Abstract
There has been renewed interest in the surgical treatment of Parkinson's disease (PD) over the past 20 years. In the 1940's to 1960's many PD patients underwent neurosurgical procedures to ablate specific brain targets to alleviate tremor and, to a lesser extent, akinesia and rigidity. With the introduction of levodopa in the 1960s, and the realization of its striking benefits, surgical treatment of movement disorders virtually disappeared. With time, limitations and adverse effects associated with drug treatment became all too apparent. With complications associated with long-term drug treatment, particularly levodopa-induced motor fluctuations and dyskinesias, limiting therapeutic effectiveness in many patients, surgery has been reexamined to address this unmet need. This has lead to the development and, now, widespread adoption of high-frequency deep brain stimulation (DBS). DBS has been shown to be a safe and effective treament for dopaminergic motor symptoms of PD, particularly tremor, rigidity, and bradykinesia, and has resulted in important reductions in motor complications of medical therapy. While DBS provides important symptomatic benefit, it does not appear to alter the natural history of PD. Other surgical strategies, including cellular transplantation and gene therapy aiming at neural repair and restoration, are currently being examined, but these have yet to be proven useful.
Keywords: Parkinsons disease, Deep brain stimulation, surgical treatment, VIM, Internal pulse generators, UPDRS, Hemiballismus, PPNa, Levodopa, Postcommissural putamen
CNS & Neurological Disorders - Drug Targets
Title: The Surgical Management of Parkinson's Disease
Volume: 10 Issue: 6
Author(s): Francisco A. Ponce and Andres M. Lozano
Affiliation:
Keywords: Parkinsons disease, Deep brain stimulation, surgical treatment, VIM, Internal pulse generators, UPDRS, Hemiballismus, PPNa, Levodopa, Postcommissural putamen
Abstract: There has been renewed interest in the surgical treatment of Parkinson's disease (PD) over the past 20 years. In the 1940's to 1960's many PD patients underwent neurosurgical procedures to ablate specific brain targets to alleviate tremor and, to a lesser extent, akinesia and rigidity. With the introduction of levodopa in the 1960s, and the realization of its striking benefits, surgical treatment of movement disorders virtually disappeared. With time, limitations and adverse effects associated with drug treatment became all too apparent. With complications associated with long-term drug treatment, particularly levodopa-induced motor fluctuations and dyskinesias, limiting therapeutic effectiveness in many patients, surgery has been reexamined to address this unmet need. This has lead to the development and, now, widespread adoption of high-frequency deep brain stimulation (DBS). DBS has been shown to be a safe and effective treament for dopaminergic motor symptoms of PD, particularly tremor, rigidity, and bradykinesia, and has resulted in important reductions in motor complications of medical therapy. While DBS provides important symptomatic benefit, it does not appear to alter the natural history of PD. Other surgical strategies, including cellular transplantation and gene therapy aiming at neural repair and restoration, are currently being examined, but these have yet to be proven useful.
Export Options
About this article
Cite this article as:
A. Ponce Francisco and M. Lozano Andres, The Surgical Management of Parkinson's Disease, CNS & Neurological Disorders - Drug Targets 2011; 10 (6) . https://dx.doi.org/10.2174/187152711797247795
DOI https://dx.doi.org/10.2174/187152711797247795 |
Print ISSN 1871-5273 |
Publisher Name Bentham Science Publisher |
Online ISSN 1996-3181 |
Call for Papers in Thematic Issues
Diagnosis and treatment of central nervous system infectious diseases
Infectious diseases of the central nervous system (CNS) can be divided into bacterial, tuberculous, viral, fungal, parasitic infections, etc. Early etiological treatment is often the most crucial means to reduce the mortality rate of patients with central nervous system infections, reduce complications and sequelae, and improve prognosis. The initial clinical ...read more
Techniques of Drug Repurposing: Delivering a new life to Herbs & Drugs
Of late, with the adaptation of innovative approaches and integration of advancements made towards medical sciences as well as the availability of a wide range of tools; several therapeutic challenges are being translated into viable clinical solutions, with a high degree of efficacy, safety, and selectivity. With a better understanding ...read more
Trends and perspectives in the rational management of CNS disorders
Central nervous system (CNS) diseases enforce a significant global health burden, driving ongoing efforts to improve our understanding and effectiveness of therapy. This issue investigates current advances in the discipline, focusing on the understanding as well as therapeutic handling of various CNS diseases. The issue covers a variety of diseases, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Sleepiness, Sleep Disorders and Attention-Deficit/Hyperactivity Disorder: Pathophysiological Rationale and Future Perspectives
Current Psychiatry Reviews Bone Morphogenetic Protein-Smad Pathway as Drug Targets for Osteoporosis and Cancer Therapy
Endocrine, Metabolic & Immune Disorders - Drug Targets Can Increased Food Intake Improve Psychosis? A Brief Review and Hypothesis
Current Molecular Pharmacology Impact of Nutrition Transition and Resulting Morbidities on Economic and Human Development
Current Diabetes Reviews Integrins: Regulators of Tissue Function and Cancer Progression
Current Pharmaceutical Design Combining Angiogenesis Inhibitors with Radiation: Advances and Challenges in Cancer Treatment
Current Pharmaceutical Design COVID-19 and Autoimmune Diseases: A Systematic Review of Reported Cases
Current Rheumatology Reviews Physiological Roles of Neuronal Nicotinic Receptors Subtypes: New Insights on the Nicotinic Modulation of Neurotransmitter Release, Synaptic Transmission and Plasticity
Current Topics in Medicinal Chemistry Peroxisome Proliferator-Activated Receptor (PPAR) in Metabolic Syndrome and Type 2 Diabetes Mellitus
Current Diabetes Reviews Endothelial Progenitor Cells Dysfunction and Senescence: Contribution to Oxidative Stress
Current Cardiology Reviews Targeting Opioid and Neurokinin-1 Receptors to Treat Alcoholism
Current Medicinal Chemistry Antidepressants Alter Mesostriatal Dopamine Interactions with Serotonin Signaling
Current Psychiatry Reviews Effects of ACE-Inhibitors and Angiotensin Receptor Blockers on Inflammation
Current Pharmaceutical Design Linking New Paradigms in Protein Chemistry to Reversible Membrane-Protein Interactions
Current Protein & Peptide Science Chemosensitizers in Drug Transport Mechanisms Involved in Protozoan Resistance
Current Drug Targets - Infectious Disorders Role of Adenosine Receptors in Rare Neurodegenerative Diseases with Motor Symptoms
Current Protein & Peptide Science Inflammatory and Cell Death Pathways in Brain and Peripheral Blood in Parkinson’s Disease
CNS & Neurological Disorders - Drug Targets Patent Selections:
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Medications Acting on the Dopaminergic System in the Treatment of Alcoholic Patients
Current Pharmaceutical Design Natural Plants with Antiepileptic Activity-The Present and Future Perspectives
The Natural Products Journal