Due to the concern that subthalamic lesioning can lead to hemiballismus, subthalamic lesioning was not preferred for treating Parkinson’s disease.

Left subthalamic nucleus lesion

But reports have come up showing effectiveness and safety of lesioning in Parkinson’s patients.The surgical protocol and the steps are same as used for STN DBS but instead of placing electrodes, a lesion is created in the STN using Radio frequency electrode.

STN lesion has the benefit of being cheaper as compared to STN DBS but has the disadvantage of being irreversible. In certain cases where either the patient does have the ability to travel to the center for programming of DBS or is not able to afford, STN lesion can be used as an alternative. The improvement achieved by lesioning is comparable to STN DBS. Only few centers around the world have necessary equipment and expertise to perform this surgery.