Deep Brain Stimulation Therapy for the Treatment of Parkinson's Disease

Abstract

In our experience, placing a 15-mm diameter burr-hole at a position 35 mm anterior to the bregma with head up at under 30 degrees from the horizontal plane of the ground is useful for reducing leakage of cerebrospinal fluid and air influx into the subdural space during stereotactic operations, and for protecting against brain shift. Furthermore, such an anterior location for the burr-hole is necessary in order to insert the DBS electrode at an angle of about 45 degrees from the horizontal plane of the AC-PC line, to pass through not only the subthalamic nucleus (STN) but also Forel H2. This makes it possible for the STN, zona incerta, and Forel H2 to be stimulated together. A new dual-floor burr-hole technique for use in deep brain stimulation therapy has also been developed by us. The thalamic Vim/Vop nucleus, globus pallidus interna (GPi), and subthalamic nucleus (STN) are selected as stimulation points for the treatment of Parkinson's disease. In the present paper, we mainly introduce our method and results for STN stimulation in the treatment of advanced Parkinson's disease.