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Manes JL, Bullock L, Meier AM, Turner RS, Richardson RM, Guenther FH. A neurocomputational view of the effects of Parkinson's disease on speech production. Front Hum Neurosci 2024; 18:1383714. [PMID: 38812472 PMCID: PMC11133703 DOI: 10.3389/fnhum.2024.1383714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Abstract
The purpose of this article is to review the scientific literature concerning speech in Parkinson's disease (PD) with reference to the DIVA/GODIVA neurocomputational modeling framework. Within this theoretical view, the basal ganglia (BG) contribute to several different aspects of speech motor learning and execution. First, the BG are posited to play a role in the initiation and scaling of speech movements. Within the DIVA/GODIVA framework, initiation and scaling are carried out by initiation map nodes in the supplementary motor area acting in concert with the BG. Reduced support of the initiation map from the BG in PD would result in reduced movement intensity as well as susceptibility to early termination of movement. A second proposed role concerns the learning of common speech sequences, such as phoneme sequences comprising words; this view receives support from the animal literature as well as studies identifying speech sequence learning deficits in PD. Third, the BG may play a role in the temporary buffering and sequencing of longer speech utterances such as phrases during conversational speech. Although the literature does not support a critical role for the BG in representing sequence order (since incorrectly ordered speech is not characteristic of PD), the BG are posited to contribute to the scaling of individual movements in the sequence, including increasing movement intensity for emphatic stress on key words. Therapeutic interventions for PD have inconsistent effects on speech. In contrast to dopaminergic treatments, which typically either leave speech unchanged or lead to minor improvements, deep brain stimulation (DBS) can degrade speech in some cases and improve it in others. However, cases of degradation may be due to unintended stimulation of efferent motor projections to the speech articulators. Findings of spared speech after bilateral pallidotomy appear to indicate that any role played by the BG in adult speech must be supplementary rather than mandatory, with the sequential order of well-learned sequences apparently represented elsewhere (e.g., in cortico-cortical projections).
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Affiliation(s)
- Jordan L. Manes
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States
- Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, United States
| | - Latané Bullock
- Program in Speech and Hearing Bioscience and Technology, Division of Medical Sciences, Harvard Medical School, Boston, MA, United States
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Andrew M. Meier
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States
| | - Robert S. Turner
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA, United States
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD, United States
| | - R. Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Frank H. Guenther
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States
- Department of Biomedical Engineering, Boston University, Boston, MA, United States
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, United States
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2
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Chen L, Daniels S, Dvorak R, Chu HY. Reduced thalamic excitation to motor cortical pyramidal tract neurons in parkinsonism. SCIENCE ADVANCES 2023; 9:eadg3038. [PMID: 37611096 PMCID: PMC10446482 DOI: 10.1126/sciadv.adg3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
Degeneration of midbrain dopaminergic (DA) neurons alters the connectivity and functionality of the basal ganglia-thalamocortical circuits in Parkinson's disease (PD). Particularly, the aberrant outputs of the primary motor cortex (M1) contribute to parkinsonian motor deficits. However, cortical adaptations at cellular and synaptic levels in parkinsonism remain poorly understood. Using multidisciplinary approaches, we found that DA degeneration induces cell subtype- and input-specific reduction of thalamic excitation to M1 pyramidal tract (PT) neurons. At molecular level, we identified that N-methyl-d-aspartate (NMDA) receptors play a key role in mediating the reduced thalamocortical excitation to PT neurons. At circuit level, we showed that the reduced thalamocortical transmission in parkinsonian mice can be rescued by chemogenetically suppressing basal ganglia outputs. Together, our data suggest that cell subtype- and synapse-specific adaptations in M1 contribute to altered cortical outputs in parkinsonism and are important aspects of PD pathophysiology.
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Affiliation(s)
- Liqiang Chen
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815
| | - Samuel Daniels
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Rachel Dvorak
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Hong-Yuan Chu
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815
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3
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Monje MH, Mañez‐Miró JU, Obeso JA. The Apparent Impunity of the Basal Ganglia to Therapeutic Lesioning: Clinical and Scientific Lessons. Mov Disord Clin Pract 2023; 10:S42-S46. [PMID: 37637986 PMCID: PMC10448138 DOI: 10.1002/mdc3.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Mariana H.G. Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal)Hospital Universitario HM Puerta del Sur, HM HospitalesMadridSpain
- Ken and Ruth Davee Department of NeurologyNorthwestern University, Feinberg School of MedicineChicagoIllinoisUSA
| | - Jorge U. Mañez‐Miró
- HM CINAC (Centro Integral de Neurociencias Abarca Campal)Hospital Universitario HM Puerta del Sur, HM HospitalesMadridSpain
- PhD Program in NeuroscienceAutónoma de Madrid University‐Cajal InstituteMadridSpain
- Neurology Department, IMED HospitalesValenciaSpain
| | - José A. Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal)Hospital Universitario HM Puerta del Sur, HM HospitalesMadridSpain
- Universidad San Pablo‐CEUMadridSpain
- CIBERNED, Instituto de Salud Carlos IIIMadridSpain
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4
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de A Marcelino AL, Gray O, Al-Fatly B, Gilmour W, Douglas Steele J, Kühn AA, Gilbertson T. Pallidal neuromodulation of the explore/exploit trade-off in decision-making. eLife 2023; 12:79642. [PMID: 36727860 PMCID: PMC9940911 DOI: 10.7554/elife.79642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/01/2023] [Indexed: 02/03/2023] Open
Abstract
Every decision that we make involves a conflict between exploiting our current knowledge of an action's value or exploring alternative courses of action that might lead to a better, or worse outcome. The sub-cortical nuclei that make up the basal ganglia have been proposed as a neural circuit that may contribute to resolving this explore-exploit 'dilemma'. To test this hypothesis, we examined the effects of neuromodulating the basal ganglia's output nucleus, the globus pallidus interna, in patients who had undergone deep brain stimulation (DBS) for isolated dystonia. Neuromodulation enhanced the number of exploratory choices to the lower value option in a two-armed bandit probabilistic reversal-learning task. Enhanced exploration was explained by a reduction in the rate of evidence accumulation (drift rate) in a reinforcement learning drift diffusion model. We estimated the functional connectivity profile between the stimulating DBS electrode and the rest of the brain using a normative functional connectome derived from heathy controls. Variation in the extent of neuromodulation induced exploration between patients was associated with functional connectivity from the stimulation electrode site to a distributed brain functional network. We conclude that the basal ganglia's output nucleus, the globus pallidus interna, can adaptively modify decision choice when faced with the dilemma to explore or exploit.
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Affiliation(s)
- Ana Luisa de A Marcelino
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus MitteBerlinGermany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Core Facility GenomicsBerlinGermany
| | - Owen Gray
- Division of Imaging Science and Technology, Medical School, University of DundeeDundeeUnited Kingdom
| | - Bassam Al-Fatly
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus MitteBerlinGermany
| | - William Gilmour
- Division of Imaging Science and Technology, Medical School, University of DundeeDundeeUnited Kingdom
| | - J Douglas Steele
- Division of Imaging Science and Technology, Medical School, University of DundeeDundeeUnited Kingdom
| | - Andrea A Kühn
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus MitteBerlinGermany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Core Facility GenomicsBerlinGermany
- Berlin School of Mind and Brain, Charité - University Medicine BerlinBerlinGermany
- NeuroCure, Charité - University Medicine BerlinBerlinGermany
- DZNE, German Centre for Degenerative DiseasesBerlinGermany
| | - Tom Gilbertson
- Division of Imaging Science and Technology, Medical School, University of DundeeDundeeUnited Kingdom
- Department of Neurology, Ninewells Hospital & Medical SchoolDundeeUnited Kingdom
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5
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Abstract
Recent breakthroughs in artificial intelligence (AI) have enabled machines to plan in tasks previously thought to be uniquely human. Meanwhile, the planning algorithms implemented by the brain itself remain largely unknown. Here, we review neural and behavioral data in sequential decision-making tasks that elucidate the ways in which the brain does-and does not-plan. To systematically review available biological data, we create a taxonomy of planning algorithms by summarizing the relevant design choices for such algorithms in AI. Across species, recording techniques, and task paradigms, we find converging evidence that the brain represents future states consistent with a class of planning algorithms within our taxonomy-focused, depth-limited, and serial. However, we argue that current data are insufficient for addressing more detailed algorithmic questions. We propose a new approach leveraging AI advances to drive experiments that can adjudicate between competing candidate algorithms.
