Seminars in Neurosurgery 2001; 12(2): 195-212
DOI: 10.1055/s-2001-17126
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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
Further Information

Publication History

Publication Date:
13 September 2001 (online)

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.

REFERENCES

  • 1 Bjorklund A, Lindvall O. Dopamine in dendrites of the substantia nigra neurons: suggestions for a role in dendritic terminals.  Brain Res . 1975;  83 531-537
  • 2 Hornykiewicz O, Kish S J. Biochemical pathophysiology of Parkinson's disease.  Adv Neurol . 1986;  45 19-34
  • 3 Lavoie B, Smith Y, Parent A. Dopaminergic innervation of the basal ganglia in the squirrel monkey as revealed by tyrosine hydroxylase immunohistochemistry.  J Comp Neurol . 1989;  289 36-52
  • 4 Meiback R C, Katzman R. Catecholaminergic innervation of the subthalamic nucleus: evidence for a rostral continuation of the A9 (substantia nigra) dopaminergic cell group.  Brain Res . 1979;  173 364-368
  • 5 Obeso J A, Olanow C W, Nutt J G. Levodopa motor complications in Parkinson's disease.  Trends Neurosci . 2000;  23(suppl) 2-7
  • 6 Laitinen L V, Bergenheim A T, Hariz M I. Leksell's posteroventral pallidotomy in the treatment of Parkinson's disease.  J Neurosurg . 1992;  76 53-61
  • 7 Alterman R L, Stereo D, Beric A, Kelly P J. Microelectrode recording during posterovental pallidotomy: impact on target selection and complications.  Neurosurgery . 1999;  44 315-321
  • 8 Baron M S, Vitek J L, Bakay R AE. Treatment of advanced Parkinson's disease by posterior GPi pallidotomy: 1-year results of a pilot study.  Ann Neurol . 1996;  40 355-366
  • 9 Baron M S, Vitek J L, Bakay R AE. Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4-year results of a pilot study.  Mov Disord . 2000;  15 230-237
  • 10 Ceballos-Baumann A O, Obeso J A, Vitek J L. Restoration of thalamocortical activity after posteroventral pallidotomy in Parkinson's disease.  Lancet . 1994;  344 814
  • 11 De Brie M A R, De Haan J R, Nijssen P CG. Unilateral pallidotomy in Parkinson's disease: a randomized, single-blind, multicentre trial.  Lancet . 1999;  354 1665-1669
  • 12 Dogali M, Fazzini E, Kolodny E. Stereotactic ventral pallidotomy for Parkinson's disease.  Neurology . 1995;  45 753-761
  • 13 Eidelberg D, Moeller J R, Ishikawa T. Regional metabolic correlates of surgical outcome following unilateral pallidotomy for Parkinson's disease.  Ann Neurol . 1996;  39 450-459
  • 14 Favre J, Taha J M, Nguyen T T, Gildenberg P L, Burchiel K J. Pallidotomy: a survey of current practice in North America.  Neurosurgery . 1996;  39 883-890
  • 15 Fazzini E, Dogali M, Stereo D, Eidelberg D, Beric A. Stereotactic pallidotomy for Parkinson's disease: a long-term follow-up of unilateral pallidotomy.  Neurology . 1997;  48 1273-1277
  • 16 Fine J, Duff J, Chen R, Hutchinson W, Lozano A M, Lang A E. Long-term follow-up of unilateral pallidotomy in advanced Parkinson's disease.  N Engl J Med . 2000;  342 1708-1714
  • 17 Freidman J H, Epstein M, Sanes J N. Gamma knife pallidotomy in advanced Parkinson's disease.  Ann Neurol . 1996;  39 535-538
  • 18 Ghika J, Ghika-Schmid F, Fankhauser H. Bilateral contemporaneous posteroventral pallidotomy for the treatment of Parkinson's disease: neuropsychological and neurological side effects: report of four cases and review of the literature.  J Neurosurg . 1999;  91 313-321
  • 19 Giller C A, Dewey R B, Ginsburg M I, Mendelsohn D B, Berk A M. Stereotactic pallidotomy and thalamotomy using individual variations of the anatomic landmarks for localization.  Neurosurgery . 1999;  90 175-177
  • 20 Grafton A T, Waters C, Sutton J, Lew M F, Couldwell W C. Pallidotomy increases activity of motor association cortex in Parkinson's disease: a positron emission tomographic study.  Ann Neurol . 1995;  37 776-783
  • 21 Gross R E, Lombardi W J, Lang A E. Relationship of lesion location to clinical outcome following microelectrode-guided pallidotomy for Parkinson's disease.  Brain . 1999;  122 405-416
  • 22 Gross R E, Lombardi W J, Hutchison W. Variability in lesion location after microelectrode-guided pallidotomy for Parkinson's disease: anatomical, physiological, and technical factors that determine lesion distribution.  J Neurosurg . 1999;  90 468-477
  • 23 Guridi J, Gorospe A, Ramos E, Linazasoro G, Rodriguez M C, Obeso J A. Stereotactic targeting of the globus pallidus internus in Parkinson's disease: imaging versus electrophysiological mapping.  Neurosurgery . 1999;  45 278-287
  • 24 Hariz M I, Bergenheim A T, Fodstad H. Crusade for microelectrode guidance in pallidotomy.  J Neurosurg . 1999;  90 175-177
  • 25 Iacono R P, Shima F, Lonser R R, Kuniyoshi S, Maeda G, Yamada S. The results, indications, and physiology of posteroventral pallidotomy for patients with Parkinson's disease.  Neurosurgery . 1995;  36 1118-1127
