The centromedian nucleus: Anatomy, physiology, and clinical implications

Ilyas, Adeel; Pizarro, Diana; Romeo, Andrew; Riley, Kristen; Pati, Sandipan

doi:10.1016/j.jocn.2019.01.050

Cited by 90 publications

(112 citation statements)

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“…Aside from the surgical targets routinely used in clinical treatment (e.g., subthalamic nucleus, nucleus accumbens), there are some other targets with potential effectiveness in treating neurological and psychiatric diseases. The CM nucleus or centromedian-parafasicular nucleus complex, situated within the intralaminar nuclei of the thalamus, has abundant fiber connections with other thalamic nuclei, basal ganglia, and cerebral cortex (Ilyas et al, 2019). In several studies, the CM nucleus has been suggested as a potentially effective DBS target for the treatment of Parkinson's disease (Caparros-Lefebvre et al, 1999;Mazzone et al, 2006;Peppe et al, 2008;Stefani et al, 2009) and Tourette syndrome (Houeto et al, 2005;Savica et al, 2012;Marano et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…However, direct visualization of the CM nucleus using the standard T1w and T2w MRI sequences is challenging. On one hand, the volume of the CM is small (smaller than 10 mm in most dimensions; Ilyas et al, 2019). On the other hand, the contrast between the CM nucleus and its surrounding thalamic structures is pretty low.…”

Section: Introductionmentioning

confidence: 99%

“…The centromedian nucleus (CM) or centromedian-parafasicular nucleus complex, located in the caudal intralaminar thalamic nuclei, has been reported to be a potentially effective target for deep brain stimulation (DBS) or ablative surgeries for the treatment of various neurological and psychiatric diseases, e.g., Parkinson's disease, Tourette syndrome, generalized epilepsy, and intractable neuropathic pain (Ilyas et al, 2019). However, the surgeries targeting CM still relied on the indirect targeting method by registering a normalized atlas to the patient's magnetic resonance imaging (MRI) data and then the CM coordinates are used for target localization (Krauss et al, 2002;Kim et al, 2017;Sharma et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Gutierrez

et al. 2020

Front. Hum. Neurosci.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Gutierrez

et al. 2020

Front. Hum. Neurosci.

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“…There is also evidence of a critical involvement of intralaminar thalamic nuclei in the generalization of SWDs (Inoue et al 1993;Kostopoulos, 2001;Seidenbecher & Pape, 2001;Gorji et al 2011), most likely through recruitment of their widespread cortical connections (Benarroch, 2008). One nucleus of interest is the centromedian thalamus (CM), which connects to distinct regions of the basal ganglia and cortex, and receives major input from the ascending brainstem system (Ilyas et al 2019). More specifically, the CM receives major glutamatergic input from S1 and sends axonal projections to both primary and secondary motor cortex (M1 and M2, respectively) (Groenewegen & Berendse, 1994;van der Werf et al 2002).…”

Section: Introductionmentioning

confidence: 99%

“…More specifically, the CM receives major glutamatergic input from S1 and sends axonal projections to both primary and secondary motor cortex (M1 and M2, respectively) (Groenewegen & Berendse, 1994;van der Werf et al 2002). The CM has been proposed to serve as a gate control for salient stimuli during attentional tasks, and has thus emerged as potential target for intervention during pathological states of the thalamocortical system such as generalized epilepsy (Ilyas et al 2019). Of note, CM activity has been found to critically contribute to SWDs in human absence epilepsy (Velasco et al 1997;Tyvaert et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Spike‐wave discharges in absence epilepsy: segregation of electrographic components reveals distinct pathways of seizure activity

Terlau

Yang

Khastkhodaei

et al. 2020

The Journal of Physiology

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Key points The major electrophysiological hallmarks of absence seizures are spike and wave discharges (SWDs), consisting of a sharp spike component and a slow wave component. In a widely accepted scheme, these components are functionally coupled and reflect an iterative progression of neuronal excitation during the spike and post‐excitatory silence during the wave. In a genetic rat model of absence epilepsy, local pharmacological inhibition of the centromedian thalamus (CM) selectively suppressed the spike component, leaving self‐contained waves in epidural recordings. Thalamic inputs induced activity in cortical microcircuits underlying the spike component, while intracortical oscillations generated the wave component. Based on these findings, we propose a model in which oscillatory waves provide adequate time windows for integration of thalamocortical inputs and feedback responses during generation of a synchronized SWD. Abstract Spike and wave discharges (SWDs) are the electrographic hallmark of absence seizures and the major diagnostic criterion for childhood absence epilepsy (CAE). In a widely accepted scheme, the alternating sequence of spikes and waves reflects an iterative progression of neuronal excitation during the spike component and post‐excitatory silence during the wave component. Here we challenge this view by showing that these two components are not necessarily coupled. In a genetic rat model of CAE, self‐contained waves occurred in motor cortex in synchrony with SWDs in the somatosensory system during blockade of afferent input from the thalamus. Current‐source density analyses of multi‐site local field potentials (LFPs) revealed layer‐specific activity, in which thalamic inputs induced a sequence of cellular‐synaptic events underlying the spike component, while intracortical oscillations generated the wave component. These findings indicate novel principles of SWDs, where oscillatory cortical waves provide adequate time windows for integration of thalamocortical inputs and feedback responses during generation of seizure activity.

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Network Architecture of Verticality Processing in the Human Thalamus

Conrad

Baier

Eberle

et al. 2023

Annals of Neurology

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Objective Thalamic dysfunction in lesions or neurodegeneration may alter verticality perception and lead to postural imbalance and falls. The aim of the current study was to delineate the structural and functional connectivity network architecture of the vestibular representations in the thalamus by multimodal magnetic resonance imaging. Methods Seventy‐four patients with acute unilateral isolated thalamic infarcts were studied prospectively with emphasis on the perception of verticality (tilts of the subjective visual vertical [SVV]). We used multivariate lesion–symptom mapping based on support‐vector regression to determine the thalamic nuclei associated with ipsiversive and contraversive tilts of the SVV. The lesion maps were used to evaluate the white matter disconnection and whole brain functional connectivity in healthy subjects. Results Contraversive SVV tilts were associated with lesions of the ventral posterior lateral/medial, ventral lateral, medial pulvinar, and medial central/parafascicular nuclei. Clusters associated with ipsiversive tilts were located inferiorly (ventral posterior inferior nucleus) and laterally (ventral lateral, ventral posterior lateral, and reticular nucleus) to these areas. Distinct ascending vestibular brainstem pathways terminated in the subnuclei for ipsi‐ or contraversive verticality processing. The functional connectivity analysis showed specific patterns of cortical connections with the somatomotor network for lesions with contraversive tilts, and with the core multisensory vestibular representations (areas Ri, OP2‐3, Ig, 3av, 2v) for lesions with ipsiversive tilts. Interpretation The functional specialization may allow both a stable representation of verticality for sensorimotor integration and flexible adaption to sudden changes in the environment. A targeted modulation of this circuitry could be a novel therapeutic strategy for higher level balance disorders of thalamocortical origin. ANN NEUROL 2023;94:133–145

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The centromedian nucleus: Anatomy, physiology, and clinical implications

Cited by 90 publications

References 88 publications

Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Spike‐wave discharges in absence epilepsy: segregation of electrographic components reveals distinct pathways of seizure activity

Network Architecture of Verticality Processing in the Human Thalamus

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