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Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Martínez-Fernández R, Obeso JA. Present and future of subthalamotomy in the management of Parkinson´s disease: a systematic review. Expert Rev Neurother 2021; 21:533-545. [PMID: 33788645 DOI: 10.1080/14737175.2021.1911649] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: The subthalamic nucleus (STN) is known to be involved in the pathophysiology of Parkinson´s disease and by reducing its abnormal activity, normal output of basal ganglia can be restored along with improvement in PD cardinal motor features. Deep brain stimulation of the STN is currently the main surgical procedure for PD with motor complications, but lesioning can be an alternative.Areas covered: Here, the authors systematically review the current evidence regarding subthalamotomy both with radiofrequency and, more recently, with focused ultrasound (FUS) for the treatment of PD.Expert opinion: Unilateral subthalamotomy for the treatment of PD motor features can be considered a viable option in asymmetric patients, particularly with FUS which allows a minimally invasive safe and effective ablation of the STN. Risk of inducing dyskinesia (i.e., hemichorea/ballism) may be strikingly reduced when lesions enlarge dorsally to impinge on pallidothalamic fibers.
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Affiliation(s)
- Jorge U Máñez-Miró
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - Rafael Rodríguez-Rojas
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - Marta Del Álamo
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - R Martínez-Fernández
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - José A Obeso
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain.,CEU-San Pablo University, Móstoles, Madrid, Spain
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7
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Postural instability in Parkinson’s disease: Review and bottom-up rehabilitative approaches. Neurophysiol Clin 2020; 50:479-487. [DOI: 10.1016/j.neucli.2020.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/07/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022] Open
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8
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Schwab BC, Kase D, Zimnik A, Rosenbaum R, Codianni MG, Rubin JE, Turner RS. Neural activity during a simple reaching task in macaques is counter to gating and rebound in basal ganglia-thalamic communication. PLoS Biol 2020; 18:e3000829. [PMID: 33048920 PMCID: PMC7584254 DOI: 10.1371/journal.pbio.3000829] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/23/2020] [Accepted: 09/14/2020] [Indexed: 12/24/2022] Open
Abstract
Task-related activity in the ventral thalamus, a major target of basal ganglia output, is often assumed to be permitted or triggered by changes in basal ganglia activity through gating- or rebound-like mechanisms. To test those hypotheses, we sampled single-unit activity from connected basal ganglia output and thalamic nuclei (globus pallidus-internus [GPi] and ventrolateral anterior nucleus [VLa]) in monkeys performing a reaching task. Rate increases were the most common peri-movement change in both nuclei. Moreover, peri-movement changes generally began earlier in VLa than in GPi. Simultaneously recorded GPi-VLa pairs rarely showed short-time-scale spike-to-spike correlations or slow across-trials covariations, and both were equally positive and negative. Finally, spontaneous GPi bursts and pauses were both followed by small, slow reductions in VLa rate. These results appear incompatible with standard gating and rebound models. Still, gating or rebound may be possible in other physiological situations: simulations show how GPi-VLa communication can scale with GPi synchrony and GPi-to-VLa convergence, illuminating how synchrony of basal ganglia output during motor learning or in pathological conditions may render this pathway effective. Thus, in the healthy state, basal ganglia-thalamic communication during learned movement is more subtle than expected, with changes in firing rates possibly being dominated by a common external source.
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Affiliation(s)
- Bettina C. Schwab
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Technical Medical Center, University of Twente, Enschede, the Netherlands
| | - Daisuke Kase
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Andrew Zimnik
- Department of Neuroscience, Columbia University Medical Center, New York, New York, United States of America
| | - Robert Rosenbaum
- Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, South Bend, Indiana, United States of America
| | - Marcello G. Codianni
- Department of Mathematics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jonathan E. Rubin
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Mathematics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Robert S. Turner
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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9
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Bloem BR, Monje MHG, Obeso JA. Understanding motor control in health and disease: classic single (n = 1) observations. Exp Brain Res 2020; 238:1593-1600. [PMID: 32172352 PMCID: PMC7413913 DOI: 10.1007/s00221-020-05763-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/25/2020] [Indexed: 02/06/2023]
Abstract
The field of neuroscience is increasingly dominated by a preferred use of big data, where analysis of large numbers has become an essential area of development. We here draw attention to the importance of smaller numbers, and more specifically, to the historical and continued importance of detailed and judiciously performed studies in single healthy volunteers or single patients with a unique clinical presentation, as an important approach to study normal functions of the nervous system, and to understand the pathophysiology underlying neurological movement disorders. We illustrate this by discussing several historical examples and by summarising Professor John Rothwell's impressive body of work in single-patient studies, highlighting some of his seminal n = 1 studies that have had a great impact on the field. In doing so, we hope to provide a powerful incentive for the next generation of neuroscientists to keep appreciating the value of detailed analyses of single observations.
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Affiliation(s)
- Bastiaan R Bloem
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, PO Box 9101 (947), 6500 HB, Nijmegen, The Netherlands.
| | - Mariana H G Monje
- HM-CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, 28938, Móstoles, Madrid, Spain
| | - Jose A Obeso
- HM-CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, 28938, Móstoles, Madrid, Spain.
- Medical School, CEU-San Pablo University, Madrid, Spain.
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Instituto Carlos III, Madrid, Spain.
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10
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Jiang H, Wang R, Zheng Z, Zhu J. Deep brain stimulation for the treatment of cerebral palsy: A review. BRAIN SCIENCE ADVANCES 2020. [DOI: 10.26599/bsa.2020.9050002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Deep brain stimulation (DBS) has been used as a safe and effective neuromodulation technique for treatment of various diseases. A large number of patients suffering from movement disorders such as dyskinesia may benefit from DBS. Cerebral palsy (CP) is a group of permanent disorders mainly involving motor impairment, and medical interventions are usually unsatisfactory or temporarily active, especially for dyskinetic CP. DBS may be another approach to the treatment of CP. In this review we discuss the targets for DBS and the mechanisms of action for the treatment of CP, and focus on presurgical assessment, efficacy for dystonia and other symptoms, safety, and risks.
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Affiliation(s)
- Hongjie Jiang
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Rui Wang
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zhe Zheng
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Junming Zhu
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
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11
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de Almeida Marcelino AL, Horn A, Krause P, Kühn AA, Neumann WJ. Subthalamic neuromodulation improves short-term motor learning in Parkinson's disease. Brain 2020; 142:2198-2206. [PMID: 31169872 DOI: 10.1093/brain/awz152] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/12/2019] [Accepted: 04/08/2019] [Indexed: 11/14/2022] Open
Abstract
The basal ganglia and cerebellum are implicated in both motor learning and Parkinson's disease. Deep brain stimulation (DBS) is an established treatment for advanced Parkinson's disease that leads to motor and non-motor effects by modulating specific neural pathways. Recently, a disynaptic projection from the subthalamic nucleus (STN) to cerebellar hemispheres was discovered. To investigate the functional significance of this pathway in motor learning, short-term improvement in motor execution in 20 patients with Parkinson's disease on and off STN-DBS and 20 age-matched healthy controls was studied in a visuomotor task combined with whole-brain connectomics. Motor learning was impaired in Parkinson's disease off stimulation but was partially restored through DBS. Connectivity between active DBS contacts and a distributed network of brain regions correlated with improvement in motor learning. Region of interest analysis revealed connectivity from active contact to cerebellar hemisphere ipsilateral to hand movement as the strongest predictor for change in motor learning. Peak predictive voxels in the cerebellum localized to Crus II of lobule VII, which also showed higher STN than motor cortex connectivity, suggestive of a connection surpassing motor cortex. Our findings provide new insight into the circuit nature of Parkinson's disease and the distributed network effects of DBS in motor learning.
