Question: How does DBS/STN work? Rev. 02/03
Answer: Perhaps the most exciting new development for Parkinson's patients is the surgical intervention in the area of the brain called the subthalamic nucleus (STN). The subthalamic nucleus is a structure located deep within the brain that controls many aspects of normal motor function. In Parkinson's disease (PD), the subthalamic nucleus is hyperactive, sending an excess of electrical signals to other parts of the brain. Lesioning the STN, or subthalamotomy, carries a high risk of inducing abnormal movements known as hemiballismus. However, the reversible and adjustable features of DBS have permitted its use in the STN. Electrical stimulation can block the hyperactivity of the STN, and ameliorate many of the symptoms of Parkinson's including rigidity, bradykinesia, postural instability, drug-induced dyskinesias, as well as tremor.
High frequency electrical stimulation is believed to "jam" the signals, normal or abnormal, emanating from the brain site. Stimulation therefore has the same outward effect of a lesion but, unlike a permanent lesion, the effect is reversible. Turn the stimulator off and within minutes to hours, the structure begins to function as it had prior to stimulation. Thus, if stimulation yields an unwanted side effect, the stimulator may be turned off or repositioned. With lesioning procedures, what's done is done.
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