Lesions as therapy: surgical intervention in Parkinson's disease prior to L-dopa

The study of Parkinson's disease has undergone vast changes across its almost 200 year history. Over this period, research scientists have added dramatic detail to their understanding both of the motor system in general and the etiology of Parkinson's disease specifically. This expanded understanding has been facilitated, particularly, by the work of clinicians with the goal of improving treatments designed to ameliorate its symptoms. This article examines the evolution of one particular clinical approach, the production of lesions to segments of the basal ganglia, from its inception, through its "golden era," disuse, and rebirth.