  • 26 Iacono R P, Lonser R R, Kuniyoshi S. Unilateral versus bilateral simultaneous posteroventral pallidotomy in subgroups of patients with Parkinson's disease.  Stereotact Funct Neurosurg . 1995;  65 6-10
  • 27 Johansson F, Malm J, Nordh E, Hariz M. Usefulness of pallidotomy in advanced Parkinson's disease.  J Neurol Neurosurg Psychiatry . 1997;  62 125-132
  • 28 Kishore A, Turnbull I M, Snow B J. Efficacy, stability and predictors of outcome of pallidotomy for Parkinson's disease. Six-month follow-up with additional 1-year observations.  Brain . 1997;  120 729-737
  • 29 Krauss J K, Desaloms J M, Lai E C, King D E, Jankovic J, Grossman R G. Microelectrode-guided posteroventral pallidotomy for treatment of Parkinson's disease: postoperative magnetic resonance imaging analysis.  J Neurosurg . 1997;  87 358-367
  • 30 Laitinen L V. Pallidotomy for Parkinson's disease.  Neurosurg Clin N Amer . 1995;  6 105-112
  • 31 Lang A E, Duff J, Saint-Cyr J A. Posteroventral medial pallidotomy in Parkinson's disease.  J Neurol . 1999;  246(suppl) II/28-II/42
  • 32 Lang A E, Lozano A, Montgomery E, Duff J, Tasker R, Hutchinson W. Posteroventral medial pallidotomy in advanced Parkinson's disease.  New Engl J Med . 1997;  337 1036-1042
  • 33 Lang A E, Lozano A, Tasker R, Duff J, Saint-Cyr J, Trépanier L. Neuropsychological and behavioral changes and weight gain after medial pallidotomy [letter].  Ann Neurol . 1997;  41
  • 34 Lozano A, Hutchison W, Kiss Z, Tasker R, Davis K, Dostrovsky J. Methods for microelectrode-guided posteroventral pallidotomy.  J Neurosurg . 1996;  84 194-202
  • 35 Lozano A M, Lang A E, Galvez-Jimenez N. Effects of GPi pallidotomy on motor function in Parkinson's disease.  Lancet . 1995;  346 1383-1387
  • 36 Merello M, Nouzeilles M I, Cammarota A, Betti O, Leiguarda R. Comparison of 1-year follow-up evaluations of patients with indication for pallidotomy who did not undergo surgery versus patients with Parkinson's disease who did undergo pallidotomy: a case control study.  Neurosurgery . 1999;  44 461-467
  • 37 Pal P K, Samii A, Kishore A. Long-term outcome of unilateral pallidotomy: follow-up of 15 patients for 3 years.  J Neurol Neurosurg Psychiatry . 2000;  69 337-344
  • 38 Rand R W, Jacques D B, Melbye R W, Copcutt B G, Fisher M R, Levenick M N. Gamma knife thalamotomy and pallidotomy in patients with movement disorders: preliminary results.  Stereotact Funct Neurosurg . 1993 (suppl 1);  61 (65-92)
  • 39 Samii A, Tumbull I M, Kishore A. Reassessment of unilateral pallidotomy in Parkinson's disease: a 2-year follow-up study.  Brain . 1999;  122 417-425
  • 40 Scott R, Gregory R, Hines N. Neuropyschological, neurological and functional outcome following pallidotomy for Parkinson's disease: a consecutive series of eight simultaneous bilateral and twelve unilateral procedures.  Brain . 1998;  121 659-675
  • 41 Shannon K M, Penn R D, Kroin J S. Stereotactic pallidotomy for the treatment of Parkinson's disease: efficacy and adverse effects at 6 months in 26 patients.  Neurology . 1998;  50 434-438
  • 42 Shima F, Ishido K, Sun S. Surgical control of akinesia in Parkinson's disease.  Eur Neurol . 1996 (suppl 1);  36 (55-61)
  • 43 Sutton J P, Couldwell W C, Lew M F. Ventroposterior medial pallidotomy in patients with advanced Parkinson's disease.  Neurosurgery . 1995;  36 1112-1117
  • 44 Taha J M, Favre J, Baumann T K, Burchiel K J. Tremor control after pallidotomy in patients with Parkinson's disease: correlation with microrecording findings.  J Neurosurg . 1997;  86 642-647
  • 45 Tsao K J, Wilkinson S, Overman J, Koller W C, Batnitzky S, Gordon M A. Pallidotomy lesion locations: significance of microelectrode refinement.  Neurosurgery . 1998;  43 506-512
  • 46 Uitti R J, Wharen R E, Turk M F. Unilateral pallidotomy for Parkinson's disease: comparison of outcome in younger versus older patients.  Neurology . 1997;  49 1072-1077
  • 47 Van Horn G, Hassenbusch S, Zouridakis G, Mullani N, Wilde M, Papanicolaou A. Pallidotomy: a comparison of responders and nonresponders.  Neurosurgery . 2001;  48 263-273
  • 48 Vitek J L, Bakay R AE, DeLong M R. Microelectrode guided GPi pallidotomy for medically intractable Parkinson's disease.  Adv Neurol . 1998;  74 183-198
  • 49 Vitek J L, Bakay R AE, Hashimoto T. Microelectrode-guided pallidotomy: technical approach and application for medically intractable Parkinson's disease.  J Neurosurg . 1999;  88 1027-1043
  • 50 Young R F, Vermeulen S S, Grimm P, Posewitz A. Electrophysiological target localization is not required for the treatment of functional disorders.  Stereotact Funct Neurosurg . 1997 (suppl 1);  66 (309-319)
