The Surgical Treatment of Parkinson's Disease

• Published in: Annual review of medicine Vol. 51; no. 1; pp. 135 - 147
• Main Author: Follett, Kenneth A
• Format: Journal Article
• Language: English
• Published: Palo Alto, CA 94303-0139 Annual Reviews 01.01.2000; 4139 El Camino Way, P.O. Box 10139 Annual Reviews, Inc; USA
• Subjects: Biological and medical sciences; deep brain stimulation; Electric Stimulation Therapy; Humans; Medical sciences; movement disorder; Neurosurgery; Neurosurgical Procedures - methods; pallidotomy; Parkinson Disease - physiopathology; Parkinson Disease - surgery; Parkinson's disease; Skull, brain, vascular surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; thalamotomy; Thalamus - surgery; Human; Nervous system diseases; Indication; Parkinson disease; Surgical resection; Transplantation; Review; Homotransplantation; Pallidum; Cerebral disorder; Physical handicap; Galvanic vestibular test; Surgery; Central nervous system disease; Thalamus; Degenerative disease; Technique; Gene therapy; Extrapyramidal syndrome
• ISSN: 0066-4219; 1545-326X
• DOI: 10.1146/annurev.med.51.1.135

Surgical treatment of Parkinson's disease (PD) can provide gratifying symptomatic improvements for many individuals who suffer from persistent disabling symptoms despite the best available medical management. Current surgical therapies include ablative techniques (thalamotomy and pallidotomy), augmentative techniques (nondestructive) (deep brain stimulation), and restorative techniques (tissue transplantation and gene therapy). Ablative procedures can provide substantial clinical benefit, but the current trend is toward deep brain stimulation, which can provide similar symptomatic improvement in a nondestructive manner. Restorative techniques, such as tissue transplantation and gene therapy, are exciting but have significant obstacles to overcome before their promise can be realized. Until the underlying pathological defect of PD can be identified and treated, surgical intervention is likely to remain important in the symptomatic treatment of this disabling disease.