Tratamiento quirúrgico para Parkinson: actualización bibliográfica.

Abstract

Introduction: Parkinson’s disease is a chronic condition characterized by the progressive loss of dopaminergic neurons, leading to disabling motor symptoms. In the initial stages, pharmacological treatments are employed; nonetheless, in cases of insufficient response or advanced disease phases, surgical interventions such as deep brain stimulation (DBS), thalamotomy, and pallidotomy are considered. Objective: To identify the current surgical techniques used in the treatment of Parkinson's disease. Method: A systematic review following PRISMA 2020 guidelines was conducted, utilizing information from the last 5 years and databases including PubMed, Scopus, and Springer. Results: Eighty percent of the included studies focused on Deep Brain Stimulation. It produced sustained motor improvements in 75–80% of patients in the long term. Pallidotomy and thalamotomy improved motor symptoms in 65% of cases. These ablative procedures are irreversible and carry risks (hemorrhages, infections). Furthermore, benefits in non-motor symptoms were observed in approximately 70% of patients treated with DBS. Conclusions: DBS is the surgical technique of choice for advanced Parkinson's disease due to its high efficacy (80% motor improvement) and adjustable nature. Pallidotomy and thalamotomy are options for selected cases, providing significant improvements (65%) but with irreversible risk. Collectively, these surgical procedures improve long-term symptomatic control and reduce medication dependency. The selection of the technique should be individualized based on clinical criteria. Keywords: Parkinson’s, functional surgery, Deep Brain Stimulation, pallidotomy, thalamotomy