  • 51 Diederich N, Goetz C G, Stebbins G T. Blinded evaluation confirms long-term asymmetric effect of unilateral thalamotomy or subthalamotomy on tremor in Parkinson's disease.  Neurology . 1992;  42 1311-1314
  • 52 Fox M W, Ahlskog J E, Kelly P J. Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson's disease patients.  J Neurosurg . 1991;  75 723-730
  • 53 Gabriel E M, Nashold B S. Evolution of neuroablative surgery for involuntary movement disorders: an historical review.  Neurosurgery . 1998;  42 575-591
  • 54 Gildenberg P L. Studies in stereoencephalotomy VIII. Comparison of the variability of subcortical lesions produced by various procedures.  Confin Neurol . 1957;  17 299-309
  • 55 Hassler R, Mundinger F, Riechert T. Stereotaxis in Parkinson Syndrome.  New York: Springer-Verlag 1979: 183-196
  • 56 Jankovic J, Cardoso F, Grossman R G, Hamilton W J. Outcome after stereotactic thalamotomy for Parkinsonian, essential, and other types of tremor.  Neurosurgery . 1995;  37 680-687
  • 57 Kelly P J, Gillingham F J. The long-term results of stereotaxic surgery and L-dopa therapy in patients with Parkinson's disease.  J Neurosurg . 1980;  53 332-337
  • 58 Matsumoto K, Shichijo F, Fukami T. Long-term follow-up review of cases of Parkinson's disease after unilateral or bilateral thalamotomy.  J Neurosurg . 1984;  60 1033-1044
  • 59 Mundinger F. Postoperative and long-term results of 1561 stereotactic operations in parkinsonism.  Appl Neurophysiol . 1995;  48 293
  • 60 Narabayashi H, Yokochi F, Nakajima Y. Levodopa-induced dyskinesias and thalamotomy.  J Neurol Neurosurg Psychiatr . 1984;  47 831-839
  • 61 Nagaseki Y, Shibazaki T, Hirai T. Long-term follow-up results of selective VIM-thalamotomy.  J Neurosurg . 1986;  65 296-302
  • 62 Tasker R R, Siqueira J, Hawrylyshyn P, Organ L W. What happened to VIM thalamotomy for Parkinson's disease?.  Appl Neurophysiol . 1983;  46 68-83
  • 63 Wester K, Hauglie-Hanssen E. Stereotaxic thalamotomy-experiences from the levodopa era.  J Neurol Neurosurg Psychiatr . 1990;  53 427-430
  • 64 Alvarez-Gonzalez L, Macias R, Guridi J. Lesion of the subthalamic nucleus in Parkinson's disease: long-term follow-up [abstract].  Ann Neurol . 1999;  46 492
  • 65 Gill S S, Heywood P. Bilateral dorsolateral subthalamotomy for advanced Parkinson's disease [letter].  Lancet . 1997;  50 1224
  • 66 Guridi J, Luquin M R, Herrero M T, Obeso J A. The subthalamic nucleus: a possible target for stereotaxic surgery in Parkinson's disease.  Mov Disord . 1993;  8 421-429
  • 67 Guridi J, Obeso J. The role of the subthalamic nucleus in the origin of hemiballism and parkinsonism: new surgical perspectives.  Adv Neurol . 1987;  74 235-248
  • 68 Obeso J, Alvarez L, Macias R J. Lesion of the subthalamic nucleus (STN) in Parkinson's disease (PD) [abstract].  Neurology . 1997;  48 (suppl) A138
  • 69 Alesch F, Pinter M M, Helscher R J, Fertl L, Benabid A L, Koos W T. Stimulation of the ventral intermediate thalamic nucleus in tremor dominated Parkinson's disease and essential tremor.  Acta Neurochir . 1995;  136 75-81
  • 70 Benabid A L, Pollak P, Gao D. Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.  J Neurosurg . 1996;  84 203-214
  • 71 Blond S, Caparros-Lefebvre D, Parker F. Control of tremor and involuntary movement disorders by chronic stereotactic stimulation of the ventral intermediate thalamic nucleus.  J Neurosurg . 1992;  77 62-68
  • 72 Blond S, Siegfried J. Thalamic stimulation for the treatment of tremor and other movement disorders.  Acta Neurochir . 1991;  52(suppl) 109-111
  • 73 Caparros-Lefebvre D, Blond S, Vermersch P, Pécheux N, Guieu J D, Petit H. Chronic thalamic stimulation improves tremor and levodopa-induced dyskinesias in Parkinson's disease.  J Neurol Neurosurg Psychiatr . 1993;  56 268-273
  • 74 Caparros-Lefebvre D, Blond S, Feltin M P, Pollak P, Benabid A L. Improvement of levodopa induced dyskinesias by thalamic deep brain stimulation is related to slight variation in electrode placement: possible involvement of the centre median and parafascicularis complex.  J Neurol Neurosurg Psychiatry . 1999;  67 308-314
  • 75 Hariz G M, Bergenheim A T, Hariz M I, Lindberg M. Assessment of ability/disability in patients treated with chronic thalamic stimulation for tremor.  Mov Disord . 1998;  13 78-83
  • 76 Hubble J P, Busenbark K L, Wilkinson S. Effects of thalamic deep brain stimulation based on tremor type and diagnosis.  Mov Disord . 1997;  2 337-341
  • 77 Limousin P, Speelman J D, Gielen F, Janssens M. Multicentre European study of thalamic stimulation in parkinsonian and essential tremor.  J Neurol Neurosurg Psychiatry . 1999;  66 289-296
  • 78 Obwegeser A, Uitti R, Witte R, Lucas J, Turk M, Wharen R. Quantitative and qualitative outcome measures after thalamic deep brain stimulation to treat disabling tremors.  Neurosurgery . 2001;  48 274-284
