Ablative Surgery and Deep Brain Stimulation for Parkinson's Disease

Ablative Surgery and Deep Brain Stimulation for Parkinson's Disease AbstractSURGICAL OPTIONS FOR Parkinson's disease (PD) are rapidly expanding and include ablative procedures, deep brain stimulation, and cell transplantation. The target nuclei for ablative surgery and deep brain stimulation are the motor thalamus, the globus pallidus, and the subthalamic nucleus. Multiple factors have led to the resurgence of interest in the surgical treatment of PD: 1) recognition that long-term medical therapy for PD is often unsatisfactory, with patients eventually suffering from drug-induced dyskinesias, motor fluctuations, and variable responses to medication; 2) greater understanding of the pathophysiology of PD, providing a better scientific rationale for some previously developed procedures and suggesting new targets; and 3) use of improved techniques, such as computed tomography- and magnetic resonance imaging-guided stereotaxy and single-unit microelectrode recording, making surgical intervention in the basal ganglia more precise. We review the present status of ablative surgery and deep brain stimulation for PD, including theoretical aspects, surgical techniques, and clinical results. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Ablative Surgery and Deep Brain Stimulation for Parkinson's Disease

Ablative Surgery and Deep Brain Stimulation for Parkinson's Disease

TOPIC REVIEW Ablative Surgery and Deep Brain Stimulation for Parkinson's Disease Philip A. Starr, M.D., Ph.D., Jerrold L. Vitek, M.D., Ph.D., Roy A.E. Bakay, M.D. Departments of Neurosurgery (PAS, RAEB) and N eu ro logy (JLV), Emory University, Atlanta, Georgia SURGICAL O P T IO N S FOR Parkinson's disease (PD) are rapidly expanding and include ablative procedures, deep brain stimulation, and cell transplantation. The target nuclei for ablative surgery and deep brain stimulation are the motor thalamus, the globus pallidus, and the subthalamic nucleus. Multiple factors have led to the resurgence of interest in the surgical treatment of PD: 1) recognition that long-term medical therapy for PD is often unsatisfactory, with patients eventually suffering from drug-induced dyskinesias, motor fluctuations, and variable responses to medication; 2) greater understanding of the pathophysiology of PD, providing a better scientific rationale for some previously developed procedures and suggesting new targets; and 3) use of improved techniques, such as computed tomography- and magnetic resonance imaging-guided stereotaxy and single-unit microelectrode recording, making surgical intervention in the basal ganglia more precise. We review the present status of ablative surgery and deep brain stimulation for PD, including theoretical aspects, surgical techniques, and clinical results. (Neurosurgery 43:989-1 01 5, 1998) Parkinson's disease, Stereotactic techniques, Thalamus Keywords: Basal ganglia, Electrical stimulation therapy, Globus pallidus, c e d u r e s s h a r e s i m i l a r t a r g e t s , t e c h n i c a l a p p r o a c h e s , a n d t h e ­ a r k i n s o n ' s d i s e a s e ( P D ) is a p r o g r e s s i v e d e g e n e r a t i v e o r e t i c a l r a t i o n a l e s . d i s e a s e o f t h e b a s a l g a n g l i a . P a t h o l o g i c a l l y , it is c h a r a c ­ T h e r e a r e c u r r e n t l y t h r e e s u b c o r t i c a l t a r g e...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199811000-00001
Publisher site
See Article on Publisher Site

Abstract

AbstractSURGICAL OPTIONS FOR Parkinson's disease (PD) are rapidly expanding and include ablative procedures, deep brain stimulation, and cell transplantation. The target nuclei for ablative surgery and deep brain stimulation are the motor thalamus, the globus pallidus, and the subthalamic nucleus. Multiple factors have led to the resurgence of interest in the surgical treatment of PD: 1) recognition that long-term medical therapy for PD is often unsatisfactory, with patients eventually suffering from drug-induced dyskinesias, motor fluctuations, and variable responses to medication; 2) greater understanding of the pathophysiology of PD, providing a better scientific rationale for some previously developed procedures and suggesting new targets; and 3) use of improved techniques, such as computed tomography- and magnetic resonance imaging-guided stereotaxy and single-unit microelectrode recording, making surgical intervention in the basal ganglia more precise. We review the present status of ablative surgery and deep brain stimulation for PD, including theoretical aspects, surgical techniques, and clinical results.

Journal

NeurosurgeryOxford University Press

Published: Nov 1, 1998

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