Amidst the challenges of the pandemic, a ray of hope shines brightly in the medical field with the introduction of the High-Intensity Focused Ultrasound (HIFU), also known as Magnetic Resonance guided Focused Ultrasound (MRgFUS), as a groundbreaking treatment for Parkinson’s Disease in the Philippines.
The HIFU, a therapeutic technique that uses non-ionizing ultrasonic waves to ablate tissues in the brain with no cutting of the skin or skull, marks a significant milestone in the fight against the degenerative neurological disorder known as X-Linked Dystonia Parkinsonism (XDP) or Lubag. XDP is a severe neurodegenerative disease that primarily affects males in their fourth or fifth decade of life with early symptoms of focal dystonia and tremors, followed by parkinsonism and other motor and cognitive impairments. It has long affected individuals with maternal ancestry to Panay Islands.
Researchers from the UP Manila National Institutes of Health’s Institute of Human Genetics, led by Dr. Eva Maria C. Cutiongco-Dela Paz, have been working with the Collaborative Center for X-Linked Dystonia-Parkinsonism and Philippine Genome Center to study the epidemiology of XDP. Their goal is to gain a comprehensive understanding of the prevalence of the genetic cause of XDP which is believed to be a founder mutation originating in the Panay Islands population.
At the Philippine General Hospital, PGH Director and Neurosurgery Chief Dr. Gerardo Legaspi has been leading the extensive research in exploring the possibility of HIFU as a cure for XPD. He highlighted the progressive nature of XDP and Parkinson’s Disease, rendering patients increasingly reliant on others and impacting their ability to swallow or breathe properly.
In 2021, the UP-PGH acquired the first magnetic resonance HIFU unit in the Philippines. Magnetic resonance imaging is used to identify and target the treated tissue, guide and control the treatment in real time, and confirm the effectiveness of the treatment. Initially approved for treating tremors associated with Parkinsonism, PGH researchers are exploring its potential to treat Parkinson’s Disease and related psychiatric conditions linked to Lubag.
The HIFU treatment process has shown remarkable efficiency, with patients experiencing relief from tremors and involuntary movements within just two to three hours of admission to the magnetic resonance imaging unit.
“We started doing HIFU lesioning procedures for XDP this year at the PGH. This is an ongoing clinical trial approved by our IRB and registered at clinicaltrials.gov,” Dr. Jose Francisco “Jett” Aguilar, PGH neurologist, stated during the Stop C.O.V.I.D. Deaths Webinar #155 held on July 21, 2023. He stressed that initial data from their study shows significant improvement in the dystonia scores of up to 81%. These initial results indicate that HIFU lesioning could be beneficial for XPD.
“Not all tremors are Parkinson’s, since you need the other associated manifestations to make a diagnosis. If you are interested in getting evaluated, you should go to the neurologist and have yourself evaluated so you can get a proper diagnosis,” urged Dr. Carissa Paz C. Dioquino, PGH Department of Neurosciences chairperson.
For those interested in HIFU treatment, PGH offers initial screening through its website, www.treatyourtremor.com. Eligible patients are then scheduled for treatment, with charity cases receiving the treatment free of charge. The availability of HIFU treatment in the Philippines significantly reduces costs (compared to having the treatment abroad), making this modality accessible and affordable even for private patients.
Charmaine A. Lingdas