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Affiliation(s)
- Ana Luísa de Almeida Marcelino
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus Mitte, Charité - University Medicine Berlin, Berlin, Germany
| | - Andreas Horn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus Mitte, Charité - University Medicine Berlin, Berlin, Germany
| | - Patricia Krause
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus Mitte, Charité - University Medicine Berlin, Berlin, Germany
| | - Andrea A Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus Mitte, Charité - University Medicine Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Charité - University Medicine Berlin, Berlin, Germany.,NeuroCure, Charité - University Medicine Berlin, Berlin, Germany.,DZNE, German Centre for Degenerative Diseases, Berlin, 10117, Germany
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité Campus Mitte, Charité - University Medicine Berlin, Berlin, Germany
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12
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Wichmann T. Changing views of the pathophysiology of Parkinsonism. Mov Disord 2019; 34:1130-1143. [PMID: 31216379 DOI: 10.1002/mds.27741] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Studies of the pathophysiology of parkinsonism (specifically akinesia and bradykinesia) have a long history and primarily model the consequences of dopamine loss in the basal ganglia on the function of the basal ganglia/thalamocortical circuit(s). Changes of firing rates of individual nodes within these circuits were originally considered central to parkinsonism. However, this view has now given way to the belief that changes in firing patterns within the basal ganglia and related nuclei are more important, including the emergence of burst discharges, greater synchrony of firing between neighboring neurons, oscillatory activity patterns, and the excessive coupling of oscillatory activities at different frequencies. Primarily focusing on studies obtained in nonhuman primates and human patients with Parkinson's disease, this review summarizes the current state of this field and highlights several emerging areas of research, including studies of the impact of the heterogeneity of external pallidal neurons on parkinsonism, the importance of extrastriatal dopamine loss, parkinsonism-associated synaptic and morphologic plasticity, and the potential role(s) of the cerebellum and brainstem in the motor dysfunction of Parkinson's disease. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Thomas Wichmann
- Department of Neurology/School of Medicine and Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
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13
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Pyle R, Rosenbaum R. A Reservoir Computing Model of Reward-Modulated Motor Learning and Automaticity. Neural Comput 2019; 31:1430-1461. [PMID: 31113300 DOI: 10.1162/neco_a_01198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Reservoir computing is a biologically inspired class of learning algorithms in which the intrinsic dynamics of a recurrent neural network are mined to produce target time series. Most existing reservoir computing algorithms rely on fully supervised learning rules, which require access to an exact copy of the target response, greatly reducing the utility of the system. Reinforcement learning rules have been developed for reservoir computing, but we find that they fail to converge on complex motor tasks. Current theories of biological motor learning pose that early learning is controlled by dopamine-modulated plasticity in the basal ganglia that trains parallel cortical pathways through unsupervised plasticity as a motor task becomes well learned. We developed a novel learning algorithm for reservoir computing that models the interaction between reinforcement and unsupervised learning observed in experiments. This novel learning algorithm converges on simulated motor tasks on which previous reservoir computing algorithms fail and reproduces experimental findings that relate Parkinson's disease and its treatments to motor learning. Hence, incorporating biological theories of motor learning improves the effectiveness and biological relevance of reservoir computing models.
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Affiliation(s)
- Ryan Pyle
- Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, IN 46556, U.S.A.
| | - Robert Rosenbaum
- Department of Applied and Computational Mathematics and Statistics and Interdisciplinary Center for Network Science and Applications, University of Notre Dame, Notre Dame, IN 46556, U.S.A.
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14
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Rodriguez-Rojas R, Carballo-Barreda M, Alvarez L, Guridi J, Pavon N, Garcia-Maeso I, Mací As R, Rodriguez-Oroz MC, Obeso JA. Subthalamotomy for Parkinson's disease: clinical outcome and topography of lesions. J Neurol Neurosurg Psychiatry 2018; 89:572-578. [PMID: 29222224 DOI: 10.1136/jnnp-2017-316241] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/18/2017] [Accepted: 11/20/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Subthalamotomy is an effective alternative for the treatment of Parkinson's disease (PD). However, uncertainty about the optimal target location and the possibility of inducing haemichorea-ballism have limited its application. We assessed the correlation between the topography of radiofrequency-based lesions of the subthalamic nucleus (STN) with motor improvement and the emergence of haemichorea-ballism. METHODS Sixty-four patients with PD treated with subthalamotomy were evaluated preoperatively and postoperatively using the Unified Parkinson's Disease Rating Scale motor score (UPDRSm), MRI and tractography. Patients were classified according to the degree of clinical motor improvement and dyskinesia scale. Lesions were segmented on MRI and averaged in a standard space. We examined the relationship between the extent of lesion-induced disruption of fibres surrounding the STN and the development of haemichorea-ballism. RESULTS Maximum antiparkinsonian effect was obtained with lesions located within the dorsolateral motor region of the STN as compared with those centre-placed in the dorsal border of the STN and the zona incerta (71.3%, 53.5% and 20.8% UPDRSm reduction, respectively). However, lesions that extended dorsally beyond the STN showed lower probability of causing haemichorea-ballism than those placed entirely within the nucleus. Tractography findings indicate that interruption of pallidothalamic fibres probably determines a low probability of haemichorea-ballism postoperatively. CONCLUSIONS The topography of the lesion is a major factor in the antiparkinsonian effect of subthalamotomy in patients with PD. Lesions involving the motor STN and pallidothalamic fibres induced significant motor improvement and were associated with a low incidence of haemichorea-ballism.
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Affiliation(s)
- Rafael Rodriguez-Rojas
- HM CINAC, Hospital Universitario HM Puerta del Sur, CEU-San Pablo University, Madrid, Spain.,CIBERNED, Institute Carlos III, Madrid, Spain
| | - Maylen Carballo-Barreda
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Lazaro Alvarez
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Jorge Guridi
- Service of Neurosurgery, Clinica Universidad de Navarra, Pamplona, Spain
| | - Nancy Pavon
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Ivan Garcia-Maeso
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Raul Mací As
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Maria C Rodriguez-Oroz
- CIBERNED, Institute Carlos III, Madrid, Spain.,BioDonostia Health Research Institute, Basque Center on Cognition Brain and Language, San Sebastian, Guipuzcoa, Spain
| | - Jose Angel Obeso
- HM CINAC, Hospital Universitario HM Puerta del Sur, CEU-San Pablo University, Madrid, Spain.,CIBERNED, Institute Carlos III, Madrid, Spain
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15
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Cenci MA, Jörntell H, Petersson P. On the neuronal circuitry mediating L-DOPA-induced dyskinesia. J Neural Transm (Vienna) 2018; 125:1157-1169. [PMID: 29704061 PMCID: PMC6060876 DOI: 10.1007/s00702-018-1886-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/17/2018] [Indexed: 11/27/2022]
Abstract
With the advent of rodent models of l-DOPA-induced dyskinesia (LID), a growing literature has linked molecular changes in the striatum to the development and expression of abnormal involuntary movements. Changes in information processing at the striatal level are assumed to impact on the activity of downstream basal ganglia nuclei, which in turn influence brain-wide networks, but very little is actually known about systems-level mechanisms of dyskinesia. As an aid to approach this topic, we here review the anatomical and physiological organisation of cortico-basal ganglia-thalamocortical circuits, and the changes affecting these circuits in animal models of parkinsonism and LID. We then review recent findings indicating that an abnormal cerebellar compensation plays a causal role in LID, and that structures outside of the classical motor circuits are implicated too. In summarizing the available data, we also propose hypotheses and identify important knowledge gaps worthy of further investigation. In addition to informing novel therapeutic approaches, the study of LID can provide new clues about the interplay between different brain circuits in the control of movement.