  • 79 Ondo W, Almaguer M, Jankovic J, Simpson R. Thalamic deep brain stimulation: comparison between unilateral and bilateral placment.  Arch Neurol . 2001;  58 218-222
  • 80 Taha J M, Janszen M A, Favre J. Thalamic deep brain stimulation for the treatment of head, voice, and bilateral limb tremor.  J Neurosurg . 1999;  91 68-72
  • 81 Schuurman P R, Bosch D A, Bossuty P MM. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor.  N Engl J Med . 2000;  342 461-468
  • 82 Siegfried J, Lippitz B. Chronic electrical stimulation of the VL-VPL complex and of the pallidum in the treatment of movement disorders: personal experience since 1982.  Stereotact Funct Neurosurg . 1994;  62 71-75
  • 83 Bejjani B, Damier P, Arnulf I. Pallidal stimulation for Parkinson's Disease: two targets?.  Neurology . 1997;  49 1564-1569
  • 84 Burchiel K J, Anderson V C, Favre J, Hammerstad J P. Comparison of pallidal and subthalamic nucleus deep brain stimulation for advanced Parkinson's disease: results of a randomized, blinded pilot study.  Neurosurgery . 1999;  45 1375-1384
  • 85 Durif F, Lemaire J J, Debilly B, Dordain G. Acute and chronic effects of anteromedial globus pallidus stimulation in Parkinson's disease.  J Neurol Neurosurg Psychiatry . 1999;  67 315-322
  • 86 Gálvez-Jiménez N, Lozano A, Tasker R, Duff J, Hutchison W, Lange A E. Pallidal stimulation in Parkinson's disease patients with a prior unilateral pallidotomy.  Can J Neurol Sci . 1998;  25 300-305
  • 87 Ghika J, Villemure J G, Fankhauser H. Efficiency and safety of bilateral contemporaneous pallidal stimulation (deep brain stimulation) in levodopa-responsive patients with Parkinson's disease with severe motor fluctuations: a 2-year follow-up review.  J Neurosurg . 1998;  89 713-718
  • 88 Gross C, Rougier A, Guehl D, Boraud T, Julien J, Bioulac B. High-frequency stimulation of the globus pallidus internalis in Parkinson's disease: a study of seven cases.  J Neurosurg . 1997;  87 491-498
  • 89 Kumar R, Lang A E, Rodriguez-Oroz M C. Deep brain stimulation of the globus pallidus pars interna in advanced Parkinson's disease.  Neurology . 2000 (suppl 6);  55 (S34-S39)
  • 90 Iacono R P, Lonser R R, Maeda G. Chronic anterior pallidal stimulation for Parkinson's disease.  Acta Neurochir . 1995;  137 106-112
  • 91 Limousin P, Greene J, Pollak P, Rothwell J, Benabid A L, Frackowiak R. Changes in cerebral activity pattern due to subthalamic nucleus or internal pallidum stimulation in Parkinson's disease.  Ann Neurol . 1997;  42 283-291
  • 92 Merello M, Nouzeilles M I, Kuzis G. Unilateral radiofrequency lesion versus electrostimulation of posteroventral pallidum: a prospective randomized comparison.  Mov Disord . 1999;  14 50-56
  • 93 Pahwa R, Wilkinson S, Smith D, Lyons K, Miyawaki E, Koller W C. High-frequency stimulation of the globus pallidus for the treatment of Parkinson's disease.  Neurology . 1997;  49 249-253
  • 94 Siegfried J, Lippitz B. Bilateral chronic electrostimulation of ventroposterolateral pallidum: a new therapeutic approach for alleviating all Parkinsonian symptoms.  Neurosurgery . 1994;  35 1126-1129
  • 95 Volmann J, Strum V, Weiss P. Bilateral high-frequency stimulation of the internal globus pallidus in advanced Parkinson's disease.  Ann Neurol . 1998;  44 953-961
  • 96 Houeto J L, Damier P, Bejjani P B. Subthalamic stimulation in Parkinson's disease. A multidisciplinary approach.  Arch Neurol . 2000;  57 461-465
  • 97 Krack P, Pollack P, Limousin P. Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson's disease.  Brain . 1998;  121 451-457
  • 98 Krack P, Benazzouz A, Pollak P. Treatment of tremor in Parkinson's disease by subthalamic nucleus stimulation.  Mov Disord . 1998;  13 907-914
  • 99 Kumar R, Lozano A M, Kim Y J. Double-blind evaluation of subthalamic nucleus deep brain stimulation in advanced Parkinson's disease.  Neurology . 1998;  51 850-855
  • 100 Limousin P, Krack P, Pollak P. Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease.  N Engl J Med . 1998;  339 1105-1111
  • 101 Limousin P, Pollak P, Hoffman D, Benazzouz A, Perret J E, Benabid A L. Abnormal involuntary movements induced by subthalamic nucleus stimulation in parkinsonian patients.  Mov Disord . 1996;  11 231-235
  • 102 Limousin P L, Pollak P, Benazzouz A. Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation.  Lancet . 1995;  345 91-95
  • 103 Molinuevo J, Valldeoriola F, Tolosa E. Levodopa withdrawal after bilateral subthalamic nucleus stimulation in advanced Parkinson's disease.  Arch Neurol . 2000;  57 983-988
  • 104 Moro E, Scerrati M, Romito L M, Roselli R, Tonali P, Albanese A. Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson's disease.  Neurology . 1999;  53 85-90
