scholarly journals Revisiting the “Paradox of Stereotaxic Surgery”: Insights Into Basal Ganglia-Thalamic Interactions

2021 ◽  
Vol 15 ◽  
Author(s):  
Jennifer L. Magnusson ◽  
Daniel K. Leventhal
Keyword(s):  
Basal Ganglia ◽  
Movement Disorders ◽  
Motor Output ◽  
Clinical Effects ◽  
Stereotaxic Surgery ◽  
Standard Rate ◽  
Standard Models ◽  
Cortical Physiology ◽  
Motor Thalamus ◽  
Deep Brain

Basal ganglia dysfunction is implicated in movement disorders including Parkinson Disease, dystonia, and choreiform disorders. Contradicting standard “rate models” of basal ganglia-thalamic interactions, internal pallidotomy improves both hypo- and hyper-kinetic movement disorders. This “paradox of stereotaxic surgery” was recognized shortly after rate models were developed, and is underscored by the outcomes of deep brain stimulation (DBS) for movement disorders. Despite strong evidence that DBS activates local axons, the clinical effects of lesions and DBS are nearly identical. These observations argue against standard models in which GABAergic basal ganglia output gates thalamic activity, and raise the question of how lesions and stimulation can have similar effects. These paradoxes may be resolved by considering thalamocortical loops as primary drivers of motor output. Rather than suppressing or releasing cortex via motor thalamus, the basal ganglia may modulate the timing of thalamic perturbations to cortical activity. Motor cortex exhibits rotational dynamics during movement, allowing the same thalamocortical perturbation to affect motor output differently depending on its timing with respect to the rotational cycle. We review classic and recent studies of basal ganglia, thalamic, and cortical physiology to propose a revised model of basal ganglia-thalamocortical function with implications for basic physiology and neuromodulation.

Basal ganglia local field potentials: applications in the development of new deep brain stimulation devices for movement disorders

2007 ◽  
Vol 4 (5) ◽  
pp. 605-614 ◽  
Author(s):  
Sara Marceglia ◽  
Lorenzo Rossi ◽  
Guglielmo Foffani ◽  
AnnaMaria Bianchi ◽  
Sergio Cerutti ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Local Field ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Local Field Potentials ◽  
Field Potentials ◽  
Deep Brain

scholarly journals Common therapeutic mechanisms of pallidal deep brain stimulation for hypo- and hyperkinetic movement disorders

2015 ◽  
Vol 114 (4) ◽  
pp. 2090-2104 ◽  
Author(s):  
Kevin W. McCairn ◽  
Atsushi Iriki ◽  
Masaki Isoda
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Information Transfer ◽  
Motor Behavior ◽  
Global Network ◽  
Symptom Profiles ◽  
Stimulus Effect ◽  
Deep Brain

Abnormalities in cortico-basal ganglia (CBG) networks can cause a variety of movement disorders ranging from hypokinetic disorders, such as Parkinson's disease (PD), to hyperkinetic conditions, such as Tourette syndrome (TS). Each condition is characterized by distinct patterns of abnormal neural discharge (dysrhythmia) at both the local single-neuron level and the global network level. Despite divergent etiologies, behavioral phenotypes, and neurophysiological profiles, high-frequency deep brain stimulation (HF-DBS) in the basal ganglia has been shown to be effective for both hypo- and hyperkinetic disorders. The aim of this review is to compare and contrast the electrophysiological hallmarks of PD and TS phenotypes in nonhuman primates and discuss why the same treatment (HF-DBS targeted to the globus pallidus internus, GPi-DBS) is capable of ameliorating both symptom profiles. Recent studies have shown that therapeutic GPi-DBS entrains the spiking of neurons located in the vicinity of the stimulating electrode, resulting in strong stimulus-locked modulations in firing probability with minimal changes in the population-scale firing rate. This stimulus effect normalizes/suppresses the pathological firing patterns and dysrhythmia that underlie specific phenotypes in both the PD and TS models. We propose that the elimination of pathological states via stimulus-driven entrainment and suppression, while maintaining thalamocortical network excitability within a normal physiological range, provides a common therapeutic mechanism through which HF-DBS permits information transfer for purposive motor behavior through the CBG while ameliorating conditions with widely different symptom profiles.