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Affiliation(s)
- M Angela Cenci
- Basal Ganglia Pathophysiology Unit, Department Experimental Medical Science, Lund University, Lund, Sweden.
| | - Henrik Jörntell
- Neural Basis of Sensorimotor Control, Department Experimental Medical Science, Lund University, Lund, Sweden
| | - Per Petersson
- The Group for Integrative Neurophysiology and Neurotechnology, Neuronano Research Centre, Department Experimental Medical Science, Lund University, Lund, Sweden
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
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16
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Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study. Lancet Neurol 2018; 17:54-63. [DOI: 10.1016/s1474-4422(17)30403-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/15/2017] [Accepted: 10/16/2017] [Indexed: 11/19/2022]
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17
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Jahanshahi M, Rothwell JC. Inhibitory dysfunction contributes to some of the motor and non-motor symptoms of movement disorders and psychiatric disorders. Philos Trans R Soc Lond B Biol Sci 2017; 372:rstb.2016.0198. [PMID: 28242732 DOI: 10.1098/rstb.2016.0198] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2016] [Indexed: 12/13/2022] Open
Abstract
Recently, it has been proposed that similar to goal-directed and habitual action mediated by the fronto-striatal circuits, the fronto-striato-subthalamic-pallidal-thalamo-cortical network may also mediate goal-directed and habitual (automatic) inhibition in both the motor and non-motor domains. Within this framework, some of the clinical manifestations of Parkinson's disease, dystonia, Tourette syndrome and obsessive-compulsive disorder can be considered to represent an imbalance between goal-directed and habitual action and inhibition. It is possible that surgical interventions targeting the basal ganglia nuclei, such as deep brain stimulation of the subthalamic nucleus or the internal segment of the globus pallidus, improve these disorders by restoring a functional balance between facilitation and inhibition in the fronto-striatal networks. These proposals require investigation in future studies.This article is part of the themed issue 'Movement suppression: brain mechanisms for stopping and stillness'.
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Affiliation(s)
- Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
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18
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Чипизубов В, Chipizubov V, Петров С, Petrov S, Михалевич И, Mikhalevich I. DIFFERENTIATED COMPLEX TREATMENT OF PARKINSON’S DISEASE WITH ACCOUNT OF THE DEGREE OF BRAIN ATROPHY. ACTA BIOMEDICA SCIENTIFICA 2017. [DOI: 10.12737/article_5955e6b4c2a202.26751657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Сергей Петров
- Иркутская ордена «Знак почёта» областная клиническая больница
| | | | - Исай Михалевич
- Научный центр проблем здоровья семьи и репродукции человека
- Иркутская государственная медицинская академия последипломного образования
| | - Isai Mikhalevich
- Nauchnyy centr problem zdorov'ya sem'i i reprodukcii cheloveka
- Irkutsk State Medical Academy of Postgraduate Education
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19
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Hariz M. Stereotactic ablative surgery does not just mean "adding another lesion". Mov Disord 2017; 32:1112-1113. [PMID: 28612947 DOI: 10.1002/mds.27064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/09/2017] [Accepted: 04/10/2017] [Indexed: 11/07/2022] Open
Affiliation(s)
- Marwan Hariz
- Simon Sainsbury Chair of Functional Neurosurgery, Unit of Functional Neurosurgery, UCL - Institute of Neurology, Queen Square, London, UK.,Adjunct Professor of Stereotactic Surgery, Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
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20
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Obeso JA, Martinez-Fernandez R, Del Álamo M, Krack P. To lesion or not to lesion: That was the question (Reply to "stereotactic ablative surgery does not just mean 'adding another lesion'"). Mov Disord 2017; 32:1113-1114. [PMID: 28612948 DOI: 10.1002/mds.27066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/14/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jose A Obeso
- CINAC-Hospital Universitario HM Puerta del Sur, CEU-San Pablo University, Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | | | - Marta Del Álamo
- CINAC-Hospital Universitario HM Puerta del Sur, CEU-San Pablo University, Madrid, Spain.,Neurosurgery Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Paul Krack
- Neurology Division, Department of Clinical Neurosciences, University Hospital of Geneva, Switzerland
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21
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Cif L, Hariz M. Seventy Years with the Globus Pallidus: Pallidal Surgery for Movement Disorders Between 1947 and 2017. Mov Disord 2017; 32:972-982. [PMID: 28590521 DOI: 10.1002/mds.27054] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/20/2017] [Accepted: 04/23/2017] [Indexed: 12/25/2022] Open
Abstract
The year 2017 marks the 70th anniversary of the birth of human stereotactic neurosurgery. The first procedure was a pallidotomy for Huntington's disease. However, it was for Parkinson's disease that pallidotomy was soon adopted worldwide. Pallidotomy was abandoned in the late 1950s in favor of thalamotomy because of the latter's more striking effect on tremor. The advent of levodopa put a halt to all surgery for PD. In the mid-1980s, Laitinen reintroduced the posteroventral pallidotomy of Leksell, and this procedure spread worldwide thanks to its efficacy on most parkinsonian symptoms including levodopa-induced dyskinesias and thanks to basic scientific work confirming the role of the globus pallidus internus in the pathophysiology of PD. With the advent of deep brain stimulation of the subthalamic nucleus, pallidotomy was again abandoned, and even DBS of the GPi has been overshadowed by STN DBS. The GPi reemerged in the late 1990s as a major stereotactic target for DBS in dystonia and, recently, in Tourette syndrome. Lately, lesioning of the GPI is being proposed to treat refractory status dystonicus or to treat DBS withdrawal syndrome in PD patients. Hence, the pallidum as a stereotactic target for either lesioning or DBS has been the phoenix of functional stereotactic neurosurgery, constantly abandoned and then rising again from its ashes. This review is a tribute to the pallidum on its 70th anniversary as a surgical target for movement disorders, analyzing its ebbs and flows and highlighting its merits, its versatility, and its resilience. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Laura Cif
- Unités des Pathologies Cérébrales Résistantes, Département de Neurochirurgie, Centre Hospitalier Universitaire, Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Institut de Génomique Fonctionnelle, Université Montpellier, Montpellier, France
| | - Marwan Hariz
- Unit of Functional Neurosurgery, University College London-Institute of Neurology, Queen Square, London, UK.,Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
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22
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Berencsi A, Gombos F, Kovács I. Capacity to improve fine motor skills in Williams syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:956-968. [PMID: 27485486 DOI: 10.1111/jir.12317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 06/12/2016] [Accepted: 06/22/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Individuals with Williams syndrome (WS) are known to have difficulties in carrying out fine motor movements; however, a detailed behavioural profile of WS in this domain is still missing. It is also unknown how great the capacity to improve these skills with focused and extensive practice is. METHOD We studied initial performance and learning capacity in a sequential finger tapping (FT) task in WS and in typical development. Improvement in the FT task has been shown to be sleep dependent. WS subjects participating in the current study have also participated in earlier polysomnography studies, although not directly related to learning. RESULTS WS participants presented with great individual variability. In addition to generally poor initial performance, learning capacity was also greatly limited in WS. We found indications that reduced sleep efficiency might contribute to this limitation. CONCLUSIONS Estimating motor learning capacity and the depth of sleep disorder in a larger sample of WS individuals might reveal important relationships between sleep and learning, and contribute to efficient intervention methods improving skill acquisition in WS.
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Affiliation(s)
- A Berencsi
- Laboratory for Psychological Research, Pázmány Péter Catholic University, Budapest, Hungary.
