CLINICAL VIGNETTE A 67-year-old female with advanced Parkinson's disease (PD), medically refractory tremor, and a history of significant depression presented for evaluation of deep brain stimulation (DBS) candidacy. CLINICAL DILEMMA Traditionally, the subthalamic nucleus (STN) has been preferred over the globus pallidus interna (GPi) as a DBS target for PD patients with levodopa-responsive fl...

Introduction Although the subthalamic nucleus (STN) has proven to be a safe and effective target for deep brain stimulation (DBS) in treatment of primary dystonia, rates individual improvement vary considerably. On premise selecting appropriate patients, location contacts dorsolateral sensorimotor area STN may an important factor affecting therapeutic effects, but optimal remains unclear. This ...

The subthalamic nucleus (STN) influences the output of the basal ganglia, thereby interfering with motor behavior. The main inputs to the STN are GABAergic. We characterized the GABA(A) receptors expressed in the STN and investigated the response of subthalamic neurons to the activation of GABA(A) receptors. Cell-attached and whole cell recordings were made from rat brain slices using the patch...

Parkinsonian symptoms are currently thought to be related to hyperactivity of the subthalamic nucleus (STN). Because the STN is known to receive many inputs including glutamatergic cortical afferent fibers, we sought to determine whether the activity of this pathway is altered after dopaminergic denervation to estimate its contribution to the impairment of STN activity. A precise mapping of the...

Concern about cognitive worsening, especially after subthalamic nucleus (STN) deep brain stimulation (DBS) has been reported in Parkinson’s disease (PD) patients, although it has not been deemed severe enough to discredit DBS as a powerful tool in the armamentarium against PD. We here provide an in-depth and critical review of the current literature on this topic, summarizing the available data...

In the last five years, Deep Brain Stimulation (DBS) has become the most popular and effective surgical technique for the treatent of Parkinson's disease (PD). The Subthalamic Nucleus (STN) is the usual target involved when applying DBS. Unfortunately, the STN is in general not visible in common medical imaging modalities. Therefore, atlas-based segmentation is commonly considered to locate it ...

The current state of the art for identification of motor related neural activity during deep brain stimulation (DBS) surgery utilizes manual movements of the patient's joints while observing the recorded raw data of a single electrode. Here we describe an intra-operative method for detection of the motor territory of the subthalamic nucleus (STN) during DBS surgery. The method incorporates eigh...

In Parkinson’s Disease, pacemaker-like stimulation of the Subthalamic Nucleus (STN) at a frequency near 130 Hz can suppress symptoms like tremor, rigidity and bradykinesia. However, the mechanism by which this so-called Deep Brain Stimulation (DBS) exerts its effect is unknown. In order to increase our understanding of the network in which the STN is involved (the basal ganglia, among others in...

This study describes novel methods for supporting navigation and placement of electrodes during surgeries for deep brain stimulation (DBS). Critical to these procedures in neurosurgery is the localization and identification of different target structures along the electrode's trajectory in the brain such as the subthalamic nucleus (STN), and finding the best position for the stimulating electro...

Increasing attention is being paid to the non-motor symptoms of Parkinson's disease (PD). While deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been shown to clearly improve motor symptoms of PD, the effects of STN DBS on autonomic symptoms have not been well studied. We examined 11 patients undergoing STN DBS for PD. Patients were administered a questionnaire by phone to eval...