Most effective stimulation site in subthalamic deep brain stimulation for Parkinson's disease

The optimal stimulation site in subthalamic deep brain stimulation (STN‐DBS) was evaluated by correlation of the stereotactic position of the stimulation electrode with the electrophysiologically specified dorsal STN border. In a series of 25 electrodes, best clinical results with least energy consumption were found in contacts located in the dorsolateral border zone, whereas contacts within the subthalamic white matter, e.g., zona incerta, were significantly less effective. We suggest that the dorsolateral STN border should be covered by STN‐DBS. © 2004 Movement Disorder Society

[1]  J. Volkmann,et al.  Introduction to the programming of deep brain stimulators , 2002, Movement disorders : official journal of the Movement Disorder Society.

[2]  A. Benabid,et al.  Effect of high-frequency stimulation of the subthalamic nucleus on the neuronal activities of the substantia nigra pars reticulata and ventrolateral nucleus of the thalamus in the rat , 2000, Neuroscience.

[3]  T. Hirai,et al.  The correlation between tremor characteristics and the predicted volume of effective lesions in stereotaxic nucleus ventralis intermedius thalamotomy. , 1983, Brain : a journal of neurology.

[4]  E. Moro,et al.  Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson’s disease , 1999, Neurology.

[5]  L Lopiano,et al.  Deep brain stimulation of the subthalamic nucleus: anatomical, neurophysiological, and outcome correlations with the effects of stimulation , 2002, Journal of neurology, neurosurgery, and psychiatry.

[6]  M. Delong,et al.  Primate models of movement disorders of basal ganglia origin , 1990, Trends in Neurosciences.

[7]  G. Boczán,et al.  Subthalamotomy in Parkinson's disease. , 1970, Confinia neurologica.

[8]  Bettina Schrader,et al.  Two‐year follow‐up of subthalamic deep brain stimulation in Parkinson's disease , 2003, Movement disorders : official journal of the Movement Disorder Society.

[9]  A L Benabid,et al.  Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson's disease. , 1998, Brain : a journal of neurology.

[10]  Paul Krack,et al.  Intraoperative microrecordings of the subthalamic nucleus in Parkinson's disease , 2002, Movement disorders : official journal of the Movement Disorder Society.

[11]  A. Benabid,et al.  Predictors of effective bilateral subthalamic nucleus stimulation for PD , 2002, Neurology.

[12]  J. Vitek.  Mechanisms of deep brain stimulation: Excitation or inhibition , 2002, Movement disorders : official journal of the Movement Disorder Society.

[13]  Jens Volkmann,et al.  Bilateral high-frequency stimulation in the subthalamic nucleus for the treatment of Parkinson disease: correlation of therapeutic effect with anatomical electrode position. , 2002, Journal of neurosurgery.

[14]  Aviva Abosch,et al.  Localization of clinically effective stimulating electrodes in the human subthalamic nucleus on magnetic resonance imaging. , 2002, Journal of neurosurgery.

[15]  P Ashby,et al.  Neurophysiological effects of stimulation through electrodes in the human subthalamic nucleus. , 1999, Brain : a journal of neurology.

[16]  W. Hamel,et al.  Documentation of electrode localization , 2002, Movement disorders : official journal of the Movement Disorder Society.

[17]  A. Benabid,et al.  Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease. , 2003, The New England journal of medicine.

[18]  J. Dostrovsky,et al.  Mechanisms of deep brain stimulation , 2002, Movement disorders : official journal of the Movement Disorder Society.

[19]  P J Kelly,et al.  Comparison of anatomic and neurophysiological methods for subthalamic nucleus targeting. , 2000, Neurosurgery.

[20]  R. Hassler.  Fiber connections within the extrapyramidal system. , 1974, Confinia neurologica.

[21]  R. J. Allan,et al.  Neurophysiological identification of the subthalamic nucleus in surgery for Parkinson's disease , 1998, Annals of neurology.

[22]  F. Mundinger.  Stereotaxic interventions on the zona incerta area for treatment of extrapyramidal motor disturbances and their results. , 1965, Confinia neurologica.