- Bárczi Gusztáv Faculty of Special Education, Institute for Methodology of Special Education and Rehabilitation, Eötvös Loránd University, Budapest, Hungary.
| | - F Gombos
- Laboratory for Psychological Research, Pázmány Péter Catholic University, Budapest, Hungary
- Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary
| | - I Kovács
- Laboratory for Psychological Research, Pázmány Péter Catholic University, Budapest, Hungary
- Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary
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23
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Crossman AR, Obeso JA. Functions of the basal ganglia-paradox or no paradox? Mov Disord 2016; 31:1120-1. [PMID: 27506637 DOI: 10.1002/mds.26745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 06/27/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Jose A Obeso
- HM CINAC, HM Puerta del Sur, Mostoles, Madrid, Universidad CEU San Pablo, Madrid, Spain.,Center for Networked Biomedical Research on Neurodegenerative Diseases, Madrid, Spain
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24
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Movement-related potentials in Parkinson’s disease. Clin Neurophysiol 2016; 127:2509-19. [DOI: 10.1016/j.clinph.2016.04.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/29/2016] [Accepted: 04/01/2016] [Indexed: 11/20/2022]
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25
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Wichmann T, DeLong MR. Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality? Neurotherapeutics 2016; 13:264-83. [PMID: 26956115 PMCID: PMC4824026 DOI: 10.1007/s13311-016-0426-6] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
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 ganglia-thalamocortical 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.
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Affiliation(s)
- Thomas Wichmann
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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26
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Piron C, Kase D, Topalidou M, Goillandeau M, Orignac H, N'Guyen TH, Rougier N, Boraud T. The globus pallidus pars interna in goal-oriented and routine behaviors: Resolving a long-standing paradox. Mov Disord 2016; 31:1146-54. [PMID: 26900137 DOI: 10.1002/mds.26542] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/18/2015] [Accepted: 12/23/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND There is an apparent contradiction between experimental data showing that the basal ganglia are involved in goal-oriented and routine behaviors and clinical observations. Lesion or disruption by deep brain stimulation of the globus pallidus interna has been used for various therapeutic purposes ranging from the improvement of dystonia to the treatment of Tourette's syndrome. None of these approaches has reported any severe impairment in goal-oriented or automatic movement. METHOD To solve this conundrum, we trained 2 monkeys to perform a variant of a 2-armed bandit-task (with different reward contingencies). In the latter we alternated blocks of trials with choices between familiar rewarded targets that elicit routine behavior and blocks with novel pairs of targets that require an intentional learning process. RESULTS Bilateral inactivation of the globus pallidus interna, by injection of muscimol, prevents animals from learning new contingencies while performance remains intact, although slower for the familiar stimuli. We replicate in silico these data by adding lateral competition and Hebbian learning in the cortical layer of the theoretical model of the cortex-basal ganglia loop that provided the framework of our experimental approach. CONCLUSION The basal ganglia play a critical role in the deliberative process that underlies learning but are not necessary for the expression of routine movements. Our approach predicts that after pallidotomy or during stimulation, patients should have difficulty with complex decision-making processes or learning new goal-oriented behaviors. © 2016 Movement Disorder Society.
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Affiliation(s)
- Camille Piron
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France.,CNRS, French-Israeli Neuroscience Lab, Bordeaux, France
| | - Daisuke Kase
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France.,CNRS, French-Israeli Neuroscience Lab, Bordeaux, France
| | - Meropi Topalidou
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France.,INRIA, Bordeaux Sud-Ouest, Talence, France.,University of Bordeaux, UMR 5800, LABRI, IPB, Talence, France.,CNRS, UMR 5800, LABRI, IPB, Talence, France
| | - Michel Goillandeau
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France
| | - Hugues Orignac
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France
| | - Tho-Haï N'Guyen
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France
| | - Nicolas Rougier
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France.,INRIA, Bordeaux Sud-Ouest, Talence, France.,University of Bordeaux, UMR 5800, LABRI, IPB, Talence, France.,CNRS, UMR 5800, LABRI, IPB, Talence, France
| | - Thomas Boraud
- University of Bordeaux, UMR 5293, IMN, Bordeaux, France.,CNRS, UMR 5293, IMN, Bordeaux, France.,CNRS, French-Israeli Neuroscience Lab, Bordeaux, France.,CHU de Bordeaux, IMN Clinique, Bordeaux, France
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27
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Georgiev D, Dirnberger G, Wilkinson L, Limousin P, Jahanshahi M. In Parkinson's disease on a probabilistic Go/NoGo task deep brain stimulation of the subthalamic nucleus only interferes with withholding of the most prepotent responses. Exp Brain Res 2016; 234:1133-43. [PMID: 26758720 PMCID: PMC4785203 DOI: 10.1007/s00221-015-4531-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/12/2015] [Indexed: 01/31/2023]
Abstract
The evidence on the impact of subthalamic nucleus deep brain stimulation (STN-DBS) on action restraint on Go/NoGO reaction time (RT) tasks in Parkinson’s disease (PD) is inconsistent; with some studies reporting no effect and others finding that STN stimulation interferes with withholding of responses and results in more commission errors relative to STN-DBS off. We used a task in which the probability of Go stimuli varied from 100 % (simple RT task) to 80, 50 and 20 % (probabilistic Go/NoGo RT task), thus altering the prepotency of the response and the difficulty in withholding it on NoGo trials. Twenty PD patients with STN-DBS, ten unoperated PD patients and ten healthy controls participated in the study. All participants were tested twice; the order of on versus off stimulation for STN-DBS PD patients was counterbalanced. Both STN-DBS and unoperated PD patients were tested on medication. The results indicated that STN-DBS selectively decreased discriminability when the response was most prepotent (high—80 %, as compared to low Go probability trials—50 and 20 %). Movement times were faster with STN stimulation than with DBS off across different Go probability levels. There was neither an overall nor a selective effect of STN-DBS on RTs depending on the level of Go probability. Furthermore, compared to healthy controls, both STN-DBS and unoperated PD patients were more prone to making anticipatory errors; which was not influenced by STN stimulation. The results provide evidence for ‘load-dependent’ effects of STN stimulation on action restraint as a function of the prepotency of the Go response.
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Affiliation(s)
- Dejan Georgiev
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK
| | - Georg Dirnberger
- Department of Clinical Neuroscience, Danube University, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Leonora Wilkinson
- Behavioural Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Centre Dr., MSC 1440, Bethesda, MD, 20892-1440, USA
| | - Patricia Limousin
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK
| | - Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK.
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28
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A fronto–striato–subthalamic–pallidal network for goal-directed and habitual inhibition. Nat Rev Neurosci 2015; 16:719-32. [DOI: 10.1038/nrn4038] [Citation(s) in RCA: 352] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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29
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Wilkinson L, Steel A, Mooshagian E, Zimmermann T, Keisler A, Lewis JD, Wassermann EM. Online feedback enhances early consolidation of motor sequence learning and reverses recall deficit from transcranial stimulation of motor cortex. Cortex 2015; 71:134-47. [PMID: 26204232 PMCID: PMC4575846 DOI: 10.1016/j.cortex.2015.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 02/05/2015] [Accepted: 06/11/2015] [Indexed: 11/17/2022]
Abstract
Feedback and monetary reward can enhance motor skill learning, suggesting reward system involvement. Continuous theta burst (cTBS) transcranial magnetic stimulation (TMS) of the primary motor area (M1) disrupts processing, reduces excitability and impairs motor learning. To see whether feedback and reward can overcome the learning impairment associated with M1 cTBS, we delivered real or sham stimulation to two groups of participants before they performed a motor sequence learning task with and without feedback. Participants were trained on two intermixed sequences, one occurring 85% of the time (the "probable" sequence) and the other 15% of the time (the "improbable" sequence). We measured sequence learning as the difference in reaction time (RT) and error rate between probable and improbable trials (RT and error difference scores). Participants were also tested for sequence recall with the same indices of learning 60 min after cTBS. Real stimulation impaired initial sequence learning and sequence knowledge recall as measured by error difference scores and impaired sequence knowledge recall as measured by RT difference score. Relative to non-feedback learning, the introduction of feedback during sequence learning improved subsequent sequence knowledge recall indexed by RT difference score, in both real and sham stimulation groups and feedback reversed the RT difference score based sequence knowledge recall impairment from real cTBS that we observed in the non-feedback learning condition. Only the real cTBS group in the non-feedback condition showed no evidence of explicit sequence knowledge when tested at the end of the study. Feedback improves recall of implicit and explicit motor sequence knowledge and can protect sequence knowledge against the effect of M1 inhibition. Adding feedback and monetary reward/punishment to motor skill learning may help overcome retention impairments or accelerate training in clinical and other settings.
