Which one is more effective in Parkinson's disease? stimulating the motor cortex or the basal ganglia?

AbstractParkinson’s disease (PD) is associated with abnormal beta oscillations (13-30 Hz) in the basal ganglia and motor cortex (M1). Recent reports show that M1 beta-high gamma (50-200 Hz) phase-amplitude coupling (PAC) is exaggerated in PD and is reduced following acute deep brain stimulation (DBS). Here we analyze invasive M1 electrocorticography recordings in PD patients on and off DBS, and in isolated cervical dystonia patients, and show that M1 beta oscillations are nonsinusoidal, having sharp and asymmetric features. These sharp oscillatory beta features underlie the previously reported PAC, providing an alternative to the standard interpretation of PAC as an interaction between two distinct frequency components. Specifically, the ratio between peak and trough sharpness is nearly perfectly correlated with beta-high gamma PAC (r = 0.96) and predicts PD-related motor deficit. Using a simulation of the local field potential, we demonstrate that sharp oscillatory waves can arise from synchronous synaptic activity. We propose that exaggerated beta-high gamma PAC may actually reflect such synchronous synaptic activity, manifesting as sharp beta oscillations that are “smoothed out” with DBS. These results support the “desynchronization” hypothesis of DBS wherein DBS counteracts pathological synchronization throughout the basal ganglia-thalamocortical loop. We argue that PAC can be influenced by more than one mechanism. In this case synaptic synchrony, rather than the often assumed spike-field coherence, may underlie exaggerated PAC. These often overlooked temporal features of the oscillatory waveform carry critical physiological information about neural processes and dynamics that may lead to better understanding of underlying neuropathology.

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Proton magnetic resonance spectroscopy ( 1 H-MRS) of motor cortex and basal ganglia in de novo Parkinson's disease patients

Neurological Sciences ◽

10.1007/s100720170051 ◽

2001 ◽

Vol 22 (1) ◽

pp. 69-70 ◽

Cited By ~ 34

Author(s):

C. Lucetti ◽

P. Del Dotto ◽

G. Gambaccini ◽

S. Bernardini ◽

M. C. Bianchi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Magnetic Resonance ◽

Motor Cortex ◽

Magnetic Resonance Spectroscopy ◽

Proton Magnetic Resonance ◽

Proton Magnetic Resonance Spectroscopy ◽

De Novo ◽

Resonance Spectroscopy

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What catatonia can tell us about “top-down modulation”: A neuropsychiatric hypothesis

Behavioral and Brain Sciences ◽

10.1017/s0140525x02000109 ◽

2002 ◽

Vol 25 (5) ◽

pp. 555-577 ◽

Cited By ~ 149

Author(s):

Georg Northoff

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Motor Cortex ◽

Motor Symptoms ◽

Top Down ◽

Behavioural Symptoms ◽

Clinical Appearance ◽

Cortical Areas ◽

Different Origins

Differential diagnosis of motor symptoms, for example, akinesia, may be difficult in clinical neuropsychiatry. Symptoms may be either of neurologic origin, for example, Parkinson's disease, or of psychiatric origin, for example, catatonia, leading to a so-called “conflict of paradigms.” Despite their different origins, symptoms may appear more or less clinically similar. Possibility of dissociation between origin and clinical appearance may reflect functional brain organisation in general, and cortical-cortical/subcortical relations in particular. It is therefore hypothesized that similarities and differences between Parkinson's disease and catatonia may be accounted for by distinct kinds of modulation between cortico-cortical and cortico-subcortical relations. Catatonia can be characterized by concurrent motor, emotional, and behavioural symptoms. The different symptoms may be accounted for by dysfunction in orbitofrontal-prefrontal/parietal cortical connectivity reflecting “horizontal modulation” of cortico-cortical relation. Furthermore, alteration in “top-down modulation” reflecting “vertical modulation” of caudate and other basal ganglia by GABA-ergic mediated orbitofrontal cortical deficits may account for motor symptoms in catatonia. Parkinson's disease, in contrast, can be characterized by predominant motor symptoms. Motor symptoms may be accounted for by altered “bottom-up modulation” between dopaminergic mediated deficits in striatum and premotor/motor cortex. Clinical similarities between Parkinson's disease and catatonia with respect to akinesia may be related with involvement of the basal ganglia in both disorders. Clinical differences with respect to emotional and behavioural symptoms may be related with involvement of different cortical areas, that is, orbitofrontal/parietal and premotor/motor cortex implying distinct kinds of modulation – “vertical” and “horizontal” modulation, respectively.

