Ostergaard K, Sunde N A, Dupont E
Arhus Universitetshospital, neurologisk afdeling F.
Ugeskr Laeger. 2000 Oct 9;162(41):5484-8.
Recognition of the often failing effect of levodopa treatment as Parkinson's disease (PD) progresses has led to the resumption of surgical treatment. In the 1950'ies and 1960'ies pallidotomy and thalamotomy were commonly performed to reduce parkinsonian symptoms, whilst today these permanent lesions are replaced by Deep Brain Stimulation (DBS) of implanted leads. The advantages of DBS in either the subthalamic nuclei (STN) or the internal part of the globus pallidus are that implantation of leads into these nuclei can be performed bilaterally, and that DBS is a reversible treatment. Pallidotomy and thalamotomy are permanent lesions and if performed bilaterally these lesions often cause unacceptable complications. Bilateral stimulation of the STN is often preferred due to the reduction of rigidity, hypokinesia and tremor as well as the significant reduction of dyskinesias and off-periods. The motor functions are significantly improved and stabilized.
随着帕金森病（PD）的进展，左旋多巴治疗效果常常逐渐失效，这使得手术治疗得以重新开展。在20世纪50年代和60年代，苍白球切开术和丘脑切开术常用于减轻帕金森症状，而如今这些永久性损伤已被植入电极的脑深部电刺激（DBS）所取代。在丘脑底核（STN）或苍白球内侧部进行DBS的优势在于，电极植入这些核团可双侧进行，且DBS是一种可逆性治疗。苍白球切开术和丘脑切开术会造成永久性损伤，如果双侧进行，这些损伤常常会导致不可接受的并发症。由于STN双侧刺激能减轻僵直、运动迟缓及震颤，还能显著减少异动症和“关”期，所以常常被优先选用。运动功能得到显著改善并趋于稳定。
