Deep brain stimulation for the heterogeneous pathophysiology of Parkinson’s disease

Abstract

Deep brain stimulation affects the pathophysiology of various motor disorders including essential tremor, Parkinson’s disease (PD) and dystonia. The motor deficits from PD have been explained by the firing rate and pattern models. However, due to the variability between patients’ electrophysiology, the pathophysiology for PD is difficult to sparse apart. Neither model can fully explain the spectrum of patient presentations. The localisation and stimulation of various structures including the subthalamic nucleus, globus pallidus internus and ventral intermediate nucleus lead to different effects on the patient’s motor symptoms. This group of targeted structures affects the models of PD in distinct ways. This review aims to explain the models of PD and the effects of stimulation in each structure.