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Functional Neurosurgery in Parkinson’s Disease: A Long Journey from Destruction Over Modulation Towards Restoration

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Book cover Stereotactic and Functional Neurosurgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 117))

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Abstract

Neurosurgical treatment of Parkinson’s disease (PD) has re-gained considerable attention over the last two decades due to a better understanding of the pathophysiology of the basal ganglia, the long-term complications of medical treatment, and advances in neuroimaging and neurosurgical techniques. The introduction of deep brain stimulation (DBS) has created new perspectives for the surgical management of PD patients, due to the low morbidity, reversibility and improvement of both motor function and quality of life as compared to the lesioning techniques. We present an overview of basic principles, history, indications, and results of current neurosurgical techniques available in PD.

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References

  1. Ben Shlomo Y (1997) The epidemiology of Parkinson’s disease. Baillieres Clin Neurol 6:55–68

    PubMed  CAS  Google Scholar 

  2. Benabid AL, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67–81

    Article  PubMed  Google Scholar 

  3. Benabid AL, Benazzouz A, Hoffmann D, Limousin P, Krack P, Pollak P (1998) Long-term electrical inhibition of deep brain targets in movement disorders. Mov Disord 13(Suppl 3):119–125

    PubMed  Google Scholar 

  4. Benabid AL, Pollak P, Gao D, Hoffmann D, Limousin P, Gay E, Payen I, Benazzouz A (1996) Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders. J Neurosurg 84:203–214

    Article  PubMed  CAS  Google Scholar 

  5. Benabid AL, Pollak P, Gervason C, Hoffmann D, Gao DM, Hommel M, Perret JE, de Rougemont J (1991) Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 337:403–406

    Article  PubMed  CAS  Google Scholar 

  6. Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J (1987) Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol 50:344–346

    PubMed  CAS  Google Scholar 

  7. Blond S, Caparros-Lefebvre D, Parker F, Assaker R, Petit H, Guieu JD, Christiaens JL (1992) Control of tremor and involuntary movement disorders by chronic stereotactic stimulation of the ventral intermediate thalamic nucleus. J Neurosurg 77:62–68

    Article  PubMed  CAS  Google Scholar 

  8. Burleigh AL, Horak FB, Burchiel KJ, Nutt JG (1993) Effects of thalamic stimulation on tremor, balance, and step initiation: a single subject study. Mov Disord 8:519–524

    Article  PubMed  CAS  Google Scholar 

  9. Caparros-Lefebvre D, Ruchoux MM, Blond S, Petit H, Percheron G (1994) Long-term thalamic stimulation in Parkinson’s disease: postmortem anatomoclinical study. Neurology 44:1856–1860

    Article  PubMed  CAS  Google Scholar 

  10. Cardoso F, Jankovic J, Grossman RG, Hamilton WJ (1995) Outcome after stereotactic thalamotomy for dystonia and hemiballismus. Neurosurgery 36:501–507

    Article  PubMed  CAS  Google Scholar 

  11. Ceballos-Baumann AO, Obeso JA, Vitek JL, DeLong MR, Bakay R, Linazasoro G, Brooks DJ (1994) Restoration of thalamocortical activity after posteroventral pallidotomy in Parkinson’s disease. Lancet 344:814

    Article  PubMed  CAS  Google Scholar 

  12. Chevalier G, Deniau JM (1990) Disinhibition as a basic process in the expression of striatal functions. Trends Neurosci 13:277–280

    Article  PubMed  CAS  Google Scholar 

  13. Cooper IS (1956) Neurosurgical alleviation of parkinsonism. Am Surg 22:1070–1075

    PubMed  CAS  Google Scholar 

  14. DeLong MR (1990) Primate models of movement disorders of basal ganglia origin. Trends Neurosci 13:281–285

    Article  PubMed  CAS  Google Scholar 

  15. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, Daniels C, Deutschlander A, Dillmann U, Eisner W, Gruber D, Hamel W, Herzog J, Hilker R, Klebe S, Kloss M, Koy J, Krause M, Kupsch A, Lorenz D, Lorenzl S, Mehdorn HM, Moringlane JR, Oertel W, Pinsker MO, Reichmann H, Reuss A, Schneider GH, Schnitzler A, Steude U, Sturm V, Timmermann L, Tronnier V, Trottenberg T, Wojtecki L, Wolf E, Poewe W, Voges J (2006) A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 355:896–908

