Neuronal activity of the red nucleus in Parkinson's disease.

Precise placement of the electrodes for stimulation of the subthalamic nucleus (STN) in Parkinson's disease (PD) is crucial for the therapeutic benefit. As a result of the mistargeting and misplacement of the electrodes during surgery in 2 patients with PD, we have characterized the neuronal firing in the red nucleus (RN) and observed the effects of stimulation of this nucleus. Although the neuronal firing (mean +/- SD) of the RN (34 +/- 4.4 Hz) resembles that described for the STN (33.1 +/- 16.6 Hz), a higher proportion of cells responded to the movement of the contralateral limbs (70-80%). Stimulation in the area of the RN-induced intolerable side effects without motor improvement. We conclude that the STN and RN have some similar neurophysiological features but can be distinguished intraoperatively. This initial description of the physiological characteristics of the RN in humans will draw attention to the possibility of confusing the RN and STN during intraoperative recording. (c) 2008 Movement Disorder Society.