The quest for a target and the beginning of the DBS-story

Abstract Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has revolutionized the treatment of Parkinson's disease. It is considered as a treatment of choice, after Levodopa, for patients suffering from advanced stages of the disease. Thanks to fundamental and preclinical research on animal models, notably the MPTP monkey, we were able to demonstrate that the STN is a target structure for surgery, and then that high-frequency electrical stimulation (HFS) of the STN dramatically improved the cardinal motor symptoms of Parkinson's disease, without major side-effects. These seminal works paved the way for a new surgical approach to Parkinson's disease, which involves implanting electrodes in the STN in Parkinson's patients suffering from advanced stages of the disease. In this chapter, we describe the key historical milestones that enabled the development of DBS in Parkinson's disease, focusing on its old and new era.