ABSTRACT
Stereotactic surgeries for movement disorders were introduced in the 1950s (1,2) but were not widely accepted due to significant morbidity, mortality, and limited knowledge in target selection for symptomatic benefit. In the late 1950s and early 1960s there was an increase in the number of stereotactic surgeries performed. With advances in pharmacological therapy, particularly the availability of levodopa, these surgeries were rarely performed until the late 1980s. Currently, based on the recognition of the limitations of drug treatments for Parkinson’s disease (PD) and a better understanding of the physiology and circuitry of the basal ganglia, there has been a marked increase in surgical therapies for PD. In addition, advances in surgical techniques, neuroimaging, and improved electrophysiological recordings allow stereotactic procedures to be done more accurately, leading to reduced morbidity. Over the last decade, deep brain stimulation (DBS) is increasingly replacing lesion surgery as the preferred procedure. DBS in PD is associated with three targets: the ventral intermediate nucleus (VIM) of
the thalamus, the globus pallidus interna (GPi), and the subthalamic nucleus (STN).
