Neurosurgery for Parkinson's Disease

Theresa A. Zesiewicz; Robert A. Hauser

doi:10.1055/s-2001-13124

Seminars in Neurology, Inhaltsverzeichnis

Semin Neurol 2001; 21(1): 091-102
DOI: 10.1055/s-2001-13124

Neurosurgery for Parkinson's Disease

Theresa A. Zesiewicz¹ , Robert A. Hauser^1, ²

¹Parkinson's Disease and Movement Disorders Center, Department of Neurology, University of South Florida, Tampa, Florida and
²Department of Pharmacology and Experimental Therapeutics, University of South Florida, Tampa, Florida

Abstract

ABSTRACT

Medical therapy for Parkinson's disease (PD) often becomes inadequate over several years. Disability increases despite maximal medical management and many patients develop motor fluctuations and dyskinesia. In addition, medications provide good control of tremor in only 50% of cases. In appropriately selected cases, surgical therapies for PD provide benefit for medically refractory symptoms. Recent advances have provided a greater array of surgical options. Unilateral thalamotomy and thalamic stimulation are considered safe and effective procedures to treat contralateral tremor. Pallidotomy and pallidal stimulation primarily reduce contralateral dyskinesia, with lesser effects on bradykinesia and rigidity. Studies indicate that subthalamic nucleus (STN) stimulation improves ``off'' period function, decreases ``off'' time, and lessens dyskinesia. Fetal cell transplantation remains experimental, and studies are underway to evaluate the safety and efficacy of porcine fetal cell and human retinal pigment epithelial cell transplantation. This chapter reviews the history of surgical procedures for PD, describes current procedures, and offers a look into the future of neurosurgical options for PD.

KEYWORD

Parkinson's disease - surgery - thalamotomy - thalamic stimulation - pallidotomy - pallidal stimulation - subthalamic nucleus stimulation - fetal cell transplantation - porcine cell transplantation - human retinal pigment epithelial cell transplantation

