Is Deep Brain Stimulation (DBS) targeting the pallidothalamic tract directed at the Globus Pallidus internus (GPi) or Globus Pallidus externus (GPe)?

There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.

From the Research

Deep Brain Stimulation Targeting

The pallidothalamic tract is directed at the Globus Pallidus internus (GPi) for Deep Brain Stimulation (DBS) in patients with Parkinson's disease.

• The GPi region has evolved as a potential target for DBS in Parkinson's disease (PD) 1.
• DBS of the GPi is an established, safe, and effective method for addressing many of the motor symptoms associated with advanced PD 1.
• The GPi target can be useful in choosing between the subthalamic (STN), GPi, and ventralis intermedius nucleus as lead locations to address the motor symptoms and complications of PD 1.

Comparison with Globus Pallidus Externus (GPe)

There is no evidence to suggest that the pallidothalamic tract is directed at the Globus Pallidus externus (GPe) for DBS in patients with Parkinson's disease.

• The GPi and subthalamic nucleus (STN) are the standard DBS targets for PD, with no mention of GPe as a target 2, 3.
• The choice of target should be individualized according to providers' preferences and patients' needs, with GPi and STN being the primary targets 3, 4.

Clinical Advantages of GPi DBS

GPi DBS has several clinical advantages, including:

• A direct anti-dyskinetic effect without reducing levodopa 1, 5.
• Easier programming in the outpatient setting and more flexibility in medication adjustments 1.
• A potential advantage in dyskinesia suppression and management of symptoms with unilateral leads 2, 4.