Movement Disorders: Deep-Brain Stimulation Perspective

  • John Y. K. Lee
  • Joshua M. Rosenow
  • Ali R. Rezai


The introduction and technical refinements of deep-brain stimulation (DBS) for the treatment of movement disorders over the past 15 years have resulted in a renaissance in the field of functional neurosurgery. For patients with medically refractory movement disorders, DBS procedures have largely replaced neuroablative techniques in the treatment of patients with movement disorders. This shift away from ablative procedures is multifactorial, but among the more important factors are its proven efficacy, the dramatic reversibility of the effects of neurostimulation, and the perceived minimally invasive nature of DBS compared with destructive procedures. Opposing this trend, however, has been the rise in the past decade in the use of Gamma Knife (GK) and occasionally linear accelerator (linac)-based radiosurgical units to perform thalamotomies and pallidotomies. The benefits of radiosurgical ablations include the fact that it is even less invasive than traditional surgical approaches, thus virtually eliminating the risk of hemorrhage, infection, and hardware-related complications. In addition, Gamma Knife radiosurgery is less time-consuming than microelectrode-guided radiofrequency lesioning and can be performed in patients who are at higher surgical risks for open procedures, such as patients with medical comorbidities or patients who cannot tolerate an awake procedure.


Parkinson Disease Essential Tremor Gamma Knife Subthalamic Nucleus Gamma Knife Radiosurgery 
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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • John Y. K. Lee
    • 1
    • 2
  • Joshua M. Rosenow
    • 3
    • 4
  • Ali R. Rezai
    • 5
  1. 1.Department of NeurosurgeryUniversity of PennsylvaniaPhiladelphia
  2. 2.Penn Gamma Knife at Pennsylvania HospitalUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of Neurosurgery, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Northwestern Memorial HospitalChicagoUSA
  5. 5.Brain Neuromodulation Center, Jane and Lee Seidman Chair in Functional NeurosurgeryThe Cleveland Clinic FoundationClevelandUSA

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