    Article  PubMed  CAS  Google Scholar 

  16. Diederich NJ, Alesch F (1997) Neurosurgical methods in treatment of Parkinson disease. Current status. Nervenarzt 68:466–476

    Article  PubMed  CAS  Google Scholar 

  17. Dogali M, Fazzini E, Kolodny E, Eidelberg D, Sterio D, Devinsky O, Beric A (1995) Stereotactic ventral pallidotomy for Parkinson’s disease. Neurology 45:753–761

    Article  PubMed  CAS  Google Scholar 

  18. Duvoisin RC (1992) A brief history of parkinsonism. Neurol Clin 10:301–316

    PubMed  CAS  Google Scholar 

  19. Evidente VG, Prekumar AP, Adler CH, Caviness JN, Driver-Dunckley E, Lyons MK (2011) Medication dose reductions after pallidal versus subthalamic stimulation in patients with Parkinson’s disease. Acta Neurol Scand 124(3):211–214

    Article  PubMed  CAS  Google Scholar 

  20. Fox MW, Ahlskog JE, Kelly PJ (1991) Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson’s disease patients. J Neurosurg 75:723–730

    Article  PubMed  CAS  Google Scholar 

  21. Galvez-Jimenez N, Lozano A, Tasker R, Duff J, Hutchison W, Lang AE (1998) Pallidal stimulation in Parkinson’s disease patients with a prior unilateral pallidotomy. Can J Neurol Sci 25:300–305

    PubMed  CAS  Google Scholar 

  22. Gao D, Benazzouz A, Bressand K, Piallat B, Benabid AL (1997) Roles of GABA, glutamate, acetylcholine and STN stimulation on thalamic VM in rats. Neuroreport 8:2601–2605

    Article  PubMed  CAS  Google Scholar 

  23. Guridi J, Obeso JA (1997) The role of the subthalamic nucleus in the origin of hemiballism and parkinsonism: new surgical perspectives. Adv Neurol 74:235–247

    PubMed  CAS  Google Scholar 

  24. Halliday G, Lees A, Stern M (2011) Milestones in Parkinson’s disease – clinical and pathologic features. Mov Disord 26:1015–1021

    Article  PubMed  Google Scholar 

  25. Hassani OK, Mouroux M, Feger J (1996) Increased subthalamic neuronal activity after nigral dopaminergic lesion independent of disinhibition via the globus pallidus. Neuroscience 72:105–115

    Article  PubMed  CAS  Google Scholar 

  26. Hassler R, Riechert T, Mundinger F, Umbach W, Ganglberger JA (1960) Physiological observations in stereotaxic operations in extrapyramidal motor disturbances. Brain 83:337–350

    Article  PubMed  CAS  Google Scholar 

  27. Hauser R, Freeman T, Olanow C (1995) Surgical therapies for Parkinson’s disease. In: Kurlan R (ed) Treatment of movement disorders. J. B. Lippincott Company, Philadelphia, pp 57–93

    Google Scholar 

  28. Herzog J, Hamel W, Wenzelburger R, Potter M, Pinsker MO, Bartussek J, Morsnowski A, Steigerwald F, Deuschl G, Volkmann J (2007) Kinematic analysis of thalamic versus subthalamic neurostimulation in postural and intention tremor. Brain 130:1608–1625

    Article  PubMed  Google Scholar 

  29. Iacono RP, Shima F, Lonser RR, Kuniyoshi S, Maeda G, Yamada S (1995) The results, indications, and physiology of posteroventral pallidotomy for patients with Parkinson’s disease. Neurosurgery 36:1118–1125

    Article  PubMed  CAS  Google Scholar 

  30. Inzelberg R, Korczyn AD (1994) Persistent hemiballism in Parkinson’s disease. J Neurol Neurosurg Psychiatry 57:1013–1014

    Article  PubMed  CAS  Google Scholar 

  31. Isacson O (2009) Cell therapy ahead for Parkinson’s disease. Science 326:1060

    Article  PubMed  CAS  Google Scholar 

  32. Jankovic J, Cardoso F, Grossman RG, Hamilton WJ (1995) Outcome after stereotactic thalamotomy for parkinsonian, essential, and other types of tremor. Neurosurgery 37:680–686

