Novel targets in deep brain stimulation for movement disorders

Neurosurg Rev. 2022 Aug;45(4):2593-2613. doi: 10.1007/s10143-022-01770-y. Epub 2022 May 5.


The neurosurgical treatment of movement disorders, primarily via deep brain stimulation (DBS), is a rapidly expanding and evolving field. Although conventional targets including the subthalamic nucleus (STN) and internal segment of the globus pallidus (GPi) for Parkinson's disease and ventral intermediate nucleus of the thalams (VIM) for tremor provide substantial benefit in terms of both motor symptoms and quality of life, other targets for DBS have been explored in an effort to maximize clinical benefit and also avoid undesired adverse effects associated with stimulation. These novel targets primarily include the rostral zona incerta (rZI), caudal zona incerta (cZI)/posterior subthalamic area (PSA), prelemniscal radiation (Raprl), pedunculopontine nucleus (PPN), substantia nigra pars reticulata (SNr), centromedian/parafascicular (CM/PF) nucleus of the thalamus, nucleus basalis of Meynert (NBM), dentato-rubro-thalamic tract (DRTT), dentate nucleus of the cerebellum, external segment of the globus pallidus (GPe), and ventral oralis (VO) complex of the thalamus. However, reports of outcomes utilizing these targets are scattered and disparate. In order to provide a comprehensive resource for researchers and clinicians alike, we have summarized the existing literature surrounding these novel targets, including rationale for their use, neurosurgical techniques where relevant, outcomes and adverse effects of stimulation, and future directions for research.

Keywords: Ataxia; Deep brain stimulation; Dystonia; Movement disorders; Novel targets; Parkinson’s disease; Tremor.

Publication types

  • Review

MeSH terms

  • Deep Brain Stimulation* / methods
  • Humans
  • Intralaminar Thalamic Nuclei*
  • Parkinson Disease* / therapy
  • Quality of Life
  • Subthalamic Nucleus* / surgery