Parkinson's Disease Surgery: Understanding The Treatment Options

Parkinson's disease is typically managed with medication as the first line of treatment. However, for patients who experience limited benefits from medication, particularly younger individuals with financial feasibility, surgical intervention might be considered. One of the most common and effective surgical approaches is Deep Brain Stimulation (DBS), often referred to as brain electrostimulation or a "brain pacemaker."

What Is Deep Brain Stimulation (DBS)?

In DBS surgery, electrodes are precisely implanted near the basal ganglia in the brain. These electrodes deliver continuous electrical impulses that help regulate abnormal brain activity. This stimulation can significantly improve symptoms such as tremors, muscle rigidity, and bradykinesia (slowness of movement). While DBS is especially effective for limb tremors and rigidity, it also offers some relief for axial rigidity, such as stiffness experienced upon waking up, and can help with freezing of gait and slowed movements.

Alternative Surgical Options: Thalamotomy and Pallidotomy

In the past, procedures like thalamotomy or pallidotomy—where specific parts of the brain are destroyed—were more commonly used to treat Parkinson's symptoms. These surgeries aimed to alleviate tremors and rigidity by targeting overactive brain regions. However, these methods are now considered outdated and are no longer widely recommended.

Why DBS Is Preferred Over Lesioning Procedures

Unlike lesioning surgeries, which permanently destroy brain tissue, DBS is reversible and adjustable. It doesn't involve the destruction of brain structures, making it a safer and more flexible option. Lesioning procedures carry a higher risk of complications, including speech difficulties, cognitive changes, and even stroke-like symptoms. Due to these risks and the superior outcomes associated with DBS, lesioning techniques have largely been phased out in modern Parkinson's treatment protocols.