Deep brain stimulation (DBS) is an established neurosurgical treatment for Parkinson’s disease (PD), mainly targeting motor symptoms resistant to pharmacological therapy. This review examines strategies to optimize DBS using advanced anatomical, functional, and imaging approaches. The subthalamic nucleus (STN) remains the principal target for alleviating bradykinesia and rigidity, while recent evidence highlights the dentato-rubro-thalamic tract (DRTt) as an additional promising target, especially for tremor control. Clinical data demonstrate that co-stimulation of both STN and DRTt via electrode electric fields results in superior motor outcomes, including greater reductions in UPDRS-III scores and lower levodopa requirements. The review highlights the use of high-resolution MRI and diffusion tensor imaging tractography in visualizing STN and DRTt with high precision. These methods support accurate targeting and individualized treatment planning. Electric field modelling is discussed as a tool to quantify stimulation overlap with target structures and predict clinical efficacy. Anatomical variability in DRTt positioning relative to the STN is emphasized, supporting the need for patient-specific DBS approaches. Alternative and emerging DBS targets—including the pedunculopontine nucleus, zona incerta, globus pallidus internus, and nucleus basalis of Meynert—are discussed for their potential in treating axial and cognitive symptoms. The review concludes with a forward-looking discussion on network-based DBS paradigms, the integration of adaptive stimulation technologies, and the potential of multimodal imaging and electrophysiological biomarkers to guide therapy. Together, these advances support a paradigm shift from focal to network-based neuromodulation in PD management.

Cerebral microdialysis enables bedside assessment of the concentration of selected metabolites in the patient’s brain. The modern microdialysis device consists of a double-lumen probe. Its interior is made of an impermeable material, while the outer layer is a semipermeable membrane through which the tested microdialysate penetrates from the brain. At the end of the probe, there is an opening connecting the outer lumen with the inner lumen, used to deliver the so-called perfusate − a solution isotonic with the brain’s extracellular fluid. Chemical compounds diffuse through the semipermeable membrane of the outer probe according to the concentration gradient, reaching the collection chamber. Therefore, the microdialysis probe placed in the brain parenchyma can be compared to an artificial capillary vessel, where substances are exchanged based on the concentration gradient. The microdialysate reflects the biochemical state of the area in which the probe is placed. There are reports on the benefits of cerebral microdialysis in patients after subarachnoid haemorrhage, traumatic brain injury, and cerebrovascular accidents. Further studies suggest the potential for its use in epilepsy, bacterial meningitis, and in the assessment of drug distribution and pharmacokinetics in the brain. Advances in temporal and spatial resolution create opportunities for the increasingly widespread use of microdialysis in both research and clinical practice. The aim of this study is to describe the principles of microdialysis, discuss examples of its application in clinical practice, and outline the limitations and indications for implanting an intracerebral microdialysis probe.