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Updated: Jan 10, 2026

Digital Spatial Profiling for Characterization of the Microenvironment in Adult-Type Diffusely Infiltrating Glioma
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Identifying the "Sweet Spot" for GPi DBS Programming.

Lubna Jafri1, Jessica Tate1, Mary Ann Thenganatt1

  • 1Department of Neurology at Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA.

Parkinsonism & Related Disorders
|November 29, 2025
PubMed
Summary
This summary is machine-generated.

Deep brain stimulation (DBS) for Parkinson's disease (PD) is optimized by targeting the postero-lateral globus pallidus interna (GPi). This study identified the ideal GPi "sweet spot" for improved motor function and reduced medication needs.

Keywords:
DBSDeep brain stimulationGPiGlobus pallidus internaImage guided programmingParkinson's disease

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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
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Area of Science:

  • Neurosurgery
  • Neurology
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) efficacy in Parkinson's disease (PD) relies on precise electrode placement and stimulation targeting within the brain.
  • A knowledge gap exists regarding the optimal stimulation site within the globus pallidus interna (GPi) for effective PD treatment.
  • Accurate targeting is crucial for maximizing clinical benefits and minimizing side effects of GPi DBS.

Purpose of the Study:

  • To identify the optimal stimulation site within the globus pallidus interna (GPi) for treating Parkinson's disease (PD).
  • To correlate stimulation field models with clinical outcomes to define ideal GPi stimulation locations.
  • To provide guidance for image-guided DBS programming in PD patients.

Main Methods:

  • Retrospective chart review of Parkinson's disease (PD) patients who underwent GPi DBS between 2020-2022.
  • Development of stimulation field models (SFMs) from post-operative data to create volumetric stimulation heatmaps.
  • Correlation of SFMs with Clinical Global Impression-Change (CGI-C) scores and Movement Disorders Society-Unified Parkinson's disease Rating Scale (MDS-UPDRS) III scores to determine optimal stimulation zones.

Main Results:

  • Thirty-six GPi leads from 22 PD patients were analyzed, with a mean age of 64 years and 67% male participants.
  • Significant motor improvements were observed, with a 41% reduction in MDS-UPDRS III scores (p=0.0003) and reduced medication needs.
  • The optimal stimulation zone, correlating with the best clinical outcomes (CGI-C=1), was identified in the postero-lateral GPi.

Conclusions:

  • The study identified a specific 'sweet spot' in the postero-lateral GPi, crucial for effective DBS in Parkinson's disease.
  • These findings align with and expand upon limited existing literature on optimal GPi targeting.
  • The identified stimulation site can enhance image-guided DBS programming for improved patient outcomes in PD.