The Subthalamic Region of Luys, Forel, and Dejerine

Abstract

The subthalamic region (ST) embraces the subthalamic nucleus (STN), zona incerta (ZI), Forel’s fields (H, H1 and H2), and their nucleus (FF). JB Luys of Paris first described STN in human brain atlases, in 1865 as drawings and in 1873 in photographs of brain slices. He completely ignored ZI and Forel’s fields. As an industrious neurologist and neuropathologist, he treated many mental patients by hypnosis. In his later public demonstrations, he neglected proper scientific controls, and was duped by collusive patients to believe in bizarre sensory properties and symptom transfer. In 1877 Forel produced the first adequate description of ST, in serial sections. He later specialised in neurology and psychiatry, directing the Zurich mental asylum. In combatting alcoholism as a cause of insanity he adopted the strategy of total abstinence. He was renowned also for his scientific work on ants. Dejerine and his wife Augusta Klumpke were an outstanding neurological team in Paris. In their great two-volume work on the anatomy of nervous centres, they established the detailed structure of ST, still largely accepted. Their devoted neurological work with the war wounded soldiers led to the exhausted Dejerine’s death in 1917. His widow continued the work until her death in 1927.