Surgical Treatments

There are some surgical options for patients with Parkinson’s disease, depending on their symptoms. Some of the available procedures are listed below:

Deep Brain Stimulation
This involves the implantation of a wire with four electrodes at its tip into one of three target sites in the brain: the thalamus, the globus pallidus, the subthalamic nucleus.
The wire is connected to a small unit called an implantable pulse generator (IPG) which is implanted under the skin, often in the chest, rather like a pacemaker. When switched on, the IPG produces electrical signals which are sent to the brain to stop or reduce Parkinson's symptoms.

Lesioning
This involves inserting an electrode into the brain, causing selective damage to certain cells in either the thalamus (thalamotomy) or the globus pallidus (pallidotomy). Unlike deep brain stimulation, the procedure is irreversible. This operation is considered when tremors are disabling and interfering with everyday life to the extent that a person requires help with nearly all tasks.

Radiosurgery
To date, radiosurgery has produced disappointing results in the treatment of Parkinson's disease. This procedure uses a high-energy dose of radiation that can be focused on a very precise point within the brain. This approach is sometimes used to treat deep-seated lesions or malformations within the brain that may be difficult to reach by conventional methods without causing damage.

Future Developments
In the future, other surgery-related treatments may be shown to be safe and beneficial and could be introduced. These are some way off, but might include brain implants using brain tissue and infusion of chemicals into basal ganglia. Brain implants would use midbrain tissue from human fetuses, which would be transplanted into the diseased area of the brain of the person with Parkinson's disease. These fetal cells would then produce dopamine, which eventually relieves the symptoms of the disease. This operation is still in the experimental stages and has major ethical implications. Research is now being carried out to find out if animal tissue could be used instead. In addition, it may be possible to develop the technology in the future to make substantia nigra cells grow or regenerate, using what are known as stem cells with trophic factors.