ABSTRACT
The major subcortical structures targeted for deep brain stimulation (DBS) or lesioning for the treatment of movement disorders include the nucleus ventralis intermedius (Vim) of the thalamus, the globus pallidus internal segment (GPi), and the subthalamic nucleus (STN). The major technical goal during surgery for movement disorders is to maximize both precision and safety. The methods for localization of the Vim, GPi, and STN are evolving and vary significantly between centers. Three types of methods may be used to determine target location before lesioning or chronic stimulator placement: image-guided stereotactic localization, microelectrode mapping, and intraoperative test stimulation through the lesioning or DBS electrode, often called ‘‘macrostimulation.’’ The first of these is based on anatomy, whereas the latter two are based on physiology.
