Abstract: In the last decade, following the demonstration by Laitinen et al. (1) of the beneficial effect of pallidotomy in advanced Parkinson’ s disease (PD), there has been a resurgence of interest in stereotactic functional neurosurgery for PD. The development of an animal model of PD leading to the development of anatomic and physiological models of basal ganglia circuitry (2) also strongly contributed to the reemergence of ablative surgery for the treatment of PD. Based on these models together with the observations by Laitinen, most centers initiating programs in PD surgery advocated lesioning or deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi). Based on the current pathophysiological model of the basal ganglia, the subthalamic nucleus (STN) is now being contemplated as a more suitable target for PD surgery. However, STN deep brain stimulation (DBS) is being used as a preferred approach to ablation owing to concerns that subthalamotomy may cause intractable unilateral or bilateral hemiballism (3–5).
Publication Year: 2003
Publication Date: 2003-01-01
Language: en
Type: article
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