Related Experiment Video
Updated: Jul 13, 2026
Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models
Published on: August 12, 2018
Surgical considerations in movement disorders: deep brain stimulation, ablation and transplantation
1Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands. p.r.schuurman@amc.nl
Abstract:
Surgical therapy for movement disorders has been practiced since the early 20th century, mostly for Parkinson's disease. At its onset, large destructive procedures like open resection of cortex, parts of the basal ganglia or its fibre connections produced variable, ill-documented results. With the introduction of the stereotactic operating technique in the second half of the century, ablative surgery became more refined, and more selective interventions became possible to alleviate the suffering of those patients for whom no other treatment modalities were yet available. However, the introduction of levodopa-based pharmacological therapy pushed surgical therapy almost completely to the background. In the past two decades, there has been a resurgence of interest in surgery for movement disorders, due to both limitations of long-term pharmacological therapy and the advent of the treatment modality of deep brain stimulation. The subject has now grown into a large field of clinical and scientific interest. Parkinson's disease is the most widespread surgical indication, but in other movement disorders considerable improvement can be achieved by surgery as well, most notably in dystonia. A short review of the surgical therapy for these disorders is presented.
Insights
Surgical treatments for movement disorders, including Parkinson's disease and dystonia, have evolved significantly. Deep brain stimulation has led to a resurgence in surgical options due to limitations in long-term drug therapies.
Area of Science:
- Neurosurgery
- Neurology
- Movement Disorders
Background:
- Surgical interventions for movement disorders date back to the early 20th century, initially with destructive procedures for Parkinson's disease.
- Stereotactic techniques refined ablative surgery, offering selective options when pharmacological treatments were insufficient.
- The advent of levodopa-based therapy diminished surgical approaches until recent advancements.
Purpose of the Study:
- To review the historical evolution and current status of surgical therapies for movement disorders.
- To highlight the resurgence of surgical interest driven by pharmacological limitations and new techniques.
- To discuss the efficacy of surgical interventions, particularly for Parkinson's disease and dystonia.
Main Methods:
- Historical review of surgical techniques for movement disorders.
- Analysis of the impact of pharmacological advancements on surgical practice.
- Examination of the role of deep brain stimulation in the modern era of movement disorder surgery.
Main Results:
- Early surgical attempts yielded variable results, but stereotactic surgery offered more precision.
- Pharmacological therapies, especially levodopa, largely replaced surgical interventions for decades.
- Deep brain stimulation has revitalized surgical options, showing significant promise for Parkinson's disease and dystonia.
Conclusions:
- Surgical therapy for movement disorders has a long history, marked by periods of decline and resurgence.
- Modern surgical techniques, particularly deep brain stimulation, offer effective alternatives for patients with movement disorders.
- Parkinson's disease and dystonia are primary indications where surgical interventions demonstrate considerable improvement.
