[Zona incerta: from anatomy and function to neuromodulation in extrapyramidal disorders]

The zona incerta (ZI) represents one of the least-explored structures within the brain. Its cytoarchitecture, afferent and efferent connections, and functional significance remain poorly understood. In recent years, the field of functional neurosurgery has advanced rapidly, with various targets for modulation under investigation. Accumulating evidence highlights a substantial role for ZI in modulating sensory inputs and motor functions. This article discusses the primary anatomical and physiological characteristics of the zona incerta. Through a thorough examination of contemporary literature, this paper provides an overview of the connections this region has with stem structures, the intermediate brain, and the cerebral cortex. The fundamental physiological functions were summarized. The review places particular emphasis on their clinical implications. Several studies are analyzed in which ZI has been targeted for deep-brain stimulation in the treatment of various extrapyramidal disorders. In conclusion, the article underscores the importance of further research into the anatomy of ZI and its connections with other areas of the central nervous system. Special focus is given to the potential targeting of this region in the treatment of central pain syndromes and motor disorders associated with extrapyramidal conditions.