe hypertension (diastolic BP \> 100 on medication).
10. Current medical condition resulting in abnormal bleeding and/or coagulopathy.
11. 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.
12. Subjects 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
13. Patient with kidney disease or on dialysis.
14. Subjects with standard contraindications for MR imaging
15. Significant claustrophobia that cannot be managed with mild medication.
16. Subjects who weigh more than the upper weight limit of the MR scanner table and who cannot fit into the MR scanner.
17. Subjects who are not able or willing to tolerate the required prolonged stationary supine position during treatment.
18. History of intracranial hemorrhage, multiple strokes, or a stroke within past 6 months.
19. Subjects with a history of seizures within the past year.
20. Subjects with brain tumors.
21. Subjects with intracranial aneurysms requiring treatment or arterial venous malformations (AVMs) requiring treatment.
22. Are participating or have participated in another clinical trial in the last 30 days.
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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InSightec

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Stanford University Medical Center

Stanford, California, United States

Site Status

Palm Beach Neuroscience Institute/Sperling Medical Group

Boynton Beach, Florida, United States

Site Status

University of Maryland Medical System

Baltimore, Maryland, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

New York University Health Langone

New York, New York, United States

Site Status

Weill Cornell Medicine

New York, New York, United States

Site Status

The Ohio State Wexner Medical Center

Columbus, Ohio, United States

Site Status

Pennsylvania Hospital Department of Neurosurgery

Philadelphia, Pennsylvania, United States

Site Status

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

Swedish Medical Center

Seattle, Washington, United States

Site Status

Toronto Western Hospital

Toronto, Ontario, Canada

Site Status

Rambam Health Care

Haifa, , Israel

Site Status

Fondazione IRCCS Neurological Institute Carlo Besta

Milan, , Italy

Site Status

Azienda Ospedaliera Universitaria di Verona, Univerista di Verona

Verona, , Italy

Site Status

Severance Hospital, Yonsei University Health System

Seoul, , South Korea

Site Status

CINAC-Hospital HM Puerta del Sur

Móstoles, Madrid, Spain

Site Status

Clinica Universidad De Navarra

Pamplona, Navarre, Spain

Site Status

Chang Bing Show Chwan Memorial Hospital

Changhua, , Taiwan

Site Status

St. Mary's Hospital

London, , United Kingdom

Site Status

Countries

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United States Canada Israel Italy South Korea Spain Taiwan United Kingdom

References

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Krishna V, Fishman PS, Eisenberg HM, Kaplitt M, Baltuch G, Chang JW, Chang WC, Martinez Fernandez R, Del Alamo M, Halpern CH, Ghanouni P, Eleopra R, Cosgrove R, Guridi J, Gwinn R, Khemani P, Lozano AM, McDannold N, Fasano A, Constantinescu M, Schlesinger I, Dalvi A, Elias WJ. Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson's Disease. N Engl J Med. 2023 Feb 23;388(8):683-693. doi: 10.1056/NEJMoa2202721.

Reference Type DERIVED
PMID: 36812432 (View on PubMed)

Other Identifiers

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PD006

Identifier Type: -

Identifier Source: org_study_id

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