Summary
Rigidity and tremor are almost completely alleviated by stereotaxic surgery on the ventral subnuclei of the thalamus without producing side effect. With use of microelectrode technique to analyze the neuronal activity, the VL, which receives the pallidal afferents, is explained responsible for rigidity and the Vim, which receives the proprioceptive afferents from periphery, for tremor. Primary akinesia is not changed at all by surgery but responds well to levodopa. Long-term observations of the postoperative course established that improvement by surgery with/without medicine was more sustained and longlasting in the cases of younger onset than in those of classical PD. This may suggest that in clinical and pathophysiological analysis, the degenerative process of the disease is limited within the nigrostriatal DA system in the former and more widespread in the latter. Within the nigrostriatum, nigroputaminal part is analysed to be first affected. Speed of progression seems to show the difference between cases of early onset parkinsonism and PD.
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Narabayashi, H. (1991). Role of stereotaxic surgery in treatment of Parkinson’s disease. In: Nagatsu, T., Narabayashi, H., Yoshida, M. (eds) Parkinson’s Disease. From Clinical Aspects to Molecular Basis. Key Topics in Brain Research. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9146-0_19
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DOI: https://doi.org/10.1007/978-3-7091-9146-0_19
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