Topographic organization of the human and non-human primate subthalamic nucleus.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is used to relieve motor symptoms of Parkinson's disease. A tripartite system of STN subdivisions serving motoric, associative, and limbic functions was proposed, mainly based on tracing studies, which are limited by low numbers of observations. The evidence is compelling and raises the question as to what extent these functional zones are anatomically segregated. The majority of studies indicate that there is anatomical overlap between STN functional zones. Using ultrahigh-resolution magnetic resonance imaging techniques it is now possible to visualize the STN with high spatial resolution, and it is feasible that in the near future stereotactic guided placement of electrical stimulators aided by high-resolution imaging will allow for more specific stimulation of the STN. The neuroanatomical and functional makeup of these subdivisions and their level of overlap would benefit from clarification before serving as surgical targets. We discuss histological and imaging studies, as well as clinical observations and electrophysiological recordings in DBS patients. These studies provide evidence for a topographical organization within the STN, although it remains unclear to what extent functionally and anatomically distinct subdivisions overlap.
Cognitive Science Center Amsterdam, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands. jmalkemade@gmail.com.
Anneke
http://orcid.org/0000-0002-3234-353X
A
Alkemade
Department of Neurology, Medical Faculty, Center for Movement Disorders and Neuromodulation, Heinrich-Heine University, Düsseldorf, Germany.|Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany.
Alfons
A
Schnitzler
Cognitive Science Center Amsterdam, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands.
Birte U
BU
Forstmann
D000818:Animals; D001479:Basal Ganglia / Q000033:anatomy & histology / Q000502:physiology / Q000648:ultrastructure; D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D011323:Primates / Q000033:anatomy & histology* / Q000502:physiology; D013329:Structure-Activity Relationship; D020531:Subthalamic Nucleus / Q000033:anatomy & histology* / Q000502:physiology / Q000648:ultrastructure
Basal ganglia; Decision making; Deep brain stimulation; Parkinson’s disease