Due to the side effects of the thalamotomy, this new type of surgery is being investigated. While using a stimulating electrode to guide a lesion placement for a thalamotomy, it was discovered that high frequency discharges could get rid of tremor. It was suggested that a chronic stimulating electrode be inserted into the brain. This method has shown to reduce the tremor, but the akinesia is still present. However, this is beneficial because as the disease progresses, there is an alternative to making a second contralateral lesion as with the thalamotomy.
This surgery consists of stereotactic insertion of an electrode, done under a local anesthetic. This connects to a pulse generator, which is inserted subcutaneously under a general anesthetic. It is thought that this works by mimicking the effects of a lesion, probably due to inhibition, not stimulation of neurons. The cost of this procedure is about $8000, where about $6000 of it is for the generator which must be replaced every 4-5 years. This is more than the cost of the pallidotomy or the thalamotomy.
Other Areas of Interest
Stimulation to this area may improve dyskinesia, but electrode settings that improve dyskinesia may worsen akinesia, and vice versa, depending on the symptoms that the individual has. (Quinn, 1998)
It is important at this point to keep in mind that the deep brain stimulation procedure is still in its experimental stages. Also, it is still not certain which target areas are the most beneficial, and what techniques, deep brain stimulation, pallidotomy, or thalamotomy, are best for what situations. Still on the horizon is fetal tissue transplantation.