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Affiliation(s)
- Leonora Wilkinson
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Adam Steel
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Eric Mooshagian
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences and the Henry M. Jackson Foundation, USA.
| | - Trelawny Zimmermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences and the Henry M. Jackson Foundation, USA.
| | - Aysha Keisler
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Jeffrey D Lewis
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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30
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Contribution of the basal ganglia to spoken language: is speech production like the other motor skills? Behav Brain Sci 2015; 37:576; discussion 577-604. [PMID: 25514965 DOI: 10.1017/s0140525x13004238] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two of the roles assigned to the basal ganglia in spoken language parallel very well their contribution to motor behaviour: (1) their role in sequence processing, resulting in syntax deficits, and (2) their role in movement "vigor," leading to "hypokinetic dysarthria" or "hypophonia." This is an additional example of how the motor system has served the emergence of high-level cognitive functions, such as language.
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31
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Zimnik AJ, Nora GJ, Desmurget M, Turner RS. Movement-related discharge in the macaque globus pallidus during high-frequency stimulation of the subthalamic nucleus. J Neurosci 2015; 35:3978-89. [PMID: 25740526 PMCID: PMC4348192 DOI: 10.1523/jneurosci.4899-14.2015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/21/2015] [Accepted: 01/23/2015] [Indexed: 12/21/2022] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) has largely replaced ablative therapies for Parkinson's disease. Because of the similar efficacies of the two treatments, it has been proposed that DBS acts by creating an "informational lesion," whereby pathologic neuronal firing patterns are replaced by low-entropy, stimulus-entrained firing patterns. The informational lesion hypothesis, in its current form, states that DBS blocks the transmission of all information from the basal ganglia, including both pathologic firing patterns and normal, task-related modulations in activity. We tested this prediction in two healthy rhesus macaques by recording single-unit spiking activity from the globus pallidus (232 neurons) while the animals completed choice reaction time reaching movements with and without STN-DBS. Despite strong effects of DBS on the activity of most pallidal cells, reach-related modulations in firing rate were equally prevalent in the DBS-on and DBS-off states. This remained true even when the analysis was restricted to cells affected significantly by DBS. In addition, the overall form and timing of perimovement modulations in firing rate were preserved between DBS-on and DBS-off states in the majority of neurons (66%). Active movement and DBS had largely additive effects on the firing rate of most neurons, indicating an orthogonal relationship in which both inputs contribute independently to the overall firing rate of pallidal neurons. These findings suggest that STN-DBS does not act as an indiscriminate informational lesion but rather as a filter that permits task-related modulations in activity while, presumably, eliminating the pathological firing associated with parkinsonism.
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Affiliation(s)
- Andrew J Zimnik
- Department of Neurobiology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, and
| | - Gerald J Nora
- Department of Neurobiology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, and
| | - Michel Desmurget
- Centre for Cognitive Neuroscience, UMR5229, CNRS, 67 Boulevard Pinel 69500 Bron, France
| | - Robert S Turner
- Department of Neurobiology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, and
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Abstract
The cortico-basal-ganglia circuit plays a critical role in decision making on the basis of probabilistic information. Computational models have suggested how this circuit could compute the probabilities of actions being appropriate according to Bayes' theorem. These models predict that the subthalamic nucleus (STN) provides feedback that normalizes the neural representation of probabilities, such that if the probability of one action increases, the probabilities of all other available actions decrease. Here we report the results of an experiment testing a prediction of this theory that disrupting information processing in the STN with deep brain stimulation should abolish the normalization of the neural representation of probabilities. In our experiment, we asked patients with Parkinson's disease to saccade to a target that could appear in one of two locations, and the probability of the target appearing in each location was periodically changed. When the stimulator was switched off, the target probability affected the reaction times (RT) of patients in a similar way to healthy participants. Specifically, the RTs were shorter for more probable targets and, importantly, they were longer for the unlikely targets. When the stimulator was switched on, the patients were still faster for more probable targets, but critically they did not increase RTs as the target was becoming less likely. This pattern of results is consistent with the prediction of the model that the patients on DBS no longer normalized their neural representation of prior probabilities. We discuss alternative explanations for the data in the context of other published results.
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Greene JG. Causes and consequences of degeneration of the dorsal motor nucleus of the vagus nerve in Parkinson's disease. Antioxid Redox Signal 2014; 21:649-67. [PMID: 24597973 DOI: 10.1089/ars.2014.5859] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
SIGNIFICANCE Parkinson's disease (PD) is no longer considered merely a movement disorder caused by degeneration of dopamine neurons in the midbrain. It is now recognized as a widespread neuropathological syndrome accompanied by a variety of motor and nonmotor clinical symptoms. As such, any hypothesis concerning PD pathogenesis and pathophysiology must account for the entire spectrum of disease and not solely focus on the dopamine system. RECENT ADVANCES Based on its anatomy and the intrinsic properties of its neurons, the dorsal motor nucleus of the vagus nerve (DMV) is uniquely vulnerable to damage from PD. Fibers in the vagus nerve course throughout the gastrointestinal (GI) tract to and from the brainstem forming a close link between the peripheral and central nervous systems and a point of proximal contact between the environment and areas where PD pathology is believed to start. In addition, DMV neurons are under high levels of oxidative stress due to their high level of α-synuclein expression, fragile axons, and specific neuronal physiology. Moreover, several consequences of DMV damage, namely, GI dysfunction and unrestrained inflammation, may propagate a vicious cycle of injury affecting vulnerable brain regions. CRITICAL ISSUES Current evidence to suggest the vagal system plays a pivotal role in PD pathogenesis is circumstantial, but given the current state of the field, the time is ripe to obtain direct experimental evidence to better delineate it. FUTURE DIRECTIONS Better understanding of the DMV and vagus nerve may provide insight into PD pathogenesis and a neural highway with direct brain access that could be harnessed for novel therapeutic interventions.
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Affiliation(s)
- James G Greene
- Department of Neurology, Emory University , Atlanta, Georgia
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Leventhal DK, Stoetzner C, Abraham R, Pettibone J, DeMarco K, Berke JD. Dissociable effects of dopamine on learning and performance within sensorimotor striatum. ACTA ACUST UNITED AC 2014; 4:43-54. [PMID: 24949283 DOI: 10.1016/j.baga.2013.11.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Striatal dopamine is an important modulator of current behavior, as seen in the rapid and dramatic effects of dopamine replacement therapy in Parkinson Disease (PD). Yet there is also extensive evidence that dopamine acts as a learning signal, modulating synaptic plasticity within striatum to affect future behavior. Disentangling these "performance" and "learning" functions is important for designing effective, long-term PD treatments. We conducted a series of unilateral drug manipulations and dopamine terminal lesions in the dorsolateral striatum of rats highly-trained to perform brief instructed head/neck movements (two-alternative forced choice task). Reaction times and accuracy were measured longitudinally to determine if task behavior changed immediately, progressed over time, and/or persisted after drug withdrawal. Enhanced dopamine signaling with amphetamine caused an immediate, nonprogressive, and bilateral decrease in reaction times (RT). The altered RT distributions were consistent with reduced distance to threshold in the linear approach to threshold with ergodic rate (LATER) model of decision-making. Conversely, the dopamine antagonist flupenthixol caused experience-dependent, persistent changes in RT and accuracy indicative of a "learning" effect. These RT distributions were consistent with a slowed rate of approach to decision threshold. Our results show that dopaminergic signaling makes dissociable contributions to current and future behavior even within a single striatal subregion, and provide important clues for both models of normal decision-making and the design of novel drug therapies in PD.
