Open AccessTime for a New 3-D Image for Globus Pallidus Internus Deep Brain Stimulation Targeting and Programming
Author(s) -
Joshua K. Wong,
Justin D. Hilliard,
Vanessa Milanesi Holanda,
Ayşegül Gündüz,
Aparna Wagle Shukla,
Kelly D. Foote,
Michael S. Okun
Publication year - 2021
Publication title -
journal of parkinson's disease/journal of parkinson's disease (online)
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.747
H-Index - 45
eISSN - 1877-718X
pISSN - 1877-7171
DOI - 10.3233/jpd-212820
Subject(s) - deep brain stimulation , neuromodulation , subthalamic nucleus , neuroscience , stimulation , globus pallidus , sacral nerve stimulation , psychology , medicine , physical medicine and rehabilitation , computer science , parkinson's disease , disease , basal ganglia , surgery , pathology , central nervous system
Deep brain stimulation (DBS) is an effective neuromodulatory therapy for Parkinson’s disease (PD). Early studies using globus pallidus internus (GPi) DBS for PD profiled the nucleus as having two functional zones. This concept disseminated throughout the neuromodulation community as the “GPi triangle”. Although our understanding of the pallidum has greatly evolved over the past 20 years, we continue to reference the triangle in our clinical decision-making process. We propose a new direction, termed the spatial boundary hypothesis, to build upon the 2-dimensional outlook on GPi DBS. We believe an updated 3-D GPi model can produce more consistent, positive patient outcomes.