D’Souza, S., Seshadri, V., Toms, J., D’Haese, P., Dawant, B. M., Li, R., Shah, H. P., Koch, P., Larson, P., & Holloway, K. L. (2024). Precision targeting in the globus pallidus interna: insights from the multicenter, prospective, blinded VA/NINDS CSP 468 study. Journal of Neurosurgery, 141(6), 1567–1577. doi: 10.3171/2024.4.JNS24139
Objective: Deep brain stimulation (DBS) targeting a part of the brain called the globus pallidus interna (GPi) can help improve movement problems in people with Parkinson’s disease who don’t respond to medication. However, the results can vary, possibly due to inaccurate targeting within the GPi. This study aims to find the best areas of the GPi to target for different symptoms. Methods: The study looked at data from 86 patients who had DBS in both sides of their GPi. These patients were part of a larger study and were checked 6 months after surgery. The researchers studied where the stimulation leads were placed and how much patients’ symptoms improved, including tremors, stiffness, and slow movements. The goal was to find the best areas in the GPi to target for symptom control. Results: The study found specific areas in the GPi that helped improve overall motor symptoms, stiffness, and slow movements. These areas were in the primary motor and premotor regions of the GPi, extending slightly into surrounding areas. This challenges older approaches that focus only on the GPi. Conclusions: This research highlights key areas in the GPi that can help with movement problems in Parkinson’s disease. These findings could help improve the accuracy of DBS surgery, leading to better results for patients.