    Article  PubMed  CAS  Google Scholar 

  33. Kleiner-Fisman G, Herzog J, Fisman DN, Tamma F, Lyons KE, Pahwa R, Lang AE, Deuschl G (2006) Subthalamic nucleus deep brain stimulation: summary and meta-analysis of outcomes. Mov Disord 21(Suppl 14):S290–S304

    Article  PubMed  Google Scholar 

  34. Koller W, Pahwa R, Busenbark K, Hubble J, Wilkinson S, Lang A, Tuite P, Sime E, Lazano A, Hauser R, Malapira T, Smith D, Tarsy D, Miyawaki E, Norregaard T, Kormos T, Olanow CW (1997) High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor. Ann Neurol 42:292–299

    Article  PubMed  CAS  Google Scholar 

  35. Koller W, Wilkinson S, Pahwa R et al (1998) Surgical treatment options in Parkinson’s disease. In: Bakay R (ed) Neurosurgery Clinics of North America: surgical treatment movement disorders. W. B. Saunders Company, Philadelphia, pp 295–306

    Google Scholar 

  36. Krack P, Batir A, Van Blercom N, Chabardes S, Fraix V, Ardouin C, Koudsie A, Limousin PD, Benazzouz A, LeBas JF, Benabid AL, Pollak P (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349:1925–1934

    Article  PubMed  CAS  Google Scholar 

  37. Krack P, Limousin P, Benabid AL, Pollak P (1997) Chronic stimulation of subthalamic nucleus improves levodopa-induced dyskinesias in Parkinson’s disease. Lancet 350:1676

    Article  PubMed  CAS  Google Scholar 

  38. Krack P, Pollak P, Limousin P, Hoffmann D, Benazzouz A, Le Bas JF, Koudsie A, Benabid AL (1998) Opposite motor effects of pallidal stimulation in Parkinson’s disease. Ann Neurol 43:180–192

    Article  PubMed  CAS  Google Scholar 

  39. Laitinen LV, Bergenheim AT, Hariz MI (1992) Leksell’s Posteroventral pallidotomy in the treatment of Parkinson’s disease. J Neurosurg 76:53–61

    Article  PubMed  CAS  Google Scholar 

  40. Lang AE, Lozano AM (1998) Parkinson’s disease. First of two parts. N Engl J Med 339:1044–1053

    Article  PubMed  CAS  Google Scholar 

  41. Lee MS, Marsden CD (1994) Movement disorders following lesions of the thalamus or subthalamic region. Mov Disord 9:493–507

    Article  PubMed  CAS  Google Scholar 

  42. Limousin P, Greene J, Pollak P, Rothwell J, Benabid AL, Frackowiak R (1997) Changes in cerebral activity pattern due to subthalamic nucleus or internal pallidum stimulation in Parkinson’s disease. Ann Neurol 42:283–291

    Article  PubMed  CAS  Google Scholar 

  43. Limousin P, Krack P, Pollak P, Benazzouz A, Ardouin C, Hoffmann D, Benabid AL (1998) Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 339:1105–1111

    Article  PubMed  CAS  Google Scholar 

  44. Limousin P, Pollak P, Benazzouz A, Hoffmann D, Le Bas JF, Broussolle E, Perret JE, Benabid AL (1995) Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet 345:91–95

    Article  PubMed  CAS  Google Scholar 

  45. Limousin P, Pollak P, Hoffmann D, Benazzouz A, Perret JE, Benabid AL (1996) Abnormal involuntary movements induced by subthalamic nucleus stimulation in parkinsonian patients. Mov Disord 11:231–235

    Article  PubMed  CAS  Google Scholar 

  46. Lozano AM, Lang AE, Galvez-Jimenez N, Miyasaki J, Duff J, Hutchinson WD, Dostrovsky JO (1995) Effect of GPi pallidotomy on motor function in Parkinson’s disease. Lancet 346:1383–1387

    Article  PubMed  CAS  Google Scholar 

  47. Lozano A, Lang A (1998) Pallidotomy for Parkinson’s disease. In: Bakay R (ed) Neurosurgery Clinics of North America: surgical treatment of movement disorders. W. B. Saunders Company, Philadelphia, pp 325–336

