MODERN METHOD APPROACHES TO SURGICAL TREATMENT OF PARKINSON'S DISEASE

Abstract

Parkinson's disease (PD) is a progressive incurable degenerative disorder of the central nervous system, which significantly limits the functional status of patients. Modern medicine has various methods of drug and surgical treatment of this disease. The review considers all stages of surgical treatment of PD, starting with historically interesting descriptions of resection of the precentral gyrus to stereotactic destruction by various methods of exposure and electrical stimulation of deep brain structures. Indications for each method, their advantages and disadvantages, principles of patient selection are presented. Indications for neurosurgical treatment are determined taking into account the international CAPSIT-PD criteria. Stereotactic destructions lead to irreversible changes in the brain tissue, so their widespread use is limited. Stimulation with deep electrodes has advantages in disease progression due to the ability to change stimulation parameters and the possibility of bilateral influence on motor symptoms. Surgical treatment of PD does not mean the abolition of drug therapy, but it allows to reduce the dose of antiparkinsonian drugs and their possible adverse effects. The best result can be achieved with timely surgery and correct selection of patients by a multidisciplinary medical team, taking into account the characteristics of the course of the disease, the possibility of long-term postoperative observation of the patient and correction of stimulation parameters.