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Affiliation(s)
- Daniel K Leventhal
- Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109 ; Movement Disorders Program, University of Michigan, Ann Arbor, Michigan 48109 ; Neuroscience Program, University of Michigan, Ann Arbor, Michigan 48109
| | - Colin Stoetzner
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Rohit Abraham
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Jeff Pettibone
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Kayla DeMarco
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Joshua D Berke
- Movement Disorders Program, University of Michigan, Ann Arbor, Michigan 48109 ; Neuroscience Program, University of Michigan, Ann Arbor, Michigan 48109 ; Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
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Obeso I, Wilkinson L, Casabona E, Speekenbrink M, Luisa Bringas M, Álvarez M, Álvarez L, Pavón N, Rodríguez-Oroz MC, Macías R, Obeso JA, Jahanshahi M. The subthalamic nucleus and inhibitory control: impact of subthalamotomy in Parkinson's disease. ACTA ACUST UNITED AC 2014; 137:1470-80. [PMID: 24657985 DOI: 10.1093/brain/awu058] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of our study was to investigate two inter-related hypotheses about the role of the subthalamic nucleus. First that the subthalamic nucleus plays a role in adjusting response thresholds and speed-accuracy trade-offs and second that it is involved in reactive and proactive inhibition and conflict resolution. These were addressed by comparing the performance of 10 patients with Parkinson's disease treated with right subthalamotomy and 12 patients with left subthalamotomy, to 14 unoperated patients with Parkinson's disease and 23 age-matched healthy control participants on a conditional stop signal task and applying the drift diffusion model. Unilateral subthalamotomy significantly improved Parkinson's disease motor signs. Patients with right subthalamotomy had significantly faster Go reaction times with their contra-lesional hand than the unoperated patients and did not differ from the control participants, indicating their speed of response initiation was 'normalized'. However, operated patients made significantly more discrimination errors than unoperated patients and controls, suggesting that subthalamotomy influenced speed-accuracy trade-offs. This was confirmed by the drift diffusion model, revealing that while the unoperated patients had significantly lower drift rate and higher response thresholds than the control participants, the response thresholds for the operated groups did not differ from the controls and the patients with right subthalamotomy had a significantly higher drift rate than unoperated patients and similar to that of controls. The drift diffusion model further established that unlike the control participants, operated patients failed to show context-dependent strategic modulation of response thresholds. The patients with right subthalamotomy could not engage in late phase, fast inhibition of the response and showed minimal proactive inhibition when tested with the contra-lesional hand. These results provide strong evidence that the subthalamic nucleus is involved in response inhibition, in modulating the rate of information accumulation and the response threshold and influencing the balance between speed and accuracy of performance. Accordingly, the subthalamic nucleus can be considered a key component of the cerebral inhibitory network.
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Affiliation(s)
- Ignacio Obeso
- 1 Cognitive-Motor Neuroscience Group and the Functional Neurosurgery Unit, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, WC1N 3BG, UK
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Benhamou L, Cohen D. Electrophysiological characterization of entopeduncular nucleus neurons in anesthetized and freely moving rats. Front Syst Neurosci 2014; 8:7. [PMID: 24574980 PMCID: PMC3918587 DOI: 10.3389/fnsys.2014.00007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 01/12/2014] [Indexed: 11/30/2022] Open
Abstract
The EntoPeduncular nucleus (EP), which is homologous to the internal segment of the Globus Pallidus (GPi) in primates, is one of the two basal ganglia (BG) output nuclei. Despite their importance in cortico-BG information processing, EP neurons have rarely been investigated in rats and there is no available electrophysiological characterization of EP neurons in vivo. We recorded and analyzed the activity of EP neurons in freely moving as well as anesthetized rats, and compared their activity patterns. Examination of neuronal firing statistics during wakefulness suggested that similar to neurons recorded in the primate GPi, EP neurons are a single population characterized by Poisson-like firing. Under isoflurane anesthesia the firing rate of EP neurons decreased substantially and their coefficient of variation and relative duration of quiescence periods increased. Investigation of the relationship between firing rate and depth of anesthesia revealed two distinct neuronal groups: one that decreased its firing rate with the increase in anesthesia level, and a second group where the firing rate was independent of anesthesia level. Post-hoc examination of the firing properties of the two groups showed that they were statistically distinct. These results may thus help reconcile in vitro studies in rats and primates which have reported two distinct neuronal populations, and in vivo studies in behaving primates indicating one homogeneous population. Our data support the existence of two distinct neuronal populations in the rat EP that can be distinguished by their characteristic firing response to anesthesia.
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Affiliation(s)
- Liora Benhamou
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel
| | - Dana Cohen
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University Ramat-Gan, Israel
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37
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Abstract
This chapter focuses on neurodevelopmental diseases that are tightly linked to abnormal function of the striatum and connected structures. We begin with an overview of three representative diseases in which striatal dysfunction plays a key role--Tourette syndrome and obsessive-compulsive disorder, Rett's syndrome, and primary dystonia. These diseases highlight distinct etiologies that disrupt striatal integrity and function during development, and showcase the varied clinical manifestations of striatal dysfunction. We then review striatal organization and function, including evidence for striatal roles in online motor control/action selection, reinforcement learning, habit formation, and action sequencing. A key barrier to progress has been the relative lack of animal models of these diseases, though recently there has been considerable progress. We review these efforts, including their relative merits providing insight into disease pathogenesis, disease symptomatology, and basal ganglia function.
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38
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Jourdain VA, Schechtmann G, Di Paolo T. Subthalamotomy in the treatment of Parkinson's disease: clinical aspects and mechanisms of action. J Neurosurg 2014; 120:140-51. [DOI: 10.3171/2013.10.jns13332] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
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.
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Affiliation(s)
- Vincent A. Jourdain
- 1Neurosciences Research Center, Centre de Recherche du CHU de Québec
- 2Faculty of Pharmacy, Laval University, Quebec City, Quebec, Canada, and
| | - Gastón Schechtmann
- 3Department of Neurosurgery and Clinical Neuroscience, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Thérèse Di Paolo
- 1Neurosciences Research Center, Centre de Recherche du CHU de Québec
- 2Faculty of Pharmacy, Laval University, Quebec City, Quebec, Canada, and
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39
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40
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Daneault JF, Carignan B, Sadikot AF, Panisset M, Duval C. Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia? BMC Med 2013; 11:76. [PMID: 23514355 PMCID: PMC3751666 DOI: 10.1186/1741-7015-11-76] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 03/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management. DISCUSSION The current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed. SUMMARY Clinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.
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Affiliation(s)
- Jean-François Daneault
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
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41
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Task-related "cortical" bursting depends critically on basal ganglia input and is linked to vocal plasticity. Proc Natl Acad Sci U S A 2013; 110:4756-61. [PMID: 23449880 DOI: 10.1073/pnas.1216308110] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
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.
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42
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Lanciego JL, Luquin N, Obeso JA. Functional neuroanatomy of the basal ganglia. Cold Spring Harb Perspect Med 2012; 2:a009621. [PMID: 23071379 DOI: 10.1101/cshperspect.a009621] [Citation(s) in RCA: 398] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The "basal ganglia" refers to a group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions. Proposed more than two decades ago, the classical basal ganglia model shows how information flows through the basal ganglia back to the cortex through two pathways with opposing effects for the proper execution of movement. Although much of the model has remained, the model has been modified and amplified with the emergence of new data. Furthermore, parallel circuits subserve the other functions of the basal ganglia engaging associative and limbic territories. Disruption of the basal ganglia network forms the basis for several movement disorders. This article provides a comprehensive account of basal ganglia functional anatomy and chemistry and the major pathophysiological changes underlying disorders of movement. We try to answer three key questions related to the basal ganglia, as follows: What are the basal ganglia? What are they made of? How do they work? Some insight on the canonical basal ganglia model is provided, together with a selection of paradoxes and some views over the horizon in the field.
