Surgery for Parkinson Disease

Lang, Anthony E.

doi:10.1001/archneur.57.8.1118

Cited by 77 publications

(10 citation statements)

References 74 publications

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“…Added to this surgical risk was the debilitating side effect of a lesion induced-hemiballism that only a few patients did not present, for review see Guridi and Obeso [38]. Pallidotomy and thalamotomy of ventrolateral or ventromedial nuclei became popular, although not without controversies about reproducible successful locations and the need of more controlled studies [48].…”

Section: Approaches To the Treatment Of Pdmentioning

confidence: 99%

Are the Symptoms of Parkinsonism Cortical in Origin?

Arbuthnott¹,

García‐Muñoz²

2017

Computational and Structural Biotechnology Journal

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We present three reasons to suspect that the major deleterious consequence of dopamine loss from the striatum is a cortical malfunction. We suggest that it is cortex, rather than striatum, that should be considered as the source of the debilitating symptoms of Parkinson's disease (PD) since:Cortical synapses onto striatal dendritic spines are lost in PD.All known treatments of the symptoms of PD disrupt beta oscillations. Oscillations that are also disrupted following antidromic activation of cortical neurons.The final output of basal ganglia directly modulates thalamic connections to layer I of frontal cortical areas, regions intimately associated with motor behaviour.These three reasons combined with evidence that the current summary diagram of the basal ganglia involvement in PD is imprecise at best, suggest that a re-orientation of the treatment strategies towards cortical, rather than striatal malfunction, is overdue.

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Section: Approaches To the Treatment Of Pdmentioning

confidence: 99%

Are the Symptoms of Parkinsonism Cortical in Origin?

Arbuthnott¹,

García‐Muñoz²

2017

Computational and Structural Biotechnology Journal

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“…Although the most common treatment for PD consists of dopamine (DA) precursors (typically l -DOPA) and agonists, DBS of the STN has become the treatment of choice in patients whose symptoms are less well controlled by medications (Limousin et al, 1995; Lang, 2000). The remedial effects of DBS on the motor symptoms of PD are substantial (Bergman et al, 1990; Benazzouz and Hallett, 2000; Benabid, 2003; Meissner et al, 2005; Liu et al, 2006), although the specific mechanisms underlying its therapeutic effects are still debated.…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation of the Subthalamic Nucleus Improves Reward-Based Decision-Learning in Parkinson's Disease

Wouwe¹,

Ridderinkhof²,

Wildenberg³

et al. 2011

Front. Hum. Neurosci.

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Recently, the subthalamic nucleus (STN) has been shown to be critically involved in decision-making, action selection, and motor control. Here we investigate the effect of deep brain stimulation (DBS) of the STN on reward-based decision-learning in patients diagnosed with Parkinson's disease (PD). We determined computational measures of outcome evaluation and reward prediction from PD patients who performed a probabilistic reward-based decision-learning task. In previous work, these measures covaried with activation in the nucleus caudatus (outcome evaluation during the early phases of learning) and the putamen (reward prediction during later phases of learning). We observed that stimulation of the STN motor regions in PD patients served to improve reward-based decision-learning, probably through its effect on activity in frontostriatal motor loops (prominently involving the putamen and, hence, reward prediction). In a subset of relatively younger patients with relatively shorter disease duration, the effects of DBS appeared to spread to more cognitive regions of the STN, benefiting loops that connect the caudate to various prefrontal areas importantfor outcome evaluation. These results highlight positive effects of STN stimulation on cognitive functions that may benefit PD patients in daily-life association-learning situations.

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“…The current approach differs from previous studies with similar aims in that we used a within-subject design instead of a between-subject design in which performance of clinical groups is compared with that of controls(e.g., Gauggel et al, 2004;Seiss & Praamstra 2004;Aron, Schlaghecken, et al, 2003;Rieger et al, 2003). Participants in the current study consisted of a group of patients previously implanted with electrodes in the region of the subthalamic nucleus (STN) to treat symptoms of PD, such as bradykinesia and tremor (Benabid, 2003), by electrical deepbrain stimulation (DBS) (Lang, 2000;Limousin et al, 1995). DBS results in a dramatic and stable improvement of a patient's clinical condition (Krack et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Stimulation of the Subthalamic Region Facilitates the Selection and Inhibition of Motor Responses in Parkinson's Disease

Wildenberg

Boxtel

Molen

et al. 2006

Journal of Cognitive Neuroscience

247

165

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The aim of the present study was to specify the involvement of the basal ganglia in motor response selection and response inhibition. Two samples were studied. The first sample consisted of patients diagnosed with Parkinson's disease (PD) who received deep-brain stimulation (DBS) of the subthalamic nucleus (STN). The second sample consisted of patients who received DBS for the treatment of PD or essential tremor (ET) in the ventral intermediate nucleus of the thalamus (Vim). Stop-signal task and go/no-go task performances were studied in both groups. Both groups performed these tasks with (on stimulation) and without (off stimulation) DBS to address the question of whether stimulation is effective in improving choice reaction time (RT) and stop-signal RT. The results show that DBS of the STN was associated with significantly enhanced inhibitory control, as indicated by shorter stop-signal RTs. An additional finding is that DBS of the STN led to significantly shorter choice RT. The effects of DBS on responding and response inhibition were functionally independent. Although DBS of the Vim did not systematically affect task performance in patients with ET, a subgroup of Vim-stimulated PD patients showed enhanced stop-signal RTs in on stimulation versus off stimulation. This result suggests that the change in performance to stop signals may not be directly related to STN function, but rather results from a change in PD function due to DBS in general. The findings are discussed in terms of current functional and neurobiological models that relate basal ganglia function to the selection and inhibition of motor responses.

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Surgery for Parkinson Disease

Cited by 77 publications

References 74 publications

Are the Symptoms of Parkinsonism Cortical in Origin?

Are the Symptoms of Parkinsonism Cortical in Origin?

Deep Brain Stimulation of the Subthalamic Nucleus Improves Reward-Based Decision-Learning in Parkinson's Disease

Stimulation of the Subthalamic Region Facilitates the Selection and Inhibition of Motor Responses in Parkinson's Disease

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