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Referenzen

REFERENCES

1 Koller W C, Busenbark K, Minor K, and the ET Study Group. Relationship of essential tremor to other movement disorders: report on 678 patients. Ann Neurol . 1994; 35 717-723
2 Lang A E, Lozano A M. Parkinson's disease. N Engl J Med . 1998; 339 1130-1143
3 Das K, Benzil D L, Rovit R. Irving S. Cooper (1922-1985): a pioneer in functional neurosurgery. J Neurosurg . 1988; 89 865-873
4 Meyers H R. The modification of alternating tremors, rigidity, and festination by surgery of the basal ganglia. Nerv Ment Dis . 1942; 21 602-665
5 Meyers H R. Surgical procedure for postencephalitic tremor, with notes on the physiology of the premotor fibers. Arch Neurol Psychiatry . 1940; 44 455-457
6 Bucy P C. Cortical extirpation in the treatment of involuntary movements. Res Nerv Ment Dis Proc . 1942; 21 551-595
7 Cooper I S, Bravo G J. Implications of a five-year study of 700 basal ganglia operations. Neurology . 1958; 8 344-346
8 Cooper I S, Bravo G J, Riklan M. Chemopallidectomy and chemothalamectomy for parkinsonism. Geriatrics . 1958; 13 127-144
9 Svennilson E, Torvik A, Lowe R, Leksell L. Treatment of parkinsonism by stereotactic thermolesions in the pallidal region. Acta Psychiatr Scand . 1960; 35 358-377
10 Mundinger F, Riechert T. Esgelnisse der sterotaktischen Hirnoperationen bei extrapyramidalen Bewegungsstrorungen auf Grund postoperativer und Langzeituntersuchungen. Dtsch Z Nervenheilkd . 1961; 182 5442-5576
11 Cooper I S. Parkinsonism: Its Medical and Surgical Therapy. Springfield, IL: Charles C Thomas; 1961
12 Spiegel E A, Wycis H T. Stereoencephalotomy: Part 2. Clinical and Physiological Applications New York: Grune & Stratton; 1962
13 Cooper I S. Surgical treatment of parkinsonism. Annu Rev Med . 1965; 16 309-330
14 Spiegel E A, Wycis H T, Marks M. Stereotactic apparatus for operation on the human brain. Science . 1947; 106 349-350
15 Spiegel E A, Wycis H T. Ansotomy in paralysis agitans. Arch Neurol Psychiatry . 1954; 71 598-614
16 Laitenen L V, Bergenheim A T, Hariz M I. Leskell's posteroventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg . 1992; 76 53-61
17 Laitenen L V, Bergenheim A T, Hariz M I. Ventroposterolateral pallidotomy can abolish all parkinsonian symptoms. Stereotact Funct Neurosurg . 1992; 58 14-21
18 Selby G. Stereotactic surgery for the relief of Parkinson's disease: Part I. A critical review. J Neurol Sci . 1967; 5 315-342
19 Tasker R R. Surgical aspects: symposium on extrapyramidal disease. Appl Ther . 1967; 9 454-462
20 Tasker R R, Siqueira J, Hawrylyshyn P. What happened to VIM thalamotomy for Parkinson's disease?. Appl Neurophysiol . 1983; 46 68-83
21 Kelly P J, Ahlskog J E, Goerss S J. Computer-assisted stereotactic ventralis lateralis thalamotomy with microelectrode recording in patients with Parkinson's disease. Mayo Clin Proc . 1987; 62 655-664
22 Matsumoto K, Schichijo F, Fukami T. Long-term follow-up review cases of Parkinson's disease after unilateral or bilateral thalamotomy. J Neurosurg . 1984; 60 1033-1044
23 Miyamoto T, Bekku H, Moriyama E. Present role of stereotactic thalamotomy for parkinsonism: retrospective analysis of operative results and thalamic lesions in computed tomograms. Appl Neurophysiol . 1985; 48 294-304
24 Mundinger F. Postoperative and long-term results of 1,561 stereotactic operations in parkinsonism. Appl Neurophysiol . 1985; 48 293
25 Narabayashi H, Maeda T, Yokochi F. Long-term follow-up results of selective VIM-thalamotomy. J Neurosurg . 1986; 65 296-302
26 Scott R M, Brody J A, Cooper I S. The effect of thalamotomy on the progress of unilateral Parkinson's disease. J Neurosurg . 1970; 32 286-288
27 Tasker R R. Thalamotomy. Neurol Clin . 1990; 1 841-864
28 Riechert T. Stereotactic Brain Operations: Methods, Clinical Aspects, Indications. Bern: Hans Huber 1980: 213-304
29 Linhares M N, Tasker R R. Microelectrode-guided thalamotomy for Parkinson's disease. Neurosurgery . 2000; 46 390-398
