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Anatomy of Targets for Deep Brain Stimulation

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Fundamentals and Clinics of Deep Brain Stimulation

Abstract

The purpose of Deep Brain Stimulation (DBS) is to modulate the activity of specific anatomical areas in the brain and thereby manage the symptoms of neurological and/or psychiatric disorders. Essential to this surgical management is an understanding of the anatomy and physiology of the target regions. The basal ganglia and the thalamus are the main target areas for DBS. These structures are connected to higher (cortical) and lower (brainstem) areas through both partially parallel and partly integrated projections. These projections are primarily responsible not only for motor control, but also for other functions such as motor learning, associative functions, and emotions. According to the classical basal ganglia model, information flows through the basal ganglia back to the cortex through two pathways, while new models show that parallel circuits subserve the classical functions of the basal ganglia engaging associative and limbic territories. The current targets of DBS for movement disorders are the dorsolateral part of the subthalamic nucleus, the posterior ventrolateral part of the internal globus pallidus, and the ventrolateral nuclei of the thalamus. For psychiatric disorders, relevant targets are the ventral striatum, including the nucleus accumbens, the ventral part of the internal capsule, the ventromedial part of the subthalamic nucleus, the anterior part of the internal globus pallidus, and the medial nuclei of the thalamus. The anterior nucleus of the thalamus is part of the Papez circuit and has been targeted in patients with treatment-resistant epilepsy. The anatomical details of these targets are discussed in this chapter.

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Authors and Affiliations

  1. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands

    Ali Jahanshahi & Yasin Temel

  2. Maastricht University-MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands

    Ali Jahanshahi & Yasin Temel

  3. Institute for Anatomy, Heinrich-Heine-University, Duesseldorf, Germany

    Juergen K. Mai

Authors
  1. Ali Jahanshahi
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  2. Juergen K. Mai
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  3. Yasin Temel
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Correspondence to Ali Jahanshahi .

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Editors and Affiliations

  1. Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands

    Yasin Temel

  2. Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands

    Albert F.G. Leentjens

  3. Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Noord-Holland, The Netherlands

    Rob M.A. de Bie

  4. Department of Neurosurgery, Grenoble University Hospital Center, Grenoble, France

    Stephan Chabardes

  5. Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada

    Alfonso Fasano

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Jahanshahi, A., Mai, J.K., Temel, Y. (2020). Anatomy of Targets for Deep Brain Stimulation. In: Temel, Y., Leentjens, A., de Bie, R., Chabardes, S., Fasano, A. (eds) Fundamentals and Clinics of Deep Brain Stimulation. Springer, Cham. https://doi.org/10.1007/978-3-030-36346-8_2

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  • DOI: https://doi.org/10.1007/978-3-030-36346-8_2

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