Contribution of Human Stereotaxic Surgery to Treatment and Understanding of Parkinson’s Disease

  • Hirotaro Narabayashi
Part of the Advances in Behavioral Biology book series (ABBI, volume 47)


Treatment of the extrapyramidal involuntary movement, especially rigidity and tremor in parkinsonism, has been, and is even today, the main topic in the field of human stereotaxic surgery since its start around 1950. Although the number of the cases of Parkinson’s disease (PD) subjected to stereotaxic surgery has decreased considerably after the development of levodopa treatment, stereotaxic surgical treatment of the disease is still important. It offers a valuable method for improving otherwise untreatable symptoms, when medicine does not work satisfactorily, as well as a valuable opportunity for studying the pathophysiological mechanism occurring in the depth of the brain.


Levodopa Therapy Stereotaxic Surgery Parkinsonian Tremor Sheath Electrode Human Thalamus 
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  1. Albe-Fessard, D., Arfel, G., and Guiot, G., 1963, Activités électriques caractéristiques de quelques structures cérébrales chez l’homme, Ann. Chir. 17: 1185–1214.PubMedGoogle Scholar
  2. Fukamachi, A., Ohye, C., Saito, Y., and Narabayashi, H., 1977, Estimation of the neural noise within the human thalamus, Acta Neurochir. (Suppl. 24): 121–136.CrossRefGoogle Scholar
  3. Garcia-Rill, E., 1986, The basal ganglia and the locomotor regions, Brain Res. Rev. 11: 47–63.CrossRefGoogle Scholar
  4. Gibb, W.R.G., and Lees, A.J., 1991, Anatomy, pigmentation, ventral and dorsal subpopulations of the substantia nigra, and differential cell death in Parkinson’s disease, J. Neurol. Neurosurg. Psychiatry 54: 388–396.PubMedCrossRefGoogle Scholar
  5. Goto, S., Hirano, A., and Matsumoto, S., 1989, Subdivisional involvement of nigrostriatal loop in idiopathic Parkinson’s disease and striatonigral degeneration, Ann. Neurol. 26: 766–770.PubMedCrossRefGoogle Scholar
  6. Hassler, R., 1959, Anatomy of the thalamus, in: Introduction to Stereotaxis with Atlas of the Human Brain (G. Schaltenbrand, and P. Bailey, eds.), Thieme, Stuttgart, pp. 230–290.Google Scholar
  7. Hirai, T., Miyazaki, M., Nakajima, H., Shibazaki, T., and Ohye, C., 1983, The correlation between tremor characteristics and the predicted volume of effective lesion in stereotaxic nucleus ventralis intermedius thalamotomy, Brain 106: 1001–1018.PubMedCrossRefGoogle Scholar
  8. Hughes, R.C., Polgar, J.G., Weightman, D., and Walton, J.N., 1974, L-dopa in parkinsonism and the influence of previous thalamotomy, Br. Med. J. 1:7–13.CrossRefGoogle Scholar
  9. Laitinen, L.V., Bergenheim, A.T., and Hariz, M.I., 1992, Leksell’s posteroventral pallidotomy in the treatment of Parkinson’s disease, J. Neurosurg. 76: 53–61.PubMedCrossRefGoogle Scholar
  10. Mogenson, G.J., Brudzynski, S.M., Wu, M., Yang, C.R., and Yim, C.C.Y, 1993, From motivation to action: A review of dopaminergic regulation of limbic → nucleus accumbens → ventral pallidum → pedunculopontine nucleus circuitries involved in limbic motor integraion, in: Limbic Motor Circuits and Neuropsychiatry (P.W. Kallivas, and C.D. Barnes, eds.), CRC Press, Boca Raton, FL., pp. 193–236.Google Scholar
  11. Mountcastle, V.B., and Henneman, E., 1952, The representation of tactile sensibility in the thalamus of the monkey, J. Comp. Neurol. 97: 409–440.PubMedCrossRefGoogle Scholar
  12. Mundinger, F., 1983, 30 Jahre stereotaktische Hirnoperationen beim Parkinsonismus (Ergebnisse im Vergleich pallido-thalamo-subthalamischer Ausschaltungen und Indikationen), in: Pathophysiologie, Klinik und Therapie des Parkinsonismus (H. Gänshirt, ed.), Roche, Basle, pp. 331–357.Google Scholar
