title: Locations of movement-related cells in the human subthalamic nucleus in Parkinson's disease.
abstract: The subthalamic nucleus (STN) is an emerging target for deep brain stimulator (DBS) implantation for the treatment of advanced Parkinson's disease (PD). Understanding the somatotopic organization of the STN is important for surgical navigation within the nucleus. We analyzed intraoperative data obtained during 54 procedures for the implantation of STN stimulators to assess the locations of movement-related cells. Cells were considered movement-related if they exhibited modulation of the cell discharge during passive movement of the contralateral upper or lower extremity. Microelectrode track reconstructions were plotted on a human brain atlas, using the location of the DBS electrode from postoperative magnetic resonance images as a registration mark in reconstructing microelectrode track locations. Movement-related cells were predominantly located in the dorsal part of the nucleus. The majority of the cells were related to proximal joint manipulation. Arm-related cells were located laterally and at the rostral and caudal poles, whereas leg-related cells were located medially and centrally. The finding of three or more leg-related cells on a given microelectrode track was predictive of a medial localization within the motor area. Our findings are consistent with the small number of published studies on STN somatopy in the human and the nonhuman primate.
authors.affiliation: Department of Neurosurgery, University of California, San Francisco, California 94143, USA.
authors.forename: Philip V
authors.initials: PV
authors.lastname: Theodosopoulos
authors.forename: William J
authors.initials: WJ
authors.lastname: Marks
authors.forename: Chadwick
authors.initials: C
authors.lastname: Christine
authors.forename: Philip A
authors.initials: PA
authors.lastname: Starr
mesh_terms: D000200:Action Potentials / Q000502:physiology; D001132:Arm / Q000294:innervation; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000502:physiology; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007596:Joints / Q000294:innervation*; D007866:Leg / Q000294:innervation; D008279:Magnetic Resonance Imaging; D008839:Microelectrodes; D018482:Muscle, Skeletal / Q000294:innervation*; D009460:Neurologic Examination; D038361:Neuronavigation; D009474:Neurons / Q000145:classification / Q000502:physiology; D010300:Parkinson Disease / Q000503:physiopathology* / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D013378:Substantia Nigra / Q000503:physiopathology; D020531:Subthalamic Nucleus / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome