What can man do without basal ganglia motor output? The effect of combined unilateral subthalamotomy and pallidotomy in a patient with Parkinson's disease

Obeso, José A.; Jahanshahi, Marjan; Álvarez, L.; Macıás, R.; Pedroso, I.; Wilkinson, Leonora; Pavón, Nancy; Day, Brian L.; Pinto, Serge; Rodríguez‐Oroz, María C.; Tejeiro, José Barea; Artieda, Julio; Talelli, Penelope; Swayne, Orlando; Rodríguez, Rafael; Bhatia, Kailash P.; Díaz, Manuel Rodríguez; López, G.; Guridi, Jorge; Rothwell, John C.

doi:10.1016/j.expneurol.2009.08.030

Cited by 66 publications

(71 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, the loss of behavior-locked cortical firing patterns in our birds supports the idea that pallidotomy ameliorates Parkinsonian motor deficits by blocking the spread of abnormal firing patterns from the basal ganglia to the cortex (4,6,7). Finally, the elimination of auditory feedback-driven motor plasticity in our birds by pallidal lesions parallels the impaired ability of postpallidotomy patients to learn new motor sequences (22,23).…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Task-related “cortical” bursting depends critically on basal ganglia input and is linked to vocal plasticity

Kojima

Kao

Doupe

2013

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Basal ganglia-thalamocortical circuits are critical for motor control and motor learning. Classically, basal ganglia nuclei are thought to regulate motor behavior by increasing or decreasing cortical firing rates, and basal ganglia diseases are assumed to reflect abnormal overall activity levels. More recent studies suggest instead that motor disorders derive from abnormal firing patterns, and have led to the hypothesis that surgical treatments, such as pallidotomy, act primarily by eliminating pathological firing patterns. Surprisingly little is known, however, about how the basal ganglia normally influence task-related cortical activity to regulate motor behavior, and how lesions of the basal ganglia influence cortical firing properties. Here, we investigated these questions in a songbird circuit that has striking homologies to mammalian basal ganglia-thalamocortical circuits but is specialized for singing. The “cortical” outflow nucleus of this circuit is required for song plasticity and normally exhibits increased firing during singing and song-locked burst firing. We found that lesions of the striato-pallidal nucleus in this circuit prevented hearing-dependent song changes. These basal ganglia lesions also stripped the cortical outflow neurons of their patterned burst firing during singing, without changing their spontaneous or singing-related firing rates. Taken together, these results suggest that the basal ganglia are essential not for normal cortical firing rates but for driving task-specific cortical firing patterns, including bursts. Moreover, such patterned bursting appears critical for motor plasticity. Our findings thus provide support for therapies that aim to treat basal ganglia movement disorders by normalizing firing patterns.

show abstract

Section: Discussionsupporting

confidence: 81%

“…2B) (P > 0.05). These findings demonstrate that the basal ganglia are required for normal, hearingdependent vocal motor plasticity but not for the performance of well-learned song, and they strikingly mirror clinical findings that pallidotomy does not markedly affect the execution of wellpracticed skills but impairs motor plasticity (22,23).…”

Section: Resultssupporting

confidence: 67%

Task-related “cortical” bursting depends critically on basal ganglia input and is linked to vocal plasticity

Kojima

Kao

Doupe

2013

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

show abstract

“…The clinically identifiable impairments of pallidotomy appear to be only a small degree of bradykinesia and a minor disruption of reinforcement learning [51,[318][319][320]. As mentioned above, the available evidence suggests that GPi DBS or STN DBS does not disrupt procedural learning, and may even improve it [288][289][290][291].…”

Section: The Removal Of Abnormal Basal Ganglia Output Is Sufficient Tmentioning

confidence: 95%

“…Combined single-cell/behavioral studies in primates have found highly specific changes in neuronal activity in relation to (trained) limb movements throughout the nodes of the motor circuit, particularly in relation to movement amplitude/velocity, However, the observed changes in discharge lag behind activity changes in the MC [42][43][44][45], and the activation of (antidromically identified) corticoputaminal neurons lags that of nearby corticofugal projections to brainstem and spinal cord [46,47]. Moreover, lesions interrupting the output of the motor circuit in the sensorimotor territory of GPi in normal primates and individuals with PD or dystonia [48], following pallidotomy, have little or no effect on reaction times, although a slowing of movement is a consistent finding [49][50][51][52]. Of course, it could be argued that the basal ganglia might play a more direct role in the initiation of internally generated movements.…”

Section: Functional/anatomic Considerations Of the Basal Ganglia Circmentioning

confidence: 99%

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

2016

View full text Add to dashboard Cite

Deep brain stimulation (DBS) is highly effective for both hypo-and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal gangliathalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.

show abstract

“…38,45,72,87,122 A recollection of studies indicates that subthalamotomies have beneficial effects on the motor symptoms in both off-and on-medication states with better results from bilateral lesions. The surgery significantly reduces contralateral cardinal symptoms (tremor, bradykinesia, and rigidity).…”

Section: Parkinsonian Symptomsmentioning

confidence: 99%

Subthalamotomy in the treatment of Parkinson's disease: clinical aspects and mechanisms of action

Jourdain

Schechtmann

Paolo

2014

JNS

View full text Add to dashboard Cite

Parkinson's disease (PD) is a neurodegenerative condition that can be pharmacologically treated with levodopa. However, important motor and nonmotor symptoms appear with its long-term use. The subthalamic nucleus (STN) is known to be involved in the pathophysiology of PD and to contribute to levodopa-induced complications. Surgery is considered in patients who have advanced PD that is refractory to pharmacotherapy and who display disabling dyskinesia. Deep brain stimulation of the STN is currently the main surgical procedure for PD, but lesioning is still performed. This review covers the clinical aspects and complications of subthalamotomy as one of the lesion-based options for PD patients with levodopa-induced dyskinesias. Moreover, the authors discuss the possible effects of subthalamic lesioning.

show abstract

What can man do without basal ganglia motor output? The effect of combined unilateral subthalamotomy and pallidotomy in a patient with Parkinson's disease

Cited by 66 publications

References 85 publications

Task-related “cortical” bursting depends critically on basal ganglia input and is linked to vocal plasticity

Task-related “cortical” bursting depends critically on basal ganglia input and is linked to vocal plasticity

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

Subthalamotomy in the treatment of Parkinson's disease: clinical aspects and mechanisms of action

Contact Info

Product

Resources

About