  • 105 Pillon B, Ardouin C, Damier P. Neuropsychological changes between ``off'' and ``on'' STN or GPi stimulation in Parkinson's disease.  Neurology . 2000;  55 411-418
  • 106 Pinter M M, Alesch F, Murg M, Seiwald M, Helscher R J, Binder H. Deep brain stimulation of the subthalamic nucleus for control of extrapyramidal features in advanced idiopathic Parkinson's disease: one-year follow-up.  J Neural Transm . 1999;  106 693-709
  • 107 Lang A. Surgery for Parkinson's disease. A critical evaluation of the state of the art.  Arch Neurol . 2000;  57 1118-1125
  • 108 Starr P, Vitek J, Bakay R AE. Ablative surgery and deep brain stimulation for Parkinson's disease.  Neurosurgery . 1998;  43 989-1015
  • 109 Starr P A, Vitek J L, Bakay R AE. Deep brain stimulation for movement disorders.  Neurosurg Clin N Amer . 1998;  9 381-402
  • 110 Obeso J A. Surgical treatment of Parkinson's disease.  Baillieres Clin Neurol (Eng.) . 1997;  6(1) 125-45
  • 111 Albe-Fessard D, Arfel G, Guiot G. Activités électriques caractéristiques de quelques structures cérébrales chez l'homme.  Ann Chir . 1962;  17 1185-1214
  • 112 Andy D J. Thalamic stimulation for control of movement disorders.  Appl Neurophysiol . 1983;  46 107-111
  • 113 Bertrand G, Jasper H, Wong A, Mathews G. Microelectrode recording during stereotactic surgery.  Clin Neurosurg . 1966;  16 328-356
  • 114 Hassler R, Riechert T, Munginger F, Umbach W, Ganglberger J A. Physiological observations in stereotaxic operations in extrapyramidal motor disturbances.  Brain . 1960;  83 337-350
  • 115 Hirai T, Miyazaki M, Nakajima H, Shibazaki T, Ohye C. The correlation between tremor characteristics and the predicted volume of effective lesions in stereotaxic nucleus ventralis intermedius thalamotomy.  Brain . 1983;  106 1001-1018
  • 116 Ohye C, Kubota K, Hongo T, Nagao T, Narabayashi H. Ventrolateral and subventrolateral thalamic stimulation.  Arch Neurol . 1964;  11 427-434
  • 117 Tasker R R, Organ L W, Hawrylyshyn P. Investigation of the surgical target for alleviation of involuntary movement disorders.  Appl Neurophysiol . 1982;  45 261-274
  • 118 Ranck J B. Which elements are excited in electrical stimulation of mammalian central nervous system: a review.  Brain Res . 1975;  98 417-440
  • 119 Schlag J, Villablanca J. A quantitative study of temporal and spatial response patterns in a thalamic cell population electrically stimulated. Brain Res .  1968;  8 255-270
  • 120 Benazzouz A, Gao D M, Ni Z G. Effect of high frequency stimulation of the subthalmic nucleus on the neuronal activities of the substantia nigra pars reticulata and ventral lateral nucleus of the thalamus in the rat.  Neuroscience . 2000;  99 289-295
  • 121 Benazzouz A, Piallet B, Pollak P, Benabid A L. Responses of substantia nigra pars reticulata and globus pallidus complex to high frequency stimulation of the subthalamic nucleus in rats: electrophysiological data.  Neurosci Lett . 1995;  189 77-80
  • 122 Ashby P, Kim Y B, Kumar R, Lang M E, Lozano A M. Neurophysiological effects of stimulation through electrodes in the human subthalamic nucleus.  Brain . 1999;  122 1919-1931
  • 123 Dostrovsky J O, Levy R, Wu J P. Microstimulation-induced inhibition of neuronal firing in human globus pallidus.  J Physiol . 2000;  84 570-574
  • 124 Windels F, Bruet N, Poupard A. Effects on high-frequency stimulation of subthalamic nucleus on extracellular glutamate and GABA in substantia nigra and globus pallidus in the normal rat.  Eur J Neurosci . 2000;  12 4141-4146
  • 125 Boraud T, Bezard E, Bioulac B, Gross C. High-frequency stimulation of the internal Globus Pallidus (GPi) simultaneously improves parkinsonian symptoms and reduces the firing frequency of GPi neurons in the MPTP-treated monkey.  Neurosci Lett . 1996;  215 17-20
  • 126 Deiber M P, Pollak P, Passingham R. Thalamic stimulation and suppression of parkinsonian tremor: evidence of a cerebellar deactivation using positron emission tomography.  Brain . 1993;  116 267-279
  • 127 Fager C. Evaluation of thalamic and subthalamic surgical lesions in the alleviation of Parkinson's disease.  J Neurosurg . 1967;  28 145-149
  • 128 Hassler R. Anatomy of the thalamus. In: Schaltenbrandt G, Bailey P eds. Introduction to Stereotaxis with an Atlas of the Human Brain Stuttgart: Thieme 1959: 230-290
  • 129 Lenz F, Seike M, Lin Y C. Neurons in the area of human thalamic nucleus ventralis caudalis respond to painful heat stimuli.  Brain Res . 1993;  623 235-240
  • 130 Lenz F, Seike M, Richardson R T. Thermal and pain sensations evoked by microstimulation in the area of the human ventrocaudal nucleus (Vc).  J Neurophysiol . 1993;  70 200-212
  • 131 Lenz F A, Kwan H C, Martin R L, Tasker R R, Dostrovsky J O, Lenz Y E. Single unit analysis of the human ventral thalamic nuclear group. Tremor related activity in functionally identified cells.  Brain . 1994;  117 531-543
