Deep brain stimulation of the subthalamic nucleus in Parkinson's disease 1993-2003: where are we 10 years on?

Br J Neurosurg. 2004 Feb;18(1):19-34. doi: 10.1080/02688690410001660427.


Since its advent in 1993, high frequency stimulation (HFS) of the subthalamic nucleus (STN) has rapidly developed into the most commonly practiced surgical procedure for the treatment of Parkinson's Disease (PD). Although its exact mechanism of action, be it through an inhibitory depolarization block, desynchronization of neuronal circuits or other means, is not clear, the efficacy and safety of the technique are now well established. HFS of the STN improves the motor function by at least 60%, drastically reduces the levodopa requirement and significantly improves the quality of life in PD. This review updates the recent concepts on the pathophysiology of PD and analyses the basic science principles underlying the clinical practice of the STN HFS. The evolution of the surgical technique and long-term patients' outcome are further discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Basal Ganglia / physiopathology
  • Dopamine Agents / therapeutic use
  • Electric Stimulation Therapy
  • Humans
  • Levodopa / therapeutic use
  • Neurosurgical Procedures
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology
  • Parkinson Disease / surgery*
  • Patient Selection
  • Postoperative Care / methods
  • Subthalamic Nucleus / physiopathology
  • Subthalamic Nucleus / surgery*


  • Antiparkinson Agents
  • Dopamine Agents
  • Levodopa