scholarly journals Toward adaptive deep brain stimulation for dystonia

2018 ◽  
Vol 45 (2) ◽  
pp. E3 ◽  
Author(s):  
Dan Piña-Fuentes ◽  
Martijn Beudel ◽  
Simon Little ◽  
Jonathan van Zijl ◽  
Jan Willem Elting ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Neural Oscillations ◽  
Feedback Signal ◽  
New Form ◽  
Different Characteristics ◽  
Potential Biomarkers ◽  
Deep Brain

The presence of abnormal neural oscillations within the cortico-basal ganglia-thalamo-cortical (CBGTC) network has emerged as one of the current principal theories to explain the pathophysiology of movement disorders. In theory, these oscillations can be used as biomarkers and thereby serve as a feedback signal to control the delivery of deep brain stimulation (DBS). This new form of DBS, dependent on different characteristics of pathological oscillations, is called adaptive DBS (aDBS), and it has already been applied in patients with Parkinson’s disease. In this review, the authors summarize the scientific research to date on pathological oscillations in dystonia and address potential biomarkers that might be used as a feedback signal for controlling aDBS in patients with dystonia.

scholarly journals New insights into cortico-basal-cerebellar connectome: clinical and physiological considerations

Brain ◽  
2019 ◽  
Author(s):  
Angelo Quartarone ◽  
Alberto Cacciola ◽  
Demetrio Milardi ◽  
Maria Felice Ghilardi ◽  
Alessandro Calamuneri ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Human Brain ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Current Model ◽  
Tract Tracing ◽  
Deep Brain

Abstract The current model of the basal ganglia system based on the ‘direct’, ‘indirect’ and ‘hyperdirect’ pathways provides striking predictions about basal ganglia function that have been used to develop deep brain stimulation approaches for Parkinson’s disease and dystonia. The aim of this review is to challenge this scheme in light of new tract tracing information that has recently become available from the human brain using MRI-based tractography, thus providing a novel perspective on the basal ganglia system. We also explore the implications of additional direct pathways running from cortex to basal ganglia and between basal ganglia and cerebellum in the pathophysiology of movement disorders.

scholarly journals An open cortico-basal ganglia loop allows limbic control over motor output via the nigrothalamic pathway

eLife ◽  
2019 ◽  
Vol 8 ◽  
Author(s):  
Sho Aoki ◽  
Jared B Smith ◽  
Hao Li ◽  
Xunyi Yan ◽  
Masakazu Igarashi ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Ventral Striatum ◽  
Motor Output ◽  
Functional Domain ◽  
Closed Loops ◽  
Dorsolateral Striatum ◽  
Parallel Circuits ◽  
Motor Loop ◽  
Motor Thalamus

Cortico-basal ganglia-thalamocortical loops are largely conceived as parallel circuits that process limbic, associative, and sensorimotor information separately. Whether and how these functionally distinct loops interact remains unclear. Combining genetic and viral approaches, we systemically mapped the limbic and motor cortico-basal ganglia-thalamocortical loops in rodents. Despite largely closed loops within each functional domain, we discovered a unidirectional influence of the limbic over the motor loop via ventral striatum-substantia nigra (SNr)-motor thalamus circuitry. Slice electrophysiology verifies that the projection from ventral striatum functionally inhibits nigro-thalamic SNr neurons. In vivo optogenetic stimulation of ventral or dorsolateral striatum to SNr pathway modulates activity in medial prefrontal cortex (mPFC) and motor cortex (M1), respectively. However, whereas the dorsolateral striatum-SNr pathway exerts little impact on mPFC, activation of the ventral striatum-SNr pathway effectively alters M1 activity. These results demonstrate an open cortico-basal ganglia loop whereby limbic information could modulate motor output through ventral striatum control of M1.

scholarly journals Patterned low-frequency deep brain stimulation induces motor deficits and modulates cortex-basal ganglia neural activity in healthy rats

