Locations of movement-related cells in the human subthalamic nucleus in Parkinson's disease

Authors

  • Philip V. Theodosopoulos MD,

    1. Department of Neurosurgery, University of California, San Francisco, California, USA
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  • William J. Marks Jr. MD,

    1. Department of Neurology, University of California, San Francisco, California, USA
    2. Division of Neurosurgery, Veterans Affairs Medical Center, San Francisco, California, USA
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  • Chadwick Christine MD,

    1. Department of Neurology, University of California, San Francisco, California, USA
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  • Philip A. Starr MD, PhD

    Corresponding author
    1. Department of Neurosurgery, University of California, San Francisco, California, USA
    2. Division of Neurosurgery, Veterans Affairs Medical Center, San Francisco, California, USA
    • Department of Neurological Surgery, Moffitt Hospital M787, 505 Parnassus Ave, Box 0112, San Francisco, CA 94143
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Abstract

The subthalamic nucleus (STN) is an emerging target for deep brain stimulator (DBS) implantation for the treatment of advanced Parkinson's disease (PD). Understanding the somatotopic organization of the STN is important for surgical navigation within the nucleus. We analyzed intraoperative data obtained during 54 procedures for the implantation of STN stimulators to assess the locations of movement-related cells. Cells were considered movement-related if they exhibited modulation of the cell discharge during passive movement of the contralateral upper or lower extremity. Microelectrode track reconstructions were plotted on a human brain atlas, using the location of the DBS electrode from postoperative magnetic resonance images as a registration mark in reconstructing microelectrode track locations. Movement-related cells were predominantly located in the dorsal part of the nucleus. The majority of the cells were related to proximal joint manipulation. Arm-related cells were located laterally and at the rostral and caudal poles, whereas leg-related cells were located medially and centrally. The finding of three or more leg-related cells on a given microelectrode track was predictive of a medial localization within the motor area. Our findings are consistent with the small number of published studies on STN somatopy in the human and the nonhuman primate. © 2003 Movement Disorder Society

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