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Affiliation(s)
- José L Lanciego
- Department of Neuroscience, Center for Applied Medical Research (CIMA & CIBERNED), University of Navarra Medical College, Pamplona, Spain
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43
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Hariz M. Twenty-five years of deep brain stimulation: celebrations and apprehensions. Mov Disord 2012; 27:930-3. [PMID: 22674402 DOI: 10.1002/mds.25007] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 03/22/2012] [Indexed: 11/10/2022] Open
Abstract
The year 2012 marks the 25th anniversary of the birth of modern deep brain stimulation (DBS), which was introduced by Benabid et al in 1987, initially to treat tremor with DBS of the ventral intermediate nucleus of the thalamus. The subsequent extension of DBS to the subthalamic nucleus (STN), demonstrating its efficacy on virtually all symptoms of advanced Parkinson's disease (PD), sparked an era of intense clinical and research activities, eventually transcending PD and movement disorders to encompass mood and mind. Investigations of the role of DBS in a variety of neurological, psychiatric, cognitive, and behavioral conditions is ongoing. Serendipitous discoveries and advances in functional imaging are providing "new" brain targets for an increasing number of pathologies. Toward the end of this quarter of a century of DBS, there have been some indications that the field may be at risk of gliding down a slippery slope, reminiscent of the excesses of the old-era DBS. Although there are many reasons this year to celebrate the achievements of 25 years of modern DBS, there are also reasons to fear the opening of a new Pandora's box.
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44
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Shmuelof L, Krakauer JW. Are we ready for a natural history of motor learning? Neuron 2011; 72:469-76. [PMID: 22078506 DOI: 10.1016/j.neuron.2011.10.017] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2011] [Indexed: 10/15/2022]
Abstract
Here we argue that general principles with regard to the contributions of the cerebellum, basal ganglia, and primary motor cortex to motor learning can begin to be inferred from explicit comparison across model systems and consideration of phylogeny. Both the cerebellum and the basal ganglia have highly conserved circuit architecture in vertebrates. The cerebellum has consistently been shown to be necessary for adaptation of eye and limb movements. The precise contribution of the basal ganglia to motor learning remains unclear but one consistent finding is that they are necessary for early acquisition of novel sequential actions. The primary motor cortex allows independent control of joints and construction of new movement synergies. We suggest that this capacity of the motor cortex implies that it is a necessary locus for motor skill learning, which we argue is the ability to execute selected actions with increasing speed and precision.
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Affiliation(s)
- Lior Shmuelof
- Motor Performance Lab, The Neurological Institute, Columbia University, NY 10032, USA.
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45
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Goldberg J, Bergman H. Computational physiology of the neural networks of the primate globus pallidus: function and dysfunction. Neuroscience 2011; 198:171-92. [DOI: 10.1016/j.neuroscience.2011.08.068] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/29/2011] [Accepted: 08/30/2011] [Indexed: 11/25/2022]
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Effect of micro lesions of the basal ganglia on ballistic movements in patients with deep brain stimulation. J Neurol Sci 2011; 314:175-7. [PMID: 22075047 DOI: 10.1016/j.jns.2011.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 10/06/2011] [Accepted: 10/07/2011] [Indexed: 11/23/2022]
Abstract
Bradykinesia and hypokinesia are the prominent symptoms of substantia nigra degeneration in Parkinson's disease (PD). In segmental dystonia, movements of not affected limbs are not impaired. Here we studied the impact of the mere implantation of stimulation electrodes on the performance of fast movements in these two groups. We investigated 9 PD patients with subthalamic electrodes and 9 patients with segmental dystonia with electrodes in the globus pallidus internum. Patients were studied on the first postoperative day without electrical stimulation of the electrodes. Subjects had to perform boxing movements with either touching the target or stopping the fist in front of the target. PD subjects performed significantly faster movements in the touch-task only as compared to dystonic patients. No difference was seen in the stopping task. In conclusion, our findings suggest that a small subthalamic lesion in individuals with PD specifically reverses bradykinesia during simple ballistic movements (touch) but not during complex ones requiring more pre-programming (no-touch paradigm).
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47
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Kreitzer AC, Berke JD. Investigating striatal function through cell-type-specific manipulations. Neuroscience 2011; 198:19-26. [PMID: 21867745 DOI: 10.1016/j.neuroscience.2011.08.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 08/03/2011] [Accepted: 08/06/2011] [Indexed: 12/17/2022]
Abstract
The striatum integrates convergent input from the cortex, thalamus, and midbrain, and has a powerful influence over motivated behavior via outputs to downstream basal ganglia nuclei. Although the anatomy and physiology of distinct classes of striatal neurons have been intensively studied, the specific functions of these cell subpopulations have been more difficult to address. Recently, application of new methodologies for perturbing activity and signaling in different cell types in vivo has begun to allow direct tests of the causal roles of striatal neurons in behavior.
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Affiliation(s)
- A C Kreitzer
- Gladstone Institute of Neurological Disease, San Francisco, CA 94158, USA.
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48
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Neuronal discharge patterns in the Globus Pallidus pars interna in a patient with Parkinson’s disease and hemiballismus secondary to subthalamotomy. Exp Brain Res 2011; 213:447-55. [DOI: 10.1007/s00221-011-2794-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 07/06/2011] [Indexed: 11/29/2022]
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49
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Obeso JA, Lanciego JL. Past, present, and future of the pathophysiological model of the Basal Ganglia. Front Neuroanat 2011; 5:39. [PMID: 21808607 PMCID: PMC3136734 DOI: 10.3389/fnana.2011.00039] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 06/29/2011] [Indexed: 11/29/2022] Open
Abstract
The current model of basal ganglia (BG) was introduced two decades ago and has settled most of our current understanding of BG function and dysfunction. Extensive research efforts have been carried out in recent years leading to further refinement and understanding of the normal and diseased BG. Several questions, however, are yet to be resolved. This short review provides a synopsis of the evolution of thought regarding the pathophysiological model of the BG and summarizes the main recent findings and additions to this field of research. We have also tried to identify major challenges that need to be addressed and resolved in the near future. Detailed accounts and state-of-the-art developments concerning research on the BG are provided in the articles that make up this Special Issue.
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Affiliation(s)
- José A Obeso
- Neurosciences Division, Center for Applied Medical Research, University of Navarra Pamplona, Spain
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50
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Wichmann T, DeLong MR, Guridi J, Obeso JA. Milestones in research on the pathophysiology of Parkinson's disease. Mov Disord 2011; 26:1032-41. [PMID: 21626548 PMCID: PMC4272856 DOI: 10.1002/mds.23695] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Progress in our understanding of the mechanisms underlying the cardinal motor abnormalities of Parkinson's disease (PD), in particular akinesia and bradykinesia and their treatment, has been remarkable. Notable accomplishments include insights into the functional organization of the basal ganglia and their place in the motor system as components of a family of parallel cortico-subcortical circuits that subserve motor and nonmotor functions and the development of models of the intrinsic organization of the basal ganglia, including delineation of the so-called direct, indirect, and hyperdirect pathways. Studies in primate models of PD have provided insight into the alterations of neuronal activity that are responsible for the motor features of PD, revealing both altered tonic levels of discharge and significant disturbances of the patterns of discharge throughout the motor circuitry and have led to the formulation of circuit models of PD, providing testable hypotheses for research and stimulating the development of new therapies. Most importantly, the discovery that lesions of the subthalamic nucleus, a key node of the indirect pathway, abolish the cardinal features of PD contributed to the renaissance in the use of surgical approaches to treating patients with PD, including ablation and deep brain stimulation.
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Affiliation(s)
- Thomas Wichmann
- Department of Neurology, School of Medicine, Emory University, Atlanta, Georgia, USA.
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