30 Fox M W, Ahlskog J E, Kelly P J. Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson's disease patients. J Neurosurg . 1991; 75 723-730
31 Osenbach R K, Burchiel K J. Thalamotomy: indications, techniques and results. In: Lozano AM, ed. Neurosurgical Treatment of Movement Disorders Park Ridge: AANS 1998: 107-129
32 Diederich N, Goetz C G, Stebbins G T. Blinded evaluation confirms long-term asymmetric effect of unilateral thalamotomy or subthalamotomy on tremor in Parkinson's disease. Neurology . 1992; 42 1311-1314
33 Moriyama E, Beck H, Miyamoto T. Long-term results of ventrolateral thalamotomy for patients with Parkinson's disease. Neurol Med Chir (Tokyo) . 1999; 39 350-356
34 Laitenen L V. Thalamic targets in stereotactic treatment of Parkinson's disease. J Neurosurg . 1966; 24 82-85
35 Lozano A, Hutchison W, Kiss Z, Tasker R, Davis K, Dostrovsky J. Methods for microelectrode-guided posteroventral pallidotomy. J Neurosurg . 1996; 84 194-202
36 Lang A E, Duff J, Saint-Cyr J A. Posteroventral medial pallidotomy in Parkinson's disease. J Neurol . 1999; 28-48 (28-48)
37 Laitenen L V, Bergenheim T, Hariz A L. Leksell's posteroventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg . 1992; 76 53-61
38 Dogali M, Fazzini E, Kolodny E. Stereotactic ventral pallidotomy for Parkinson's disease. Neurology . 1995; 45 753-761
39 Lozano A M, Lang A E, Galvez-Jimenez N. Effect of Gpi pallidotomy on motor function in Parkinson's disease. Lancet . 1995; 346 1383-1387
40 Baron M S, Vitek J L, Bakay R AE. Treatment of advanced Parkinson's disease by posterior Gpi pallidotomy: 1-year results of a pilot study. Ann Neurol . 1996; 40 355-366
41 Uitti R J, Wharen R E, Turk M F. Unilateral pallidotomy for Parkinson's disease: comparison of outcome in younger versus elderly patients. Neurology . 1997; 49 1072-1077
42 Fazzini E, Dogali M, Sterio D. Stereotactic pallidotomy for Parkinson's disease: a long-term follow-up of unilateral pallidotomy. Neurology . 1997; 48 1273-1277
43 Merello M, Nouzeilles M I, Cammarotta A. Changes in the motor response to acute L-dopa challenge after unilateral microelectrode-guided posteroventral pallidotomy. Clin Neuropharmacol . 1998; 21 135-138
44 Jankovic J, Ben-Arie L, Schwartz K. Movement and reaction times and fine coordination tasks following pallidotomy. Mov Disord . 1999; 14 57-62
45 Iacono R P, Shima F, Lonser R R. The results, indications and physiology of posteroventral pallidotomy for patients with Parkinson's disease. Neurosurgery . 1995; 36 1118-1127
46 Lang A E, Lozano A M, Montgomery E. Posteroventral medial pallidotomy in advanced Parkinson's disease. N Engl J Med . 1997; 337 1036-1042
47 Sutton J P, Couldwell W, Lew M F. Ventroposterior medial pallidotomy on motor function in Parkinson's disease. Neurosurgery . 1995; 36 1112-1117
48 Ondo W G, Jankovic J, Lai E C. Assessment of motor function after stereotactic pallidotomy. Neurology . 1998; 50 266-270
49 Melnick M E, Dowling G A, Aminoff M J. Effect of pallidotomy on postural control and motor function in Parkinson's disease. Arch Neurol . 1999; 56 1361-1365
50 Martinez-Martin P, Valldeoriola F, Molinuevo J L. Pallidotomy and quality of life in patients with Parkinson's disease: an early study. Mov Disord . 2000; 15 65-70
51 Uitti R J, Wharen R E, Turk M F. Efficacy of levodopa therapy on motor function after posteroventral pallidotomy for Parkinson's disease. Neurology . 1998; 51 1755-1757
52 Kishore A, Turnbull I M, Snow B J. Efficacy, stability and predictors of outcome of pallidotomy for Parkinson's disease: six month follow-up with additional 1-year observations. Brain . 1997; 120 729-737
53 Koller W C, Pahwa R, Lyons K, Albanese A. Surgical treatment of Parkinson's disease. J Neurol Sci . 1999; 167 1-10
54 Ondo W G, Ben-Aire L, Jankovic J. Weight gain following unilateral pallidotomy in Parkinson's disease. Acta Neurol Scand . 2000; 101 79-84
55 Johnson K A, Cunnginton R, Bradshaw J L. Bimanual co-ordination in Parkinson's disease. Brain . 1998; 121 743-753