  • 132 Lenz F A, Tasker R R, Kwan H C. Single unit analysis of the human ventral thalamic nuclear group: correlation of thalamic ``tremor cells'' with the 3-6 Hz component of parkinsonian tremor.  J Neurosci . 1988;  8 754-764
  • 133 Lenz F A, Normand S L, Kwan H C. Statistical prediction of the optimal site for thalamotomy in parkinsonian tremor.  Mov Disord . 1995;  10 318-328
  • 134 Hutchison W D, Lozano A M, Tasker R R, Lang A E, Dostrovsky J O. Identification and characterization of neurons with tremor-frequency activity in human globus pallidus.  Exp Brain Res . 1997;  113 557-563
  • 135 Bakay R AE, Vitek J L, DeLong M R. Thalamotomy for tremor. In: Rengachary SS, Wilkins RH, eds. Neurosurgical Operative Atlas, Vol 2 Baltimore, MD: Williams & Wilkins 1992: 299-312
  • 136 Hutchison W, Allan R, Opitz H. Neurophysiological identification of the subthalamic nucleus in surgery for Parkinson's disease.  Ann Neurol . 1998;  44 622-628
  • 137 DeLong M R. Primate models of movement disorders of basal ganglia origin.  Trends Neurosci . 1990;  13 281-285
  • 138 Wichmann T, DeLong M R, Vitek J L. Pathophysiological considerations in basal ganlia surgery: role of the basal ganglia in hypokinetic and hyperkinetic movement disorders.  Prog Neurol Surg . 2000;  15 31-57
  • 139 Alexander G E, Crutcher M D, DeLong M R. Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, ``prefrontal'' and ``limbic'' functions.  Prog Brain Res . 1990;  85 119-146
  • 140 Rye D B, Turner R S, Vitek J L, Bakay R AE, Crutcher M D, DeLong M R. Anatomical investigations of the pallidotegmental pathway in monkey and man. In: Ohye C, ed. The Basal Ganglia V New York: Plenum Press 1996: 59-75
  • 141 Bergman H, Wichmann T, DeLong M R. Reversal of experimental parkinsonism by lesions of the subthalamic nucleus.  Science . 1990;  249 1436-1438
  • 142 Bergman H, Wichmann T, Karmon B, DeLong M R. The primate subthalamic nucleus II. Neuronal activity in the MPTP model of Parkinsonism.  J Neurophys . 1994;  72 507-520
  • 143 Filion M, Tremblay L. Abnormal spontaneous activity of globus pallidus neurons in monkeys with MPTP-induced Parkinsonism.  Brain Res . 1991;  547 142-151
  • 144 Guridi J, Herrero M T, Luquin M R. Subthalamotomy in parkinsonian monkeys. Behavioral and biochemical analysis.  Brain . 1996;  119 1717-1727
  • 145 Miller W C, DeLong M R. Parkinsonian symptomatology.  An anatomical and physiological analysis. Ann NY Acad Sci . 1989;  515 287-302
  • 146 Palombo E, Porrino L J, Bankiewicz K S, Crane A M, Sokoloff L, Kopin I J. Local cerebral glucose utilization in monkeys with hemiparkinsonism induced by intracarotid infusion of the neurotoxin MPTP.  J Neurosci . 1990;  10 860-869
  • 147 Schwartzman R J, Alexander G M, Ferraro T N, Grothusen J R, Stahl S M. Cerebral metabolism of parkinsonian primates 21 days after MPTP.  Exp Neurol . 1988;  102 307-313
  • 148 Wichmann T, Bergman H, DeLong M R. The primate subthalamic nucleus III. Changes in motor behavior and neuronal activity in the internal pallidum induced by subthalamic inactivation in the MPTP model of parkinsonism.  J Neurophys . 1994;  72 521-530
  • 149 Lozano A M, Lang A E, Levy R. Neuronal recordings in Parkinson's disease patients with dyskinesias induced by apomorphine.  Ann Neurol . 2000 (suppl 1);  47 (141-146)
  • 150 Jenkins I H, Fernandez W, Playford E D. Impaired activation of the supplementary motor area in Parkinson's disease is reversed when akinesia is treated with apomorphine.  Ann Neurol . 1992;  32 749-757
  • 151 Limousin P, Brown R G, Jahanshani M. The effects of posteroventral pallidotomy on the preparation and execution of voluntary hand and arm movements in Parkinson's disease.  Brain . 1999;  122 303-314
  • 152 Samuel M, Ceballos-Baumann A O, Turjanski N. Pallidotomy in Parkinson's disease increases supplementary motor area and prefrontal activation during performance of volitional movements. An H2150 PET study.  Brain . 1997;  120 1301-1313
  • 153 Vitek J, Giroux M. Physiology of hypokinetic and hyperkinetic movement disorders: model for dyskinesia.  Ann Neurol . 2000 (suppl 1);  47 (131-140)
  • 154 Aziz T Z, Peggs D, Sambrook M A, Crossman A R. Lesions of the subthalamic nucleus for the alleviation of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism in the primate.  Mov Disord . 1991;  6 288-292
  • 155 Davis K D, Taub E, Houle S. Globus pallidus stimulation activates the cortical motor system during alleviation of parkinsonian symptoms.  Nat Med . 1997;  3 671-674
  • 156 Piallat B, Benazzouz A, Benabid A L. Subthalamic nucleus lesions in rats prevents dopaminergic nigral neuron degeneration after striatal 6-OHDA injection: behavioral and histochemical studies.  Eur J Neurosci . 1996;  8 1408-1414
