New developments in the surgery for Parkinson's disease

Despite optimization of medical therapy, a large number of patients with Pa rkinson's disease continue to be disabled. For this group, alternate treatm ent strategies such as neurosurgical intervention can be considered. Recent advances in neurosurgical techniques and in understanding the pathophysiol ogy of motor disturbances in PD have made surgery safer and more effective. Functional neurosurgical procedures to lesion or electrically modulate dys functional basal ganglia circuits or to protect or restore dopaminergic tra nsmission are being increasingly used. These procedures are having a profou nd impact on the motor disturbances of PD and are producing important impro vements in quality of life of patients.