56 Schuurman P R, De Bie M A R, Speelman J D. Bilateral posteroventral pallidotomy in advanced Parkinson's disease in three patients. Mov Disord . 1997; 12 7552-7555
57 Hoehn M M, Yahr M D. Evaluation of the long term results of surgical therapy. In: Gillingham FJ, Donaldson IML, eds. Third Symposium on Parkinson's Disease London: Livingstone 1969: 274-280
58 Scott R, Gregory T, Hines N. Neuropsychological, neurological, and functional outcome following pallidotomy for Parkinson's disease: a consecutive series of eight simultaneous bilateral and twelve unilateral procedures. Brain . 1998; 121 659-675
59 Giller C A, Dewey R B, Ginsburg M I. Stereotactic pallidotomy and thalamotomy using individual variations of anatomic landmarks for localization. Neurosurgery . 1998; 42 56-62
60 Merello M, Nouzeilles M I, Kuzis G. Unilateral radiofrequency lesion versus electrostimulation of posteroventral pallidum: a prospective randomized comparison. Mov Disord . 1999; 14 50-56
61 Siegfried J, Compte P, Meier R. Intracerebral electrode implantation system. J Neurosurg . 1983; 59 356-359
62 Siegfried J, Rea G. Advances in neurostimulation devices. In: Plichina F, Broggi G, eds. Advanced Technology in Neurosurgery Berlin: Springer 1988: 199-207
63 Tasker R R, Organ L W, Hawrylshyn P. Investigation of the surgical target for alleviation of involuntary movement disorders. Appl Neurophysiol . 1982; 45 261-274
64 Benabid A L, Pollak P, Gao D. Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders. J Neurosurg . 1996; 84 203-214
65 Blond S, Caparros-Lefebvre D, Parker F. Control of tremor and involuntary movement disorders by chronic stereotactic stimulation of the ventral intermediate thalamic nucleus. J Neurosurg . 1992; 77 62-68
66 Koller W, Pahwa R, Busenbark K. High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor. Ann Neurol . 1997; 42 292-299
67 Limousin P, Speelman J D, Gielsen F. Multicentre European study of thalamic stimulation in parkinsonian and essential tremor. J Neurol Neurosurg Psychiatry . 1999; 66 289-296
68 Ondo W, Jankovic J, Schwartz K. Unilateral thalamic deep brain stimulation for refractory essential tremor and Parkinson's disease tremor. Neurology . 1998; 51 1063-1069
69 Schuurman P R, Bosch D A, Bossuyt P. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N Engl J Med . 2000; 342 461-468
70 Siegfried J, Lippitz B. Bilateral chronic electrostimulation of ventroposterolateral pallidum: a new therapeutic approach for alleviating all parkinsonian symptoms. Neurosurgery . 1994; 35 1126-1130
71 Volkman J, Sturm V, Weiss P. Bilateral high-frequency stimulation of the internal globus pallidus in advanced Parkinson's disease. Ann Neurol . 1998; 44 953-961
72 Ghika J, Villemure J G, Fankhauser H. Efficiency and safety of bilateral contemporaneous pallidal stimulation (deep brain stimulation) in levodopa-responsive patients with Parkinson's disease with severe motor fluctuations: a 2-year follow-up review. J Neurosurg . 1998; 89 713-718
73 Benazzouz A, Piallat B, Ni G. Implication of the subthalamic nucleus in the pathophysiology and pathogenesis of Parkinson's disease. Cell Transplant . 2000; 9 215-221
74 Smith Y, Parent A. Neurons of the subthalamic nucleus in primates display glutamate but not GABA immunoreactivity. Brain Res . 1988; 453 353-356
75 Sellal F, Hirsch E, Lisovoski F. Contralateral disappearance of parkinsonian signs after subthalamic hematoma. Neurology . 1992; 42 255-256
76 Rodriguez M C, Obeso J A, Olanow C W. Subthalamic nucleus-mediated excitotoxicity in Parkinson's disease: a target for neuroprotection. Ann Neurol . 1998; S175-S188 (S175-S188)
77 Limousin P, Krack P, Pollak P. Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. N Engl J Med . 1998; 339 1105-1111
78 Krack P, Pollak P, Limousin P. Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson's disease. Brain . 1998; 121 451-457
