Pallidal Surgery for the Treatment of Parkinson's Disease and Movement Disorders

by Krauss, Joachim K.; Grossman, Robert G.; Jankovic, Joseph

• ISBN13: 9780781712255
• ISBN10: 0781712254
• Format: Hardcover
• Copyright: 1998-10-01
• Publisher: Lippincott Williams & Wilkins

Table of Contents

Contributors	xiii	(4)
Foreword	xvii	(2)
Preface	xix
1. Historical Review of Pallidal Surgery for Treatment of Parkinsonism and other Movement Disorders	1	(24)
Joachim K. Krauss
Robert G. Grossman
Basal Ganglia Surgery for Movement Disorders	2	(1)
Development of Stereotactic Pallidotomy	3	(1)
Pallidotomy during the 1950s and 1960s	4	(12)
Abandoning Pallidotomy	16	(1)
Revival of Pallidal Surgery	17	(8)
2. Primate Models for the Study of Basal Ganglia Physiology and Dysfunction	25	(16)
A.R. Crossman
J.M. Brotchie
Functional Anatomy of the Basal Ganglia	27	(1)
Ballism	28	(3)
Chorea	31	(2)
MPTP-Induced Parkinsonism	33	(2)
L-DOPA-Induced Dyskinesia	35	(1)
Summary	36	(5)
3. Pathophysiology of Parkinsonism and Dyskinesias	41	(14)
Roger L. Albin
Basal Ganglia Organization	41	(3)
Pathophysiology of Parkinson's Disease	44	(2)
Deficiencies of the Model	46	(1)
Pathophysiology of Choreoathetosis/Hemiballism	47	(1)
Peak Dose Dyskinesias	47	(3)
Dyskinesias: A Role for the Thalamus?	50	(2)
Conclusions	52	(3)
4. Rationales for Pallidal Surgery: What are the Mechanisms?	55	(12)
Allen S. Mandir
Frederick A. Lenz
Basal Ganglia Motor Circuitry: Pathophysiology in Parkinsonism	55	(1)
Pallidal Surgery for Parkinson's Disease	56	(1)
Disorders Resulting from Increased Basal Ganglia Output Activity	57	(2)
Disorders Resulting from Decreased Basal Ganglia Output Activity	59	(3)
Conclusion	62	(5)
5. Parkinson's Disease	67	(34)
William G. Ondo
Joseph Jankovic
Epidemiology	67	(1)
Clinical Features	68	(2)
Parkinson's Disease Rating Scales	70	(1)
Atypical Parkinsonism	70	(7)
Pathology of Parkinson's Disease	77	(1)
Pathophysiology of Parkinson's Disease	77	(2)
Cell Death in Parkinson's Disease	79	(1)
Etiology of Parkinson's Disease	80	(2)
Dyskinesia	82	(1)
Treatment	83	(18)
6. Clinical Assessment and Study Design for Pallidal Surgery	101	(12)
Andres M. Lozano
Anthony E. Lang
Clinical Assessment	101	(2)
Study Design	103	(1)
Study Design for Pallidal Surgery	104	(2)
Conclusion	106	(1)
Appendix 1: Modified Hoehn and Yahr Staging of Parkinson's Disease	107	(1)
Appendix 2: Unified Parkinson Disease Rating Scale	107	(5)
Appendix 3: Dyskinesia Scale Score	112	(1)
Appendix 4: Schwab and England Activities of Daily Living Scale	112	(1)
7. Indications for Pallidal Surgery for Parkinson's Disease	113	(8)
Eugene C. Lai
Joachim K. Krauss
Efficacy of PVP	113	(1)
Baylor College of Medicine Experience	113	(3)
Specific Indications for Pallidotomy	116	(1)
Specific Contraindications for Pallidotomy	117	(1)
Additional Factors for Consideration	118	(1)
Chronic Pallidal Stimulation	119	(1)
Conclusions	119	(2)
8. Operative Techniques for Pallidal Surgery	121	(14)
Joachim K. Krauss
Robert G. Grossman
Stereotactic Frame Systems and Instrumentation	121	(1)
Preoperative Preparation of the Patient	122	(1)
Stereotactic Targeting and Stereotactic Atlases	123	(1)
Stereotactic Image Acquisition	124	(2)
Surgical Technique	126	(9)
9. Microelectrode Techniques and Findings of Globus Pallidus	135	(18)
William D. Hutchison
Techniques of Microelectrode Recordings	135	(5)
Recording in Pallidum and Surrounding Structures	140	(7)
Intraoperative Observations during Microelectrode Recording	147	(3)
Conclusions	150	(3)
10. Results of Unilateral Pallidotomy for Parkinson's Disease: Two-Year Experience and Review of the Literature	153	(20)
Anthony E. Lang
Erwin B. Montgomery, Jr.
Janice L. Duff
