The Globus Pallidus, Deep Brain Stimulation, and Parkinson's Disease
Identifieur interne : 002F98 ( Main/Exploration ); précédent : 002F97; suivant : 002F99The Globus Pallidus, Deep Brain Stimulation, and Parkinson's Disease
Auteurs : Jonathan O. Dostrovsky [Canada] ; William D. Hutchison [Canada] ; Andres M. Lozano [Canada]Source :
- The Neuroscientist [ 1073-8584 ] ; 2002-06.
English descriptors
- KwdEn :
- Animals, Dopamine (metabolism), Electric Stimulation Therapy, Globus Pallidus (metabolism), Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Parkinson Disease (metabolism), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson Disease (therapy), Substantia Nigra (physiopathology), gamma-Aminobutyric Acid (metabolism).
- MESH :
- chemical , metabolism : Dopamine, gamma-Aminobutyric Acid.
- metabolism : Globus Pallidus, Parkinson Disease.
- physiopathology : Globus Pallidus, Parkinson Disease, Substantia Nigra.
- surgery : Globus Pallidus, Parkinson Disease.
- therapy : Parkinson Disease.
- Animals, Electric Stimulation Therapy, Humans.
Abstract
Parkinson's disease (PD) is caused by the degeneration of the dopaminergic neurons in the substantia nigra. Loss of dopaminergic innervation leads to hyperactivity in the internal segment of the globus pallidus (GPi), the main output nucleus of the basal ganglia and to a profound disturbance in the function of motor circuits. Lesions of the GPi (or in its upstream modulator, the subthalamic nucleus) can greatly improve the motor symptoms of PD presumably by reducing this pathological activity. Paradoxically, high-frequency electrical stimulation of the GPi (deep brain stimulation, DBS) mimics the effects of pallidotomy and has become an accepted therapeutic technique. The mechanisms underlying the beneficial effects of pallidal DBS are not known. Various mechanisms that might account for inhibiting or disrupting the pathological pallidal outflow by high-frequency DBS have been proposed ranging from depolarization block to stimulation-evoked release of GABA, and these are discussed.
Url:
DOI: 10.1177/1073858402008003014
Affiliations:
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Le document en format XML
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Hutchison</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;Department of Surgery, University of Toronto, Division of Neurosurgery, The Toronto Western Hospital, Canada;The Toronto Western Research Institute, The Toronto Western Hospital</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;Department of Surgery, University of Toronto, Division of Neurosurgery, The Toronto Western Hospital, Canada;The Toronto Western Research Institute, The Toronto Western Hospital</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Surgery, University of Toronto, Division of Neurosurgery, The Toronto Western Hospital, Canada;The Toronto Western Research Institute, The Toronto Western Hospital</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Surgery, University of Toronto, Division of Neurosurgery, The Toronto Western Hospital, Canada;The Toronto Western Research Institute, The Toronto Western Hospital</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">The Neuroscientist</title><idno type="ISSN">1073-8584</idno><idno type="eISSN">1089-4098</idno><imprint><publisher>Sage Publications</publisher><pubPlace>Sage CA: Thousand Oaks, CA</pubPlace><date type="published" when="2002-06">2002-06</date><biblScope unit="volume">8</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="284">284</biblScope><biblScope unit="page" to="290">290</biblScope></imprint><idno type="ISSN">1073-8584</idno></series><idno type="istex">1D14455C7987B35F673783BF66C23E8648D73F89</idno><idno type="DOI">10.1177/1073858402008003014</idno><idno type="ArticleID">10.1177_1073858402008003014</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1073-8584</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals</term><term>Dopamine (metabolism)</term><term>Electric Stimulation Therapy</term><term>Globus Pallidus (metabolism)</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Parkinson Disease (metabolism)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Substantia Nigra (physiopathology)</term><term>gamma-Aminobutyric Acid (metabolism)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Dopamine</term><term>gamma-Aminobutyric Acid</term></keywords><keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term><term>Substantia Nigra</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Electric Stimulation Therapy</term><term>Humans</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Parkinson's disease (PD) is caused by the degeneration of the dopaminergic neurons in the substantia nigra. Loss of dopaminergic innervation leads to hyperactivity in the internal segment of the globus pallidus (GPi), the main output nucleus of the basal ganglia and to a profound disturbance in the function of motor circuits. Lesions of the GPi (or in its upstream modulator, the subthalamic nucleus) can greatly improve the motor symptoms of PD presumably by reducing this pathological activity. Paradoxically, high-frequency electrical stimulation of the GPi (deep brain stimulation, DBS) mimics the effects of pallidotomy and has become an accepted therapeutic technique. The mechanisms underlying the beneficial effects of pallidal DBS are not known. Various mechanisms that might account for inhibiting or disrupting the pathological pallidal outflow by high-frequency DBS have been proposed ranging from depolarization block to stimulation-evoked release of GABA, and these are discussed.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. Dostrovsky</name></noRegion><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. Dostrovsky</name><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D." last="Hutchison">William D. Hutchison</name><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D." last="Hutchison">William D. Hutchison</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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