Subthalamic nucleus deep brain stimulation for Parkinson's disease: current trends and future directions

Expert Rev Med Devices. 2020 Oct;17(10):1063-1074. doi: 10.1080/17434440.2020.1747433. Epub 2020 Apr 6.

Abstract

Over the last three decades, extensive basic and clinical research has been performed on the use of subthalamic nucleus (STN) as the preferred deep brain stimulation (DBS) target for the treatment of Parkinson's disease (PD). The mechanism underlying the benefit for the motor symptoms in PD is related to the modulation of firing patterns within the hyperdirect projections from motor cortical areas, as well as within the afferent and efferent fibers to the motor STN. Advancements in neuroimaging techniques allow us to identify precisely the STN optimizing surgical targeting. In this review, we provide an update on the current uses of STN-DBS as a routine therapy as well as its experimental indications in PD, the critical aspects associated with its successful implementation and recent advances in DBS technology.

Keywords: Deep brain stimulation; lead technology; neuroimaging; neuroimaging side effects; neurophysiology; side effects; subthalamic nucleus.

Publication types

  • Review

MeSH terms

  • Deep Brain Stimulation / adverse effects
  • Deep Brain Stimulation / trends*
  • Humans
  • Motor Cortex / physiopathology
  • Parkinson Disease / surgery
  • Parkinson Disease / therapy*
  • Subthalamic Nucleus / physiopathology*
  • Time Factors