Movement Disorders 13th Meet World Soc Stereotact Funct Neurosurg, Adelaide 2001 Stereotact Funct Neurosurg 2001;77:87–90 DOI: 10.1159/000064602 Targeting the Subthalamic Nucleus T.Z. Aziz a,b,d D. Nandi a S. Parkin c X. Liu a N. Giladi a P. Bain d R.G. Gregory c C. Joint b R.B. Scott b J.F. Stein a a University Laboratory of Physiology; Departments of b Neurosurgery, and c Neurology, Radcliffe Infirmary, Oxford, and d Department of Neurology, Charing Cross Hospital, London, UK Dr. T.Z. Aziz Department of Neurosurgery, Radcliffe Infirmary Woodstock Road, Oxford OX2 6HE (UK) Tel. +44 1865 228 425, Fax +44 1865 224 898 E-Mail tipuaziz@btinternet.com ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2002 S. Karger AG, Basel 1011–6125/01/0774–0087$18.50/0 Accessible online at: www.karger.com/journals/sfn Key Words Subthalamic nucleus W Targeting W Lesions W Stimulation W Parkinson’s disease Abstract The small size and surrounding neuronal structures and fibre tracts make the STN a difficult stereotactic target. In this article we present the technique used by us to target the STN. Our combined experience from two centres comprises 18 lesions and 27 stimulator implants in the STN. Our criteria for patient selection and the use of MRI, frame-on CT and volumetric image fusion are presented. The role of a movement disorder specialist neurologist in the operating theatre, local field potential recording, impe- dance monitoring, macrostimulation, post-operative CT/MRI and test stimu- lation are detailed. Copyright © 2002 S. Karger AG, Basel Introduction Since the demonstration in parkinsonian sub-human primates that lesioning the subthalamic nucleus (STN) could alleviate the cardinal signs of Parkinson’s disease [1–3], the STN has been adopted by many groups as the target of choice.