Limbic, associative, and motor territories within the targets for deep brain stimulation: potential clinical implications.
The use of deep brain stimulation (DBS) has recently been expanding for the treatment of many neurologic disorders such as Parkinson disease, dystonia, essential tremor, Tourette's syndrome, cluster headache, epilepsy, depression, and obsessive compulsive disorder. The target structures for DBS include specific segregated territories within limbic, associative, or motor regions of very small subnuclei. In this review, we summarize current clinical techniques for DBS, the cognitive/mood/motor outcomes, and the relevant neuroanatomy with respect to functional territories within specific brain targets. Future development of new techniques and technology that may include a more direct visualization of "motor" territories within target structures may prove useful for avoiding side effects that may result from stimulation of associative and limbic regions. Alternatively, newer procedures may choose and specifically target non-motor territories for chronic electrical stimulation.
Sudhyadhom
Atchar
A
Department of Neurology, McKnight Brain Institute, 100 South Newell Drive, Gainesville, FL 32610, USA. okun@neurology.ufl.edu
Bova
Frank J
FJ
Foote
Kelly D
KD
Rosado
Christian A
CA
Kirsch-Darrow
Lindsey
L
Okun
Michael S
MS
D001479:Basal Ganglia / Q000503:physiopathology*; D046690:Deep Brain Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D008032:Limbic System / Q000503:physiopathology; D009044:Motor Cortex / Q000503:physiopathology*; D009069:Movement Disorders / Q000628:therapy*; D019636:Neurodegenerative Diseases / Q000628:therapy; D013003:Somatosensory Cortex / Q000503:physiopathology; D016896:Treatment Outcome