    Google Scholar 

  48. Mendis T, Suchowersky O, Lang A, Gauthier S (1999) Management of Parkinson’s disease a review of current and new therapies. Can J Neurol Sci 26:89–103

    PubMed  CAS  Google Scholar 

  49. Nikkhah G (2011) Journeys to the center of the brain. 60 years of stereotactic neurosurgery at the University Hospital Freiburg. Nikkhah G, Freiburg

    Google Scholar 

  50. Nikkhah G (2013) Restorative strategies for the dopaminergic nigrostriatal projection pathway. In: Nikkhah G, Pinsker M (eds) Stereotactic and Functional Neurosurgery. Acta Neurochirurgica Suppl. Springer, Wien, pp 79–85

    Google Scholar 

  51. Obeso JA, Guridi J, Linazasoro G, Ramos E (1995) Hemiballism in Parkinson’s disease. J Neurol Neurosurg Psychiatry 58:645–647

    Article  PubMed  CAS  Google Scholar 

  52. Obeso JA, Rodriguez MC, Gorospe A, Guridi J, Alvarez L, Macias R (1997) Surgical treatment of Parkinson’s disease. Baillieres Clin Neurol 6:125–145

    PubMed  CAS  Google Scholar 

  53. Pahwa R, Wilkinson S, Smith D, Lyons K, Miyawaki E, Koller WC (1997) High-frequency stimulation of the globus pallidus for the treatment of Parkinson’s disease. Neurology 49:249–253

    Article  PubMed  CAS  Google Scholar 

  54. Pollak P, Benabid AL, Gross C, Gao DM, Laurent A, Benazzouz A, Hoffmann D, Gentil M, Perret J (1993) Effects of the stimulation of the subthalamic nucleus in Parkinson disease. Rev Neurol (Paris) 149:175–176

    Google Scholar 

  55. Quinn N (1997) Parkinson’s disease: clinical features. In: Quinn N (ed) Clinical neurology. Parkinsonism. Bailliere Tindall, London, pp 1–13

    Google Scholar 

  56. Samuel M, Ceballos-Baumann AO, Turjanski N, Boecker H, Gorospe A, Linazasoro G, Holmes AP, DeLong MR, Vitek JL, Thomas DG, Quinn NP, Obeso JA, Brooks DJ (1997) Pallidotomy in Parkinson’s disease increases supplementary motor area and prefrontal activation during performance of volitional movements an H2(15)O PET study. Brain 120(Pt 8):1301–1313

    Article  PubMed  Google Scholar 

  57. Schapira A (1997) Pathogenesis of Parkinson’s disease. In: Quinn N (ed) Clinical neurology. International practice and research. Parkinsonism. Bailliere Tindall, London, pp 15–36

    Google Scholar 

  58. Schupbach WM, Chastan N, Welter ML, Houeto JL, Mesnage V, Bonnet AM, Czernecki V, Maltete D, Hartmann A, Mallet L, Pidoux B, Dormont D, Navarro S, Cornu P, Mallet A, Agid Y (2005) Stimulation of the subthalamic nucleus in Parkinson’s disease: a 5 year follow up. J Neurol Neurosurg Psychiatry 76:1640–1644

    Article  PubMed  CAS  Google Scholar 

  59. Sellal F, Hirsch E, Lisovoski F, Mutschler V, Collard M, Marescaux C (1992) Contralateral disappearance of parkinsonian signs after subthalamic hematoma. Neurology 42:255–256

    Article  PubMed  CAS  Google Scholar 

  60. Siegfried J, Lippitz B (1994) Bilateral chronic electrostimulation of ventroposterolateral pallidum: a new therapeutic approach for alleviating all parkinsonian symptoms. Neurosurgery 35:1126–1129

    Article  PubMed  CAS  Google Scholar 

  61. Smith ID, Grace AA (1992) Role of the subthalamic nucleus in the regulation of nigral dopamine neuron activity. Synapse 12:287–303

    Article  PubMed  CAS  Google Scholar 

  62. Spiegel EA, Wycis HT, Marks M, Lee AJ (1947) Stereotaxic apparatus for operations on the human brain. Science 106:349–350

    Article  PubMed  CAS  Google Scholar 

  63. Starr PA, Vitek JL, Bakay RA (1998) Deep brain stimulation for movement disorders. Neurosurg Clin N Am 9:381–402

    PubMed  CAS  Google Scholar 

  64. Strafella A, Ashby P, Munz M, Dostrovsky JO, Lozano AM, Lang AE (1997) Inhibition of voluntary activity by thalamic stimulation in humans: relevance for the control of tremor. Mov Disord 12:727–737

    Article  PubMed  CAS  Google Scholar 

  65. Tsubokawa T, Katayama Y, Yamamoto T (1995) Control of persistent hemiballismus by chronic thalamic stimulation. Report of two cases. J Neurosurg 82:501–505

    Article  PubMed  CAS  Google Scholar 

  66. Vidakovic A, Dragasevic N, Kostic VS (1994) Hemiballism: report of 25 cases. J Neurol Neurosurg Psychiatry 57:945–949

    Article  PubMed  CAS  Google Scholar 

  67. Vingerhoets FJ, Tagliati M (2012) Treating PD axial signs with DBS: is two better than one? Neurology 78:1036–1037

    Article  PubMed  Google Scholar 

  68. Volkmann J, Allert N, Voges J, Sturm V, Schnitzler A, Freund HJ (2004) Long-term results of bilateral pallidal stimulation in Parkinson’s disease. Ann Neurol 55:871–875

    Article  PubMed  Google Scholar 

  69. Weaver F, Follett K, Hur K, Ippolito D, Stern M (2005) Deep brain stimulation in Parkinson disease: a metaanalysis of patient outcomes. J Neurosurg 103:956–967

    Article  PubMed  Google Scholar 

  70. Witt K, Daniels C, Reiff J, Krack P, Volkmann J, Pinsker MO, Krause M, Tronnier V, Kloss M, Schnitzler A, Wojtecki L, Botzel K, Danek A, Hilker R, Sturm V, Kupsch A, Karner E, Deuschl G (2008) Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomised, multicentre study. Lancet Neurol 7:605–614

    Article  PubMed  Google Scholar 

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Acknowledgements

Parts of this study have been supported by grants from the Weber Petri Foundation and the German Parkinson Foundation.

Conflict of Interest Drs. Pinsker and Nikkhah report having received speaking fees from Medtronic. Dr. Nikkhah has also served as a Consultant for Medtronic. No other potential conflict of interest relevant to this article was reported.

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Authors and Affiliations

  1. Division of Stereotactic and Functional Neurosurgery, Department of General Neurosurgery, Neurosurgical Clinic, University Medical Center Freiburg, Breisacher Straße 64, Freiburg, D-79106, Germany

    Guido Nikkhah MD, PhD & Marcus Pinsker MD

  2. Neurosurgical Clinic, University Hospital Erlangen, Schwabachanlage 6, Erlangen, D-91054, Germany

    Guido Nikkhah MD, PhD

  3. Department of Neurosurgery, Hospital Adventista Silvestre, Rio de Janeiro Brazil, Rua Bambina 56 sala 105, Botafogo, Rio de Janeiro, Brazil

    Gustavo Adolpho Carvalho

  4. Klinik für Neurochirurgie, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, Berlin, DE-13125, Germany

    Marcus Pinsker MD

Authors
  1. Guido Nikkhah MD, PhD
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  2. Gustavo Adolpho Carvalho
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  3. Marcus Pinsker MD
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Corresponding author

Correspondence to Guido Nikkhah MD, PhD .

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Editors and Affiliations

  1. , Neurosurgical Clinic, University Hospital Erlangen, Schwabachanlage 6, Erlangen, 91054, Germany

    Guido Nikkhah

  2. Department of Neurosurgery, Division of Stereotactic and Functional, University Medical Center Freiburg, Breisacher Straße 64, Freiburg, 79106, Germany

    Marcus Pinsker

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Nikkhah, G., Carvalho, G.A., Pinsker, M. (2013). Functional Neurosurgery in Parkinson’s Disease: A Long Journey from Destruction Over Modulation Towards Restoration. In: Nikkhah, G., Pinsker, M. (eds) Stereotactic and Functional Neurosurgery. Acta Neurochirurgica Supplement, vol 117. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1482-7_2

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