2018 ◽  
Vol 120 (5) ◽  
pp. 2410-2422 ◽  
Author(s):  
Chintan S. Oza ◽  
David T. Brocker ◽  
Christina E. Behrend ◽  
Warren M. Grill
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Neural Activity ◽  
Low Frequency ◽  
Oscillatory Activity ◽  
Motor Deficits ◽  
Motor Symptoms ◽  
Deep Brain

Deep brain stimulation (DBS) is an effective therapy for movement disorders, including Parkinson’s disease (PD), although the mechanisms of action remain unclear. Abnormal oscillatory neural activity is correlated with motor symptoms, and pharmacological or DBS treatment that alleviates motor symptoms appears to suppress abnormal oscillations. However, whether such oscillatory activity is causal of motor deficits such as tremor remains unclear. Our goal was to generate abnormal oscillatory activity in the cortex-basal ganglia loop using patterned subthalamic nucleus DBS and to quantify motor behavior in awake healthy rats. Stimulation patterns were designed via model-based optimization to increase power in the low-frequency (7–11 Hz) band because these oscillations are associated with the emergence of motor symptoms in the 6-hydroxydopamine lesioned rat model of parkinsonism. We measured motor activity using a head-mounted accelerometer, as well as quantified neural activity in cortex and globus pallidus (GP), in response to 5 stimulation patterns that generated a range of 7- to 11-Hz spectral power. Stimulation patterns induced oscillatory activity in the low-frequency band in the cortex and GP and caused tremor, whereas control patterns and regular 50-Hz DBS did not generate any such effects. Neural and motor-evoked responses observed during stimulation were synchronous and time-locked to stimulation bursts within the patterns. These results identified elements of irregular patterns of stimulation that were correlated with tremor and tremor-related neural activity in the cortex and basal ganglia and may lead to the identification of the oscillatory activity and structures associated with the generation of tremor activity. NEW & NOTEWORTHY Subthalamic nucleus deep brain stimulation is a promising therapy for movement disorders such as Parkinson’s disease. Several groups reported correlation between suppression of abnormal oscillatory activity in the cortex-basal ganglia and motor symptoms, but it remains unclear whether such oscillations play a causal role in the emergence of motor symptoms. We demonstrate generation of tremor and pathological oscillatory activity in otherwise healthy rats by stimulation with patterns that produced increases in low-frequency oscillatory activity.

scholarly journals Deep brain stimulation in the treatment of dyskinesia and dystonia

2004 ◽  
Vol 17 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Hiroki Toda ◽  
Clement Hamani ◽  
Andres Lozano
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Improved Outcomes ◽  
Generalized Dystonia ◽  
Clinical Conditions ◽  
Better Than ◽  
Deep Brain

Deep brain stimulation (DBS) has become a mainstay of treatment for patients with movement disorders. This modality is directed at modulating pathological activity within basal ganglia output structures by stimulating some of their nuclei, such as the subthalamic nucleus (STN) and the globus pallidus internus (GPi), without making permanent lesions. With the accumulation of experience, indications for the use of DBS have become clearer and the effectiveness and limitations of this form of therapy in different clinical conditions have been better appreciated. In this review the authors discuss the efficacy of DBS in the treatment of dystonia and levodopa-induced dyskinesias. The use of DBS of the STN and GPi is very effective for the treatment of movement disorders induced by levodopa. The relative benefits of using the GPi as opposed to the STN as a target are still being investigated. Bilateral GPi stimulation is gaining importance in the therapeutic armamentarium for the treatment of dystonia. The DYT1 forms of generalized dystonia and cervical dystonias respond to DBS better than secondary dystonia does. Discrimination between the diverse forms of dystonia and a better understanding of the pathophysiological features of this condition will serve as a platform for improved outcomes.

The Effect of Deep Brain Stimulation for Movement Disorders on Emotions

2008 ◽  
Author(s):  
Jonathan D. Richards ◽  
Paul M. Wilson ◽  
Pennie S. Seibert ◽  
Carin M. Patterson ◽  
Caitlin C. Otto ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Deep Brain
Sign in / Sign up

Export Citation Format

Share Document