title: Neural circuit modulation during deep brain stimulation at the subthalamic nucleus for Parkinson's disease: what have we learned from neuroimaging studies?
abstract: Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) represents a powerful clinical tool for the alleviation of many motor symptoms that are associated with Parkinson's disease. Despite its extensive use, the underlying therapeutic mechanisms of STN-DBS remain poorly understood. In the present review, we integrate and discuss recent literature examining the network effects of STN-DBS for Parkinson's disease, placing emphasis on neuroimaging findings, including functional magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. These techniques enable the noninvasive detection of brain regions that are modulated by DBS on a whole-brain scale, representing a key experimental strength given the diffuse and far-reaching effects of electrical field stimulation. By examining these data in the context of multiple hypotheses of DBS action, generally developed through clinical and physiological observations, we define a multitude of consistencies and inconsistencies in the developing literature of this rapidly moving field.
authors.affiliation: 1 Department of Neurology, University of North Carolina , Chapel Hill, North Carolina.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Albaugh
authors.forename: Yen-Yu Ian
authors.initials: YY
authors.lastname: Shih
mesh_terms: D001933:Brain Stem / Q000502:physiology; D054022:Cerebrum / Q000502:physiology; D046690:Deep Brain Stimulation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging / Q000379:methods*; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D049268:Positron-Emission Tomography; D020531:Subthalamic Nucleus / Q000502:physiology*; D015899:Tomography, Emission-Computed, Single-Photon