79 Houeto J L, Damier P, Bejjani P B. Subthalamic stimulation in Parkinson's disease. Arch Neurol . 2000; 57 461-465
80 Moro E, Scerrati M, Romito L MA. Chronic subthalamic nucleus stimulation reduced medication requirements in Parkinson's disease. Neurology . 1999; 53 85-90
81 Krack P, Pollak P, Limousin P. From off-period dystonia to peak-dose chorea: the clinical spectrum of varying subthalamic nucleus activity. Brain . 1999; 122 1133-1146
82 Kumar R, Lozano A M, Sime E. Comparative effects of unilateral and bilateral subthalamic nucleus deep brain stimulation. Neurology . 1999; 53 561-566
83 Krack P, Pollak P, Limousin P. Subthalamic nucleus stimulation and internal pallidal stimulation in young onset Parkinson's disease. Brain . 1998; 121 451-457
84 Kumar R, Lozano A M, Montgomery E. Pallidotomy and deep brain stimulation of the pallidum and subthalamic nucleus in advanced Parkinson's disease. Mov Disord . 1998; 13 73-82
85 Burchiel K J, Anderson V C, Favre J. Comparison of pallidal and subthalamic nucleus deep brain stimulation for advanced Parkinson's disease: results of a randomized, blinded pilot study. Neurosurgery . 1999; 45 1375-1384
86 Ardouin C, Pillon B, Peiffer E. Bilateral subthalamic or pallidal stimulation for Parkinson's disease affects neither memory nor executive functions: a consecutive series of 62 patients. Ann Neurol . 1999; 46 217-223
87 Madrazo I, Drucker-Colin R, Diaz V. Open microsurgical autograft of adrenal medulla to right caudate nucleus in two patients with intractable Parkinson's disease. N Engl J Med . 1987; 316 831-834
88 Ahlskog J E, Kelly P I, van Heerden A J. Adrenal medullary transplantation into the brain for treatment of Parkinson's disease: clinical outcome and neurochemical studies. Mayo Clin Proc . 1990; 65 305-328
89 Apuzzo J L, Neal H, Waters C H. Utilization of unilateral and bilateral stereotactically placed adrenomedullary-striatal autografts in parkinsonian humans: rationale, techniques and observations. Neurosurgery . 1990; 26 746-757
90 Koller W C, Waxman M, Morantz R. Adrenal neural transplants in Parkinson's disease. Adv Neurol . 1990; 53 559-565
91 Olanow C W, Koller W C, Goetz C G. Autologous transplantation of adrenal medulla in Parkinson's disease. Arch Neurol . 1990; 47 1286-1289
92 Goetz C G, Stebbins G T, Klawans H L. United Parkinson Foundation neurotransplantation registry on adrenal medullary transplant: presurgical, and 1- and 2-year follow-up. Neurology . 1991; 41 1719-1722
93 Jankovic J, Grossman R, Goodman C. Clinical, biochemical, and neuropathologic findings following transplantation of adrenal medulla to the caudate nucleus for treatment of Parkinson's disease. Neurology . 1989; 39 1227-1234
94 Frank F, Sturiale C, Gaist C. Adrenal medulla autograft in a human brain for Parkinson's disease. Acta Neurochir (Wien) . 1988; 94 162-163
95 Hurtig H, Joyce J, Sladek J R. Post-mortem analysis of adrenal medulla-to-caudate autograft in a patient with Parkinson's disease. Ann Neurol . 1989; 25 607-614
96 Waters C H, Itabashi H H, Apuzzo M LJ. Adrenal to caudate transplantation: post mortem study. Mov Disord . 1990; 5 248-250
97 Kordower J H, Cochran E, Penn R. Putative chromaffin cell survival and enhanced host derived TH-fiber innervation following a functional adrenal medulla autograft for Parkinson's disease. Ann Neurol . 1991; 29 405-412
98 Hirsch E C, Duyckaerts C, Javoy-Agid F. Does adrenal graft enhance recovery of dopaminergic neurons in Parkinson's disease?. Ann Neurol . 1990; 27 676-682
99 Bjorklund A, Stenevi U, Schmidt R H. Intracerebral grafting of neuronal cell suspensions: I. Introduction and general methods of preparation. Acta Physiol Scand . 1983; 522 9-18
100 Perlow M, Freed W J, Hoffer B J. Brain grafts reduce motor abnormalities produced by destruction of nigro-striatal dopamine system. Science . 1979; 204 643-647
101 Clarkson E D, Freed C R. Development of fetal neural transplantation as a treatment for Parkinson's disease. Life Sci . 1999; 23 2427-2437
