What are the possible brain targets for DBS?
There are now three possible target sites in the brain that may be selected for placement of stimulating electrodes: the internal segment of the globus pallidus (GPi), the subthalamic nucleus (STN), and a subdivision of the thalamus referred to as Vim (ventro-intermediate nucleus). These structures are small clusters of nerve cells that play critical roles in the control of movement. Thalamic (Vim) stimulation is only effective for tremor, not for the other symptoms of PD. Stimulation of the globus pallidus or subthalamic nucleus, in contrast, may benefit not only tremor but also other parkinsonian symptoms such as rigidity (muscle stiffness), bradykinesia (slow movement), and gait problems. All three targets are now approved by the U.S. Food and Drug Administration, which oversees medical devices. For most patients with Parkinson’s disease, DBS of the globus pallidus or subthalamic nucleus are more appropriate choices than thalamic DBS because stimulation at these targets affects a br
There are now four possible target sites in the brain that may be selected for placement of stimulating electrodes: the internal segment of the globus pallidus (GPi), the subthalamic nucleus (STN), the pedunculopontine nucleus (PPN), and a subdivision of the thalamus referred to as Vim (ventro-intermediate nucleus). These structures are small clusters of nerve cells that play critical roles in the control of movement. Thalamic (Vim) stimulation is only effective for tremor, not for the other symptoms of PD. Stimulation of the globus pallidus or subthalamic nucleus, in contrast, may benefit not only tremor but also other parkinsonian symptoms such as rigidity (muscle stiffness), bradykinesia (slow movement), gait problems, and dyskinesias. All of three of these targets are now approved by the U.S. Food and Drug Administration, which oversees medical devices. The PPN is a new, investigational target that may be appropriate for patients with gait freezing, but there are currently few clin
