Author Affiliations: Departments of Neurosurgery (Drs Eskandar and Cosgrove) and Neurology (Dr Shinobu), Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Contempo Updates Section Editors: Janet M.
Torpy, MD, and Alice T.D. Hughes, MD, Fishbein Fellows.
Several effective neurosurgical treatments for Parkinson disease (PD)
have been developed based on an improved understanding of basal ganglia circuitry
and the continuing evolution of neurosurgical techniques. Currently, there
are 3 surgical targets for the treatment of movement disorders, the globus
pallidus interna (Gpi), the subthalamic nucleus (STN), and the Ventralis intermedius
nucleus of the thalamus. The Gpi and the STN are the preferred targets for
the treatment of PD while Ventralis intermedius is now primarily targeted
in the treatment of tremor. Options for treatment include the placement of
a deep brain stimulating (DBS) electrode in any of these areas or the creation
of a small lesion in the Gpi (pallidotomy) or in the thalamus (thalamotomy).
Eskandar EN, Cosgrove GR, Shinobu LA. Surgical Treatment of Parkinson Disease. JAMA. 2001;286(24):3056-3059. doi:10.1001/jama.286.24.3056