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Anterograde Tracing From the Göttingen Minipig Motor and Prefrontal Cortex Displays a Topographic Subthalamic and Striatal Axonal Termination Pattern Comparable to Previous Findings in Primates

Frontiers in Neural Circuits ◽

10.3389/fncir.2021.716145 ◽

2021 ◽

Vol 15 ◽

Author(s):

Johannes Bech Steinmüller ◽

Carsten Reidies Bjarkam ◽

Dariusz Orlowski ◽

Jens Christian Hedemann Sørensen ◽

Andreas Nørgaard Glud

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Prefrontal Cortex ◽

Basal Ganglia ◽

Motor Cortex ◽

Caudate Nucleus ◽

Subthalamic Nucleus ◽

Primary Motor Cortex ◽

Large Animal ◽

Göttingen Minipig

Background: Deep brain stimulation (DBS) of the dorsal subthalamic nucleus (STN) is a validated neurosurgical treatment of Parkinson’s Disease (PD). To investigate the mechanism of action, including potential DBS induced neuroplasticity, we have previously used a minipig model of Parkinson’s Disease, although the basal ganglia circuitry was not elucidated in detail.Aim: To describe the cortical projections from the primary motor cortex (M1) to the basal ganglia and confirm the presence of a cortico-striatal pathway and a hyperdirect pathway to the subthalamic nucleus, respectively, which is known to exist in primates.Materials and Methods: Five female Göttingen minipigs were injected into the primary motor cortex (n = 4) and adjacent prefrontal cortex (n = 1) with the anterograde neuronal tracer, Biotinylated Dextran Amine (BDA). 4 weeks later the animals were sacrificed and the brains cryosectioned into 30 μm thick coronal sections for subsequent microscopic analysis.Results: The hyperdirect axonal connections from the primary motor cortex were seen to terminate in the dorsolateral STN, whereas the axonal projections from the prefrontal cortex terminated medially in the STN. Furthermore, striatal tracing from the motor cortex was especially prominent in the dorsolateral putamen and less so in the dorsolateral caudate nucleus. The prefrontal efferents were concentrated mainly in the caudate nucleus and to a smaller degree in the juxtacapsular dorsal putamen, but they were also found in the nucleus accumbens and ventral prefrontal cortex.Discussion: The organization of the Göttingen minipig basal ganglia circuitry is in accordance with previous descriptions in primates. The existence of a cortico-striatal and hyperdirect basal ganglia pathway in this non-primate, large animal model may accordingly permit further translational studies on STN-DBS induced neuroplasticity of major relevance for future DBS treatments.

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Changes in metabotropic glutamate receptor expression in the basal ganglia of Parkinson's disease models

Neuroscience Research ◽

10.1016/s0168-0102(00)81571-0 ◽

2000 ◽

Vol 38 ◽

pp. S121

Author(s):

M Takada

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Glutamate Receptor ◽

Metabotropic Glutamate Receptor ◽

Receptor Expression ◽

Disease Models ◽

Metabotropic Glutamate

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SPECT-Befunde bei Hemiparkinson-Syndrom mit 99mTc-HMPAO

Nuklearmedizin ◽

10.1055/s-0038-1629476 ◽

1989 ◽

Vol 28 (03) ◽

pp. 92-94 ◽

Cited By ~ 1

Author(s):

C. Neumann ◽

H. Baas ◽

R. Hefner ◽

G. Hör

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Neuronal Activity ◽

Tracer Uptake ◽

The Body ◽

99Mtc Hmpao ◽

Do So

The symptoms of Parkinson’s disease often begin on one side of the body and continue to do so as the disease progresses. First SPECT results in 4 patients with hemiparkinsonism using 99mTc-HMPAO as perfusion marker are reported. Three patients exhibited reduced tracer uptake in the contralateral basal ganglia One patient who was under therapy for 1 year, showed a different perfusion pattern with reduced uptake in both basal ganglia. These results might indicate reduced perfusion secondary to reduced striatal neuronal activity.

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