Ronald Tasker
William D. Hutchison
Andres M. Lozano
Materials and Methods	154	(3)
Results	157	(8)
Discussion	165	(8)
11. Bilateral Pallidotomy for the Treatment of Parkinson's Disease	173	(6)
Jamal M. Taha
Jacques Favre
Kim J. Burchiel
Literature Review	173	(2)
Personal Experience	175	(2)
Conclusions	177	(2)
12. Pallidotomy: A Treatment for Parkinsonian Tremor?	179	(12)
Monique L. Giroux
Jerrold L. Vitek
Historical Perspective	180	(1)
Pathophysiology of Parkinsonian Tremor	180	(2)
Effect of Posteroventral Pallidotomy on Parkinsonian Tremor: Contemporary Literature	182	(2)
Functional Organization of the Pallidum: Relation of Lesion Location to Tremor Alleviation Following Pallidotomy	184	(3)
Conclusions	187	(4)
13. Changes in Postural Control after Pallidotomy	191	(20)
Averell S. Overby
Deborah Roberts-Warrior
Eugene C. Lai
Postural Control	191	(1)
Tests of Balance	192	(1)
Postural Dyscontrol in Parkinson's Disease	193	(2)
Results	195	(12)
Conclusions	207	(4)
14. Neuropsychological Evaluation of Patients with Parkinson's Disease Before and After Pallidal Surgery	211	(22)
Gayle M. Rettig
Eugene C. Lai
Joachim K. Krauss
Robert G. Grossman
Joseph Jankovic
Neuropsychological Impairment in Parkinson's Disease	211	(1)
Effects of PVP on Neuropsychological Function: Review of Current Literature	212	(2)
Effects of Unilateral PVP on Neuropsychological Function: Baylor College of Medicine Study	214	(8)
Discussion	222	(4)
Conclusions	226	(3)
Appendix: Neuropsychological Test Battery	229	(4)
15. Deep Brain Stimulation of the Pallidum	233	(8)
Steven B. Wilkinson
William Koller
Selection of Patients	233	(1)
Surgical Procedure	234	(3)
Results	237	(1)
Discussion	238	(3)
16. Gamma Knife Pallidotomy for Parkinson's Disease	241	(8)
Gerhard M. Friehs
Joseph H. Friedman
Mel H. Epstein
Georg Noren
Gamma Knife	241	(1)
Procedure	242	(2)
Clinical Experience	244	(2)
Conclusions	246	(3)
17. Parkinson's Disease and Stereotactic Pallidal Surgery: Studies with Positron Emission Tomography	249	(12)
Angelo Antonini
David Eidelberg
Positron Emission Tomography Studies of the Striatal Dopaminergic System	249	(3)
Surgical Treatment of Parkinsonian Symptoms	252	(4)
Conclusions	256	(5)
18. Contemporary Pallidal Surgery for Treatment of Other Parkinsonian Syndromes	261	(6)
Ron L. Alterman
Patrick J. Kelly
Parkinson Plus Syndromes	261	(2)
Pallidotomy for Parkinson Plus Syndromes	263	(1)
Pallidotomy for Other Levodopa-Unresponsive Parkinsonism	264	(1)
Conclusions	264	(3)
19. Pallidal Surgery: A New Option for Surgical Treatment of Dystonia	267	(8)
Jerrold L. Vitek
Frederick A. Lenz
Thalamotomy	267	(2)
Pallidotomy	269	(4)
Conclusions	273	(2)
20 A. Optimal Target of Pallidotomy: A Controversy	275	(10)
Roy A.E. Bakay
Phillip A. Starr
Historical Review	275	(1)
Contemporary Series	276	(1)
Pallidotomy for Parkinson's Disease: Theoretical Basis	277	(2)
Synthesizing Theory and Clinical Observations	279	(2)
Conclusions	281	(4)
20B. Optimal Target of Pallidotomy: A Controversy	285	(6)
Lauri V. Laitinen
Logical Ablative Pallidotomy Target	285	(1)
Ventroposterolateral Pallidotomy	286	(1)
Results and Adverse Effects	287	(1)
Conclusions	288	(3)
20C. Optimal Target of Pallidotomy: A Controversy	291	(6)
Joachim K. Krauss
Robert G. Grossman
Location and Size of Pallidal Lesions in Previous Studies	291	(3)
A Case for Posteroventral Lateral GPi Pallido-Subpallidotomy	294	(1)
Anatomical and Physiological Considerations	294	(2)
Perspectives	296	(1)
21. Neurosurgical Alternatives for Treatment of Parkinson's Disease	297	(10)
Richard D. Penn
Glial-Derived Neurotrophic Factor	298	(4)
Neurotransplantation	302	(1)
Pallidal Surgery Versus Neurotransplantation	302	(5)
Subject Index	307