Subthalamotomy in the treatment of Parkinson's disease: clinical aspects and mechanisms of action

J Neurosurg. 2014 Jan;120(1):140-51. doi: 10.3171/2013.10.JNS13332. Epub 2013 Nov 8.

Abstract

Parkinson's disease (PD) is a neurodegenerative condition that can be pharmacologically treated with levodopa. However, important motor and nonmotor symptoms appear with its long-term use. The subthalamic nucleus (STN) is known to be involved in the pathophysiology of PD and to contribute to levodopa-induced complications. Surgery is considered in patients who have advanced PD that is refractory to pharmacotherapy and who display disabling dyskinesia. Deep brain stimulation of the STN is currently the main surgical procedure for PD, but lesioning is still performed. This review covers the clinical aspects and complications of subthalamotomy as one of the lesion-based options for PD patients with levodopa-induced dyskinesias. Moreover, the authors discuss the possible effects of subthalamic lesioning.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / surgery*
  • Subthalamic Nucleus / physiopathology
  • Subthalamic Nucleus / surgery*
  • Treatment Outcome