  13. Narabayashi, H., 1981, Surgical approach to tremor, in: Movement Disorders (CD. Marsden, and S. Fahn, eds.), Butterworth, London, pp. 292–299.Google Scholar
  14. Narabayashi, H., 1983, Pharmacological basis of akinesia in Parkinson’s disease, J. Neural Transm. (Suppl. 19): 143–151.Google Scholar
  15. Narabayashi, H., 1986, Tremor: its generating mechanism and treatment, in: Handbook of Clinical Neurology, Volume 5(49) (P.J. Vinken, G.W. Bruyn, and H.L. Klawans, eds.), Elsevier Science Publishers, Amsterdam, pp. 597–607.Google Scholar
  16. Narabayashi, H., 1990, Surgical treatment in the levodopa era, in: Parkinson’s Disease (G. Stem, ed.), Chapman & Hall, London, pp. 597–646.Google Scholar
  17. Narabayashi, H., 1993, Three types of akinesia in the progressive course of Parkinson’s disease, in: Advances in Neurology, Volume 60 (H. Narabayashi, T. Nagatsu, N. Yanagisawa, and Y. Mizuno, eds.), Raven Press, New York, pp. 18–24.Google Scholar
  18. Narabayashi, H., 1995, The neural mechanisms and progressive nature of symptoms of Parkinson’s disease-based on clinical, neurophysiological and morphological studies, J. Neural Transm. [P-D Sect.] 10: 63–75.CrossRefGoogle Scholar
  19. Narabayashi, H., and Ohye, C., 1978, Parkinsonian tremor and nucleus intermedius of the human thalamus, in: Progress in Clinical Neurophysiology, Volume 5 (J.E. Desmedt, ed.), Karger, Basel, pp. 165–172.Google Scholar
  20. Narabayashi, H., and Ohye, C., 1980, Importance of microstereoencephalotomy for tremor alleviation. Appl. Neurophysiol. 43: 222–227.PubMedGoogle Scholar
  21. Narabayashi, H., and Ohye, C., 1983, Pathological tremor: Its generating mechanism and treatment, in: Current Concepts of Parkinson Disease and Related Disorders (M.D. Yahr, ed.), Excerpta Medica, Amsterdam, pp. 47–55.Google Scholar
  22. Narabayashi, H., and Okuma, T., 1953, Procaine oil blocking of the globus pallidus for the treatment of rigidity and tremor of parkinsonism, Proc. Jpn Acad. 29(3)Google Scholar
  23. Narabayashi, H., Okuma, T., and Shikiba, S., 1956, Procaine oil blocking of the globus pallidus, Arch. Neurol. Psychiatry 75: 36–48.CrossRefGoogle Scholar
  24. Narabayashi, H., Yokochi, F., and Nakajima, Y., 1984, Levodopa-induced dyskinesia and thalamotomy, J. Neurol. Neurosurg. Psychiatry 47: 831–839.PubMedCrossRefGoogle Scholar
  25. Ohye, C., and Narabayashi, H., 1979, Physiological study of presumed ventralis intermedius neurons in the human thalamus, J. Neurosurg. 50: 290–297.PubMedCrossRefGoogle Scholar
  26. Ohye, C., Tsukahara, N., and Narabayashi, H., 1965, Rigidity and disturbance of reciprocal innervation, Confin. Neurol. 26: 24–40.Google Scholar
  27. Ohye, C., Saito, Y., Fukamachi, A., and Narabayashi, H., 1974, An analysis of the spontaneous rhythmic and non-rhythmic burst discharges in the human thalamus, J. Neurol. Sci. 22: 245–259.PubMedCrossRefGoogle Scholar
  28. Schaltenbrand, G., and Bailey, P., 1959, Introduction to Stereotaxis with an Atlas of the Human Brain, Georg Thieme, Stuttgart.Google Scholar
  29. Smith, M.C., 1967, Stereotactic operations for Parkinson’s disease. Anatomical observations, Mod. Trend Neurol. 4:21–52.Google Scholar
  30. Svennilson, E., Torvik, E., Lowe, R., and Leksell, L.,1960, Treatment of parkinsonism by stereotactic thermolesions in the pallidal region, Acta Psychiat. Neurol. Scand. 35: 358–377.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Hirotaro Narabayashi
    • 1
  1. 1.Neurological ClinicMeguro-ku, Tokyo 153Japan

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