Newsletter

A word from Kara Doctor, M.S., PT

Treatment Options for People with Parkinson’s Disease.

My name is Kara Doctor, I am a physical therapist by trade. I have been working with people with PD since 1997. Through the years I have had the opportunity to be directly involved with various treatments for PD, primarily medication options and deep brain stimulation (DBS) as a surgical option. I have most recently been working for a company called Insightec, they offer MRI guided Focused Ultrasound (MRgFUS) as a nonsurgical, noninvasive treatment option for tremor dominant PD, and very recently FDA approved for treatment of the rigid, akinetic type of PD.

The beauty of the time we live in for PD is the multitude of options. Over the past decade, there has been a great influx of medications for PD, including extended release drugs to reduce off cycling, quick acting medications for bridging the gap between medication on and off times and, an enteral suspension of carbidopa-levodopa delivered directly to the small intestine.

DBS patient selection, options, imaging and outcomes have very much improved over the last 20 years. There is now a strict patient selection criterion, ensuring proper patients are identified for treatment. Along with that, there are more options now, including directional leads, rechargeable battery options, Brain Sensing capabilities and MRI conditionality. Over the years, DBS has slowly become the standard of care once people begin to experience motor fluctuations, known as on/off cycling with their medications. Having worked for a movement disorder specialist for 10 years, as well as a DBS company, I have seen the tremendous benefits that DBS can offer people with PD, as well as their families and carepartners.

Sadly, due to a multitude of reasons, DBS is tremendously underutilized, only used for approximately 7-8.5 % of those affected by PD.

That is why I am so excited about the option of MRI guided Focused Ultrasound (MRgFUS) as another treatment offering for those living with PD. MRgFUS was approved by the FDA in 2016 and it has quickly become a viable option for tremor dominant PD. The beautiful nature of this option is that it is incisionless, it is completed in an MRI suite, not an OR. There are no burr holes drilled and no anesthesia used. The treatment is a day procedure, meaning the person can leave that same day and the results are immediate. With this technology from Insightec, neurosurgeons are able to treat deep in the brain with no surgical incisions. Sound waves pass safely through the patient’s skull to heat and precisely ablate (destroy) the target cells responsible for PD symptoms. No hardware is implanted, the procedure takes approximately 2 hours.

It is an exciting time and brilliant technology!

If you would like more information on focused ultrasound, please visit Insightec.com. You can also view a patient's before and after procedure.

Feel free to contact me directly if you have any questions.


Kara Doctor M.S., PT
Clinical Account Manager, Insightec
Board Member, CAPS
[email protected]
(210) 336-3457