Stereotactic MRI for Functional Neurosurgery in Parkinson’s Disease

Introduction Surgical interventions to control Parkinson’s disease (PD) have a long history. Pallidotomy, for example, was performed in the 1950s for treatment of the motor symptoms of PD (1) but dissatisfaction with the long term results of surgery led to a decrease in popularity and its replacement to a large degree by thalamotomy. More recently a resurgence of interest in surgical intervention for PD has taken place including pallidotomy (2,3), thalamotomy, thalamic stimulation, subthalamic nuclei stimulation and fetal tissue transplantation (4). Stereotactic MRI has a valuable role to play in such procedures. We have developed and tested a suite of protocols for stereotactic imaging for a range of functional neurosurgery operations which we describe here.