Article highlights
The subthalamic nucleus (STN) plays a key role in the pathophysiology of Parkinson´s disease (PD).
Neurosurgical targeting of the STN with Deep Brain Stimulation is a worldwide procedure for PD.
Ablation of the STN with Radio Frequency has also been undertaken in several hundred of patients.
Recent introduction of focal ablation of brain targets with ultrasound (FUS) as an incisionless, less invasive procedure has opened new horizons.
FUS ablation of the STN has been carried out with good results and a double-blind randomized study showed significant benefit and low incidence of permanent severe side effects.
The fear to produce persistent, troublesome hemichorea-ballism by STN lesioning is not supported by data but better target definition is needed to optimize therapeutic efficacy.
Subthalamotomy (by FUS) could be considered as a early treatment strategy in the future
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If you want to know the future for Parkinson Disease Dr Roger Barker’s Edinburgh Lecture is superb.
