MR-guided Focused Ultrasound Plus GCase

Who May Qualify: - Men or women between age 35 and 80 years, inclusive. - Able and willing to give willing to sign a consent form. - Diagnosis of PD satisfying MDS Clinical Diagnostic Criteria for PD - At least 2 years from initial diagnosis - Hoehn and Yahr Stage 1-3 on PD medication - Dopaminergic deficit by a positive DAT SPECT scan - On stable regimen of PD medications for at least 90 days prior to the study - American Society of Anesthesiologists (ASA) score 1-3 - Harbor at least one GBA mutation if enrolled in the GBA PD arm or two wild-type GBA alleles if enrolled in the idiopathic PD arm Who Should NOT Join This Trial: - Positive pregnancy test (for pre-menopausal women). - Contraindication to DEFINITY ultrasound contrast agent or perflutren (e.g. hypersensitivity, known left or bidirectional cardiac shunt) - Contraindication to MRI or gadolinium-DTPA (e.g. incompatible device, hypersensitivity) - Insulin-dependent diabetes mellitus that is not well-controlled or that in the Investigator's opinion precludes participation in the study. - Severely impaired renal function with estimated glomerular filtration rate \<30 mL/min/1.73m2 and/or on dialysis. - Currently participating in another clinical therapeutic trial - Patient receiving bevacizumab (Avastin) therapy - Subjects with evidence of cranial or systemic infection. - Cerebral or systemic vasculopathy. - Documented cerebral infarction within the past 12 months or TIA in the past 1 month. - Contraindication to GCase enzyme therapy, specifically previous hypersensitivity reaction to GCase enzyme therapy - Parkinsonism plus symptoms, secondary parkinsonism - Previous neurosurgical procedure for PD Always talk to your doctor about whether this trial is right for you.