Anatomical Structures of the DBS Surgery for Parkinson’s Disease

Abstract

The main idea behinds the Deep Brain Stimulation (DBS) treatment is the symptomatic relief of some neurological and psychiatric disorders by modulating certain anatomical structures of the brain. To modulate these structures the surgeons must know the exact anatomy and relations between them. The main anatomical targets of DBS are located at the basal ganglia and thalamus. Both of the structures have connections with the cortex and brainstem in simple or complex ways. These projections are responsible for motor, associative and sensory functions. For example, the most important structures for movement disorders are located in the dorsolateral part of the subthalamic nucleus (STN), posteroventral part of globus pallidus internal (GPi) and ventrolateral core of thalamus. The targets for psychiatric disorders are located in the ventral striatum which contains the nucleus accumbens (NA), ventral part of the internal capsule, ventromedial part of the subthalamic nucleus, anterior part of globus pallidus internal and medial nucleus of the thalamus. The anterior nucleus of the thalamus which is related to the Papez Circuit is the target point for epilepsy. The main purpose of the DBS is to modulate certain anatomical structures to relieve symptoms. This approach shows the close relationship between anatomy and function. The electrode must be placed correctly for intended effects. The vast majority of adverse effects and therapeutic effects can be explained by anatomy. In this section frequently used target points of DBS will be discussed. The majority of these points are located in basal nuclei and thalamus. The interventions for these areas can be used in neurologic and psychiatric disorders. Also, nucleus-thalamus-cortex circuits and adjacent structures will be explained in this section. © 2022 Elsevier B.V., All rights reserved.