Functional neurosurgery in Parkinson's disease: a long journey from destruction over modulation towards restoration

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.