Subthalamic Nucleus Deep Brain Stimulation: Basic Concepts and Novel Perspectives

Clement Hamani, Gerson Florence, Helmut Heinsen, Birgit R Plantinga, Yasin Temel, Kamil Uludag, Eduardo Alho, Manoel J Teixeira, Edson Amaro, Erich T Fonoff

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Over the last decades, extensive basic and clinical knowledge has been acquired on the use of subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease (PD). It is now clear that mechanisms involved in the effects of this therapy are far more complex than previously anticipated. At frequencies commonly used in clinical practice, neural elements may be excited or inhibited and novel dynamic states of equilibrium are reached. Electrode contacts used for chronic DBS in PD are placed near the dorsal border of the nucleus, a highly cellular region. DBS may thus exert its effects by modulating these cells, hyperdirect projections from motor cortical areas, afferent and efferent fibers to the motor STN. Advancements in neuroimaging techniques may allow us to identify these structures optimizing surgical targeting. In this review, we provide an update on mechanisms and the neural elements modulated by STN DBS.

Original languageEnglish
Article numbere.0140-17.2017
Pages (from-to)1-14
Number of pages14
JournaleNeuro
Volume4
Issue number5
DOIs
Publication statusPublished - 3 Oct 2017

Keywords

  • Journal Article
  • Review
  • DOPAMINE DYSREGULATION SYNDROME
  • anatomy
  • BASAL GANGLIA
  • physiology
  • plasticity
  • HIGH-FREQUENCY STIMULATION
  • NIGRA PARS RETICULATA
  • deep brain stimulation
  • REACTION-TIME-TASK
  • neuroimaging
  • OBSESSIVE-COMPULSIVE DISORDER
  • PRIMARY MOTOR CORTEX
  • DECREASE IMPULSIVE CHOICE
  • MPTP-TREATED MONKEYS
  • subthalamic nucleus
  • ADVANCED PARKINSON-DISEASE
  • mechanisms

Cite this

Hamani, C., Florence, G., Heinsen, H., Plantinga, B. R., Temel, Y., Uludag, K., Alho, E., Teixeira, M. J., Amaro, E., & Fonoff, E. T. (2017). Subthalamic Nucleus Deep Brain Stimulation: Basic Concepts and Novel Perspectives. eNeuro, 4(5), 1-14. [e.0140-17.2017]. https://doi.org/10.1523/ENEURO.0140-17.2017