  • 157 Piallat B, Benazzouz A, Benabid A L. Neuroprotective effect of chronic inactivation of the subthalamic nucleus in a rat model of Parkinson's disease.  J Neural Transm . 1999;  55(suppl) 71-77
  • 158 Fahn S, Elton R L, UPDRS development committee. Unified Parkinson's disease rating scale. In: Fahn S, Marsden CD, Goldstein M, Calne DB, eds. Recent Developments in Parkinson's Disease, Vol 2. New York, NY: Macmillan 1987: 153-163
  • 159 Langston J W, Widner H, Goetz C G. Core assessment program for intracerebral transplantations (CAPIT).  Mov Disord . 1992;  7 2-13
  • 160 Schwab R S, England A C. Projection technique for evaluating surgery in Parkinson's disease. In: Gillingham FJ, Donaldson IML, eds. Third Symposium on Parkinson's Disease Edinburgh: E&S Livingstone 1969: 152-157
  • 161 Fahn S, Tolosa E, Marin C. Clinical rating scale for tremor. In: Jankovic J, Tolosa E, eds. Parkinson's disease and movement disorders 2nd ed. Baltimore, MD: Williams & Wilkins 1983: 271-280
  • 162 Guridi J, Lozano A M. A brief history of pallidotomy.  Neurosurgery . 1997;  41 1169-1183
  • 163 Narabasyhi H. Pallidotomy revisited. Analysis of posteroventral pallidotomy.  Stereotact Funct Neurosurg . 1997;  69(1-4) 54-61
  • 164 Fukuda M, Kameyama S, Yoshino M, Tanaka R, Narabayashi H. Neuropsychological outcomes following pallidotomy and thalamotomy for Parkinson's disease.  Stereotact Funct Neurosurg . 2000;  74 11-20
  • 165 Raeva S N. Localization in human thalamus of units triggered during ``verbal commands,'' voluntary movements and tremor.  Electroencephalogr Clin Neurophys . 1986;  63 160-173
  • 166 Rossitch E, Zeidman S M, Nashold B S. Evaluation of memory and language function pre- and post-thalamotomy with an attempt to define those patients at risk for postoperative dysfunction.  Surg Neurol . 1988;  29 11-16
  • 167 Kelly P J, Derome P, Guiot G. Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control.  Surg Neurol . 1978;  9 307-315
  • 168 Krayenbuhl H, Wyss O AM, Yasargil M G. Bilateral thalamotomy and pallidotomy as treatment for bilateral parkinsonism.  J Neurosurg . 1960;  18 429-444
  • 169 Ohye C, Narabayashi H. Physiological study of presumed ventralis intermedius neurons in the human thalamus.  J Neurosurg . 1979;  50 290-297
  • 170 Cooper I S, Bergmann L L, Caracalos A. Anatomic verification of the lesion which abolishes parkinsonian tremor and rigidity.  Neurology . 1963;  13 779-787
  • 171 Hassler R, Mundinger F, Reichert T. Correlations between clinical and autoptic findings in stereotaxic operations of Parkinsonism.  Confin Neurol . 1965;  26 282-290
  • 172 Pagni C A, Wildi E, Ettorre G, Infuso L, Marossero F, Cabrini G P. Anatomic verification of lesions which abolished termor and rigor in parkinsonism.  Confin Neurol . 1965;  26 291-294
  • 173 Koller W, Pahwa R, Rusenbark K. High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor.  Ann Neurol . 1997;  42 292-299
  • 174 Ondo W, Jankovic J, Schwartz K, Almaguer M, Simpson R K. Unilateral thalamic deep brain stimulation for refractory essential tremor and Parkinson's disease tremor.  Neurology . 1998;  51 1063-1069
  • 175 Tasker R R. Deep brain stimulation is preferable to thalamotomy for tremor suppression.  Surg Neurol . 1998;  49 145-153
  • 176 Vitek J L, Bakay R AE, Freeman A. Randomized clinical trial of GPi pallidotomy versus best medical therapy for Parkinson's disease.  In press.
  • 177 Laitinen L V, Hariz M I. Movement disorders. In: Youmans JR, ed. Neurological Surgery, Vol 5 4th ed. Philadelphia, PA: WB Saunders Co 1996: 3575-3609
  • 178 Biousse V, Newman N J, Carroll C. Visual fields in patients with posterior GPi pallidotomy.  Neurology . 1998;  50 258-265
  • 179 Samuel M, Caputo E, Brooks D J. A study of medial pallidotomy for Parkinson's disease: clinical outcome, MRI location and complications.  Brain . 1998;  121 59-75
  • 180 Lombardi W, Gross R, Trepanier L, Lang A, Lozano A, Saint-Cyr J. Relationship of lesion location to cognitive outcome following microelectrode-guided pallidotomy for Parkinson's disease. Support for the existence of cognitive circuits in the human pallidum.  Brain . 2000;  123 746-758
  • 181 Rettig G, York M, Lai E. Neuropsychological outcome after unilateral pallidotomy for the treatment of Parkinson's disease.  J Neurol Neurosurg Psychiatry . 2000;  69 326-336
  • 182 Soukup V M, Ingram F, Schiess M C, Bonnen J G, Nauta H JW, Calverley J R. Cognitive sequelae of unilateral posteroventral pallidotomy.  Arch Neurol . 1997;  54 947-950
  • 183 Green J, McDonald W M, Vitek J L. Neuropsychological and psychiatric sequelae of unilateral posterior pallidotomy for advanced PD: randomized clinical trial findings.  In press.