102 Lindvall O, Rehncrona S, Gustavii N. Fetal dopamine-rich mesencephalic grafts in Parkinson's disease. Lancet . 1988; 1483-1484
103 Mahalick T J, Finger T E, Stromberg I. Substantia nigra transplants into denervated striatum of the rat: ultrastructure of graft-host interconnections. J Comp Neurol . 1985; 240 60-70
104 Wuerthele S M, Freed W J, Olson L. Effects of dopamine agonists and antagonists on the electrical activity of substantia nigra neurons transplanted into the lateral ventricle of the rat. Exp Brain Res . 1981; 44 1-10
105 Schmidt R H, Ingvar M, Lindvall O. Functional activity of substantia nigra grafts reinnervating the striatum: neurotransmitter metabolism and [¹⁴C]-2-deoxy-D-glucose autoradiography. J Neurochem . 1982; 38 737-748
106 Brundin P, Bjorklund A. Survival, growth and function of dopaminergic neurons grafted to the brain. Prog Brain Res . 1987; 71 293-308
107 Sladek J R, Collier T C, Haber S N. Survival and growth of fetal catecholamine neurons transplanted into the primate brain. Brain Res Bull . 1986; 17 809-818
108 Bakay R AE, Barrow D L, Fiandca M S. Biochemical and behavioral correction of MPTP-like syndrome by fetal transplantation. Ann N Y Acad Sci . 1987; 495 623-640
109 Lindvall O. Update of fetal transplantation: the Swedish experience. Mov Disord . 1998; 83-87 (83-87)
110 Lindvall O. Neural transplantation: a hope for patients with Parkinson's disease. Neuroreport . 1997; 8 iii-x
111 Piccini P, Brooks D J, Bjorklund A. Dopamine release from nigral transplants visualized in vivo in a Parkinson's patient. Nat Neurosci . 1999; 2 1137-1140
112 Lindvall O, Sawle G, Widner H. Evidence for long-term survival and function of dopaminergic grafts in progressive Parkinson's disease. Ann Neurol . 1994; 35 172-180
113 Freeman T B, Olanow C W, Hauser R A. Bilateral fetal nigral transplantation into the postcommissural putamen in Parkinson's disease. Ann Neurol . 1995; 38 379-388
114 Kordower J H, Freeman T B, Snow B A. Neuropathological evidence of graft survival and striatal reinnervation after the transplantation of fetal mesencephalic tissue in a patient with Parkinson's disease. N Engl J Med . 1995; 332 1118-1124
115 Kordower J H, Freeman T B, Olanow C W. Neuropathology of fetal nigral grafts in patients with Parkinson's disease. Mov Disord . 1998; 88-95 (88-95)
116 Hauser R A, Freeman T B, Snow B J. Long-term evaluation of bilateral fetal nigral transplantation in Parkinson's disease. Arch Neurol . 1999; 56 179-187
117 Wenning G K, Odin P, Morrish P. Short- and long-term survival and function of unilateral intrastriatal dopaminergic grafts in Parkinson's disease. Ann Neurol . 1997; 42 95-107
118 Fahn S. Double-blind controlled trial of embryonic dopaminergic tissue transplants in advanced Parkinson's disease. Mov Disord . 2000; M114 (M114)
119 Greenley H T, Hamm T, Johnson R. The ethical use of human embryonic tissue in medicine. N Engl J Med . 1989; 320 1093-1096
120 Freeman T B, Wojak J, Brandeis L. Cross-species intracerebral grafting of embryonic swine dopaminergic neurons. Prog Brain Res . 1988; 78 473-477
121 Schumacher J M, Ellias S A, Palmer E P. Transplantation of embryonic porcine mesencephalic tissue in patients with PD. Neurology . 2000; 54 1042-1050
122 Subramanian R, Burnette B, Bakay R AE. Intrastriatal transplantation of human retinal pigmented epithelial cells attached to gelatin microcarriers (hRPE-GM) improved parkinsonian motor signs in hemiparkinsonian (HP) monkeys. Mov Disord . 1998; 13 268
123 Subramanian R, Bakay R AE, Cornfeldt M E. Blinded placebo-controlled trial to assess the effects of striatal transplantation of human retinal pigmented epithelial cells attached to microcarriers (hRPE-M) in parkinsonian monkeys. Parkinsonism Relat Disord . 1999; 5 S111
124 Chang C JG, Cornfeldt M L, Schweikert A W. Intracranial tolerability of Spheramine^TM (gelatin microcarrier-bound human retinal pigment epithelial (hRPE) cells) and gelatin microcarriers in cynomolgus monkey. Soc Neurosci . 1999; 25 747