Surgery

Surgery is available for some people with Parkinson's, depending on their symptoms. Procedures include:

Deep brain stimulation

Deep brain stimulation involves the implantation of a wire with 4 electrodes at its tip into one of 3 target sites in the brain:

• the thalamus
• the globus pallidus
• the subthalamic nucleus

The wire is connected to a small unit called an implantable pulse generator (IPG) which is implanted under the skin, often in the chest, rather like a pacemaker.

When switched on, the IPG produces electrical signals which are sent to the brain to stop or reduce Parkinson's symptoms.

Lesioning

Lesioning involves inserting an electrode into the brain, causing selective damage to certain cells in either the thalamus (thalamotomy) or the globus pallidus (pallidotomy).

Unlike deep brain stimulation, the procedure is irreversible.

There is very little lesioning being undertaken in the UK for Parkinson's.

Future developments

In the future, other surgery-related treatments may be shown to be safe and beneficial and could be introduced.

These treatments are some way off, but might include:

• brain implants using brain tissue
• infusion of chemicals into basal ganglia