title: Improving outcomes of subthalamic nucleus deep brain stimulation in Parkinson's disease.
abstract: The subthalamic nucleus (STN) has been a major target of deep brain stimulation (DBS) for Parkinson's disease (PD) over the past 20 years. The benefits of DBS of the STN include: decreased motor fluctuations and bradykinesia, tremor reduction and a reduction in dopaminergic drug requirements and dyskinesias. Despite these overall positive effects, the outcomes of STN DBS can be variable, contributing to the debate over the best DBS target for PD. Here, the authors review the current practice of STN DBS and also review both the existing and emerging technologies that are likely to improve the accuracy and effectiveness of STN DBS for PD. The authors emphasize patient selection, accuracy of electrode placement within the brain and the selection of appropriate stimulation parameters to optimize clinical benefits.
authors.affiliation: a 1 Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Neuroscience Center, University of Toronto, Toronto, ON M5T 2S8, Canada.
authors.forename: Ausaf A
authors.initials: AA
authors.lastname: Bari
authors.affiliation: b 2 Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, ON M5T 2S8, Canada.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fasano
authors.affiliation: b 2 Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, ON M5T 2S8, Canada.
authors.forename: Renato P
authors.initials: RP
authors.lastname: Munhoz
authors.affiliation: a 1 Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Krembil Neuroscience Center, University of Toronto, Toronto, ON M5T 2S8, Canada.
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
keywords: Parkinson’s disease; deep brain stimulation; neuromodulation; optimization; subthalamic nucleus