Ablative and Stimulation Procedures: Techniques and Outcome

Roy A. E. Bakay

doi:10.1055/s-2001-17126

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Seminars in Neurosurgery 2001; 12(2): 195-212
DOI: 10.1055/s-2001-17126

Ablative and Stimulation Procedures: Techniques and Outcome

Roy A. E. Bakay

Rush Presbyterian-St. Luke's Medical Center, Chicago Institute of Neurosurgery and Neuroresearch, Chicago, IL

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Publication Date:
13 September 2001 (online)

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ABSTRACT

There are four basic approaches for the treatment of Parkinson's disease (PD). Ablative surgery is the oldest and best understood. Deep brain stimulation (DBS) is relatively new and is still being evaluated. Target nuclei for ablative surgery and DBS are the motor thalamus, the globus pallidus, and the subthalamic nucleus. Neurotransplantation as replacement therapy has recently undergone a proof of principle but still is not fully accepted. The newest surgical approach is protective therapy where innovative techniques are still being developed. Although this has the greatest promise for the future, it also has the greatest number of technical hurdles to overcome before it can become standard therapy. The present status of ablative and stimulation surgical interventions for PD is reviewed and clinical results discussed.

KEYWORD

Basal ganglia - stereotactic surgery - electrical stimulation therapy - globus pallidus - thalamus - subthalamic nucleus - Parkinson's disease - movement disorders

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