TY - JOUR T1 - Subthalamic Nucleus Deep Brain Stimulation: Basic Concepts and Novel Perspectives JF - eneuro JO - eNeuro DO - 10.1523/ENEURO.0140-17.2017 VL - 4 IS - 5 SP - ENEURO.0140-17.2017 AU - Clement Hamani AU - Gerson Florence AU - Helmut Heinsen AU - Birgit R. Plantinga AU - Yasin Temel AU - Kamil Uludag AU - Eduardo Alho AU - Manoel J. Teixeira AU - Edson Amaro AU - Erich T. Fonoff Y1 - 2017/09/01 UR - http://www.eneuro.org/content/4/5/ENEURO.0140-17.2017.abstract N2 - Over the last decades, extensive basic and clinical knowledge has been acquired on the use of subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson’s disease (PD). It is now clear that mechanisms involved in the effects of this therapy are far more complex than previously anticipated. At frequencies commonly used in clinical practice, neural elements may be excited or inhibited and novel dynamic states of equilibrium are reached. Electrode contacts used for chronic DBS in PD are placed near the dorsal border of the nucleus, a highly cellular region. DBS may thus exert its effects by modulating these cells, hyperdirect projections from motor cortical areas, afferent and efferent fibers to the motor STN. Advancements in neuroimaging techniques may allow us to identify these structures optimizing surgical targeting. In this review, we provide an update on mechanisms and the neural elements modulated by STN DBS. ER -