  • 184 Svennilson E, Torvik A, Lowe R, Leksell L. Treatment of parkinsonism by stereotactic thermolesions in the pallidal region: a clinical evaluation of 81 cases.  Acta Psychiatr Neurol Scand . 1960;  35 358-377
  • 185 Hutchison W D, Lozano A M, Davis K D, Saint-Cyr J A, Lang A E, Dostrovsky J O. Differential neuronal activity in segments of globus pallidus in Parkinson's disease patients.  NeuroReport . 1994;  5 1533-1537
  • 186 Stereo D, Beric A, Dogali M, Fazzini E, Alfaro G, Devinsky O. Neurophysiological properties of pallidal neurons in Parkinson's disease.  Ann Neurol . 1994;  35 586-591
  • 187 Ondo W G, Jankovic J, Lai E C. Assessment of motor function after stereotactic pallidotomy.  Neurology . 1998;  50 266-270
  • 188 Blanchet P J, Boucher R, Bédard P J. Excitotoxic lateral pallidotomy does not relieve L-dopa induced dyskinesia in MPTP parkinsonian monkeys.  Brain Res . 1994;  650 32-39
  • 189 Zhang J, Mewes K, Chockkan V, Vitek J. The effect of GPe lesions on GPi cell activity and motor behavior in the MPTP treated monkey.  Soc Neurosci Abstract . 1997;  23(1) 542
  • 190 Lonser R R, Corthesy M E, Morrison P F, Gogate N, Oldfield E H. Convection-enhanced selective excitotoxic ablation of the neurons of the globus pallidus internus for treatment of parkinsonism in nonhuman primates.  J Neurosurg . 1999;  91 294-302
  • 191 Baron J, Sidibe M, Delong M, Smith Y. Course of motor and associative pallidothalamic projections in monkeys.  J Comp Neurol . 2001;  429 490-501
  • 192 Tronnier V M, Fogel W, Kronenbuerger M, Steinvorth S. Pallidal stimulation: an alternative to pallidotomy?.  J Neurosurg . 1997;  87 700-705
  • 193 Krack P, Pollak P, Limousin P. Opposite motor effects of pallidal stimulation in Parkinson's disease.  Ann Neurol . 1998;  43 180-192
  • 194 Troster A I, Fields J A, Wilkinson S B. Unilateral pallidal stimulation for Parkinson's disease: neurobehavioral functioning before and 3 months after electrode implantation.  Neurology . 1999;  49 1078-1083
  • 195 Ardouin C, Pillon B, Peiffer E. Bilateral subthalamic or pallidal stimulation for Parkinson's disease affects neither memory nor executive functions: a consecutive series of 62 patients.  Ann Neurol . 1999;  46 217-223
  • 196 Vingerhoets G, van der Linden C, Lanno E. Cognitive outcome after unilateral pallidal stimulation in Parkinson's disease.  J Neurol Neurosurg Psychiatry . 1999;  66 297-304
  • 197 Hristova A, Lyons K, Troster A, Pahwa R, Wilkinson S, Koller W. Effect and time course of deep brain stimulation of the globus pallidus and subthalamus on motor features of Parkinson's disease.  Clin Neuropharmacol . 2000;  23(4) 208-211
  • 198 Dewey R B, Jankovic J. Hemiballism-hemichorea, clinical and pharmacologic findings in 21 patients.  Arch Neurol . 1989;  46 862-867
  • 199 Vidakovic A, Dragasevic N, Kostic V S. Hemiballism: report of 25 cases.  J Neurol Neurosurg Psychiatry . 1994;  58 945-949
  • 200 Carpenter M B, Whittier J R, Mettler F A. Analysis of choreoid hyperkinesia in the rhesus monkey, surgical and pharmacological analyis of hyperkinesia resulting from lesions in the subthalamic nucleus.  J Comp Neurol . 1950;  92 293-331
  • 201 Crossman A R, Sambrook M A, Jackson A. Experimental hemiballism in the baboon produced by injection of a gamma-aminobutyric acid antagonist into the basal ganglia.  Neurosci Lett . 1980;  20 369-372
  • 202 Burnett L, Jankovic J. Subthalamotomy and Parkinson's disease.  Mov Disord . 1992 (suppl 1);  7 (160)
  • 203 Inzelberg R, Korczyn A D. Persistent hemiballism in Parkinson's disease [letter].  J Neurol Neurosurg Psychiatry . 1994;  58 1013
  • 204 Scoditti U, Rustichelli P, Calsetti S. Spontaneous hemiballism and disappearance of parkinsonism following contralateral lenticular lacunar infarct.  Int J Neurol . 1989;  10 575-577
  • 205 Sellal F, Hirsch E, Lisovoski F, Mutschler V, Collard M, Marescaux C. Contralateral disappearance of parkinsonian signs after subthalamic hematoma.  Neurology . 1992;  42 255-256
  • 206 Andy O J, Jurko M F, Sias F. Subthalamotomy in the treatment of Parkinsonian tremor.  J Neurosurg . 1963;  20 860-870
  • 207 Nittner K. The combined thalamo-subthalamotomy.  Confin Neurol . 1970;  32 93-99
  • 208 Rodriguez-Oroz M C, Gorospe A, Guridi J. Bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease.  Neurology . 2000 (suppl 6);  55 (S45-S51)
  • 209 Bejjani B P, Damier P, Arnulf I. Transient acute depression induced by high-frequency deep-brain stimulation.  N Engl J Med . 1999;  340 1476-1480
  • 210 Kumar R, Krack P, Pollak P. Transient acute depression induced by high-frequency deep-brain stimulation.  N Engl J Med . 1999;  341 1003-1004
  • 211 Caparros-Lefebvre D, Ruchoux M M, Blond S, Petit H, Percheron G. Long-term thalamic stimulation in Parkinson's disease: postmortem anatomoclinical study.  Neurology . 1994;  44 1856-1860
  • 212 Hariz M I. Complications of movement disorders surgery and how to avoid them.  Prog Neurol Surg . 2000;  15 246-265
  • 213 Young R F, Jacques D B, Rand R W. Medial thalamotomy with the Leksell gamma knife for treatment of chronic pain.  Acta Neurochir . 1994;  62(suppl) 105-110