Lesions as Therapy: Rigidity and Parkinsons Disease

Since James Parkinson (1817) first characterized the shaking palsy as a unique condition, significant confusion has remained concerning the causes and treatments of Parkinson‘s disease (PD). Through the 19th century, a wide variety of approaches were attempted in an effort to reduce its cardinal signs – rigidity, tremor, and bradykinesia – but to little effect. Today, approaching 200 years after Parkinson‘s seminal work, this disorder is commonly treated by surgical means, inducing a lesion in one specific portion of a small nucleus in the central nervous system (Desaloms et al., 1998, Lang et al., 1999). The notion of providing a lesion to the nervous system as a therapy for PD, however, began in earnest at the beginning of the 20th century. The first attempt to alleviate the symptoms of PD through surgical means involved a section of the dorsal roots of the spinal cord supplying the affected limb (also known as dorsal rhizotomy).Today, selective dorsal rhizotomy is commonly performed to treat chronic pain (Scrivani et al., 1999) and spasticity in children with cerebral palsy (Vaughan et al., 1998). Thus, for certain types of paralysis, this procedure relieves some measure of rigidity without producing further complications.