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Parkinson's Disease Innovations | Open Access Journals
Molecular and Genetic Medicine

Molecular and Genetic Medicine

ISSN: 1747-0862

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Parkinson's Disease Innovations

Parkinson's disease (PD) surgery was introduced in the 1930s and has undergone many adaptations as physicians have acquired knowledge, skills and experience. Early pallidotomy and thalamotomy procedures created irreversible damage - with varying levels of precision - by arterial ligation, thermal or chemical destruction, or radiofrequency ablation. Although not curative, the thalamotomy had a dramatic effect on the tremors, and the pallidotomy was variably effective for rigidity, bradykinesia and dystonia. However, with the widespread use of levodopa in the late 1960s, injury procedures declined sharply. Over time, the motor complications associated with the chronic use of levodopa, combined with improved techniques have renewed interest in surgical procedures.1 Thalamotomy and pallidotomy are still practiced in some cases, but they ultimately been exceeded by adjustable neurostimulation.

Deep brain stimulation (DBS), which essentially mimics a lesional effect, was approved by the FDA for PD in 2002 and quickly became the most common surgical procedure for Parkinson's disease.2,3 In the appropriate candidate - a person suffering from a moderate illness who remains sensitive to levodopa but suffers from debilitating complications (motor fluctuations or dyskinesia) - it can be extremely beneficial.

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