The subthalamic nucleus, hemiballismus and Parkinson's disease: reappraisal of a neurosurgical dogma
Identifieur interne : 000C39 ( Istex/Curation ); précédent : 000C38; suivant : 000C40The subthalamic nucleus, hemiballismus and Parkinson's disease: reappraisal of a neurosurgical dogma
Auteurs : Jorge Guridi ; Jose Obeso [Espagne]Source :
- Brain [ 0006-8950 ] ; 2001-01.
English descriptors
- KwdEn :
Abstract
The subthalamic nucleus (STN) currently is considered to play a key role in the pathophysiological origin of the parkinsonian state and is therefore the main target for surgical treatment of Parkinson's disease. The authors review the incidence of hemichorea/ballism (HCB) as a complication of thalamotomy, pallidotomy or campotomy procedures before the introduction of levodopa therapy, including the few reported cases accompanied by a neuropathological study. The literature shows that only a small number of parkinsonian patients with HCB had a lesion of the STN. Preliminary data in Parkinson's disease patients submitted to a subthalamotomy with current functional stereotaxy also indicate that HCB is a very rare complication. To explain this observation, we suggest that the parkinsonian state is characterized by an increased threshold for the induction of dyskinesia following STN lesioning. This arises as a consequence of reduced activity in the `direct' GABA projection to the globus pallidus medialis (GPm) which accompanies dopamine depletion. Lesioning of the STN reduces excitation of the GPm, and theoretically this should induce dyskinesias. However, an STN lesion also, simultaneously, further reduces the hypoactivity in the globus pallidus lateralis (GPl) that is a feature of Parkinson's disease, and hence may compensate for GPm hypoactivity, thus self-stabilizing basal ganglia output activity and reducing the risk of HCB. We conclude that lesioning of the STN in Parkinson's disease is a feasible approach in some circumstances.
Url:
DOI: 10.1093/brain/124.1.5
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000C39
Links to Exploration step
ISTEX:0DA2656CC88F05470844FCFC28099C662D75FF34Curation
No country items
Jorge Guridi<affiliation><mods:affiliation>Service of Neurosurgery, Hospital de Navarra and</mods:affiliation><wicri:noCountry code="subField">Hospital de Navarra and</wicri:noCountry></affiliation>Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">The subthalamic nucleus, hemiballismus and Parkinson's disease: reappraisal of a neurosurgical dogma</title><author><name sortKey="Guridi, Jorge" sort="Guridi, Jorge" uniqKey="Guridi J" first="Jorge" last="Guridi">Jorge Guridi</name><affiliation><mods:affiliation>Service of Neurosurgery, Hospital de Navarra and</mods:affiliation><wicri:noCountry code="subField">Hospital de Navarra and</wicri:noCountry></affiliation></author><author><name sortKey="Obeso, Jose A" sort="Obeso, Jose A" uniqKey="Obeso J" first="Jose" last="Obeso">Jose Obeso</name><affiliation wicri:level="1"><mods:affiliation>Movement Disorders and Basal Ganglia Unit, Department of Neurology and Neurosurgery, Neuroscience Program, Clinica Universitaria and Medical School, Universidad de Navarra, 31008 Pamplona, Spain</mods:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Movement Disorders and Basal Ganglia Unit, Department of Neurology and Neurosurgery, Neuroscience Program, Clinica Universitaria and Medical School, Universidad de Navarra, 31008 Pamplona</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:0DA2656CC88F05470844FCFC28099C662D75FF34</idno><date when="2001" year="2001">2001</date><idno type="doi">10.1093/brain/124.1.5</idno><idno type="url">https://api.istex.fr/document/0DA2656CC88F05470844FCFC28099C662D75FF34/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000C39</idno><idno type="wicri:Area/Istex/Curation">000C39</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">The subthalamic nucleus, hemiballismus and Parkinson's disease: reappraisal of a neurosurgical dogma</title><author><name sortKey="Guridi, Jorge" sort="Guridi, Jorge" uniqKey="Guridi J" first="Jorge" last="Guridi">Jorge Guridi</name><affiliation><mods:affiliation>Service of Neurosurgery, Hospital de Navarra and</mods:affiliation><wicri:noCountry code="subField">Hospital de Navarra and</wicri:noCountry></affiliation></author><author><name sortKey="Obeso, Jose A" sort="Obeso, Jose A" uniqKey="Obeso J" first="Jose" last="Obeso">Jose Obeso</name><affiliation wicri:level="1"><mods:affiliation>Movement Disorders and Basal Ganglia Unit, Department of Neurology and Neurosurgery, Neuroscience Program, Clinica Universitaria and Medical School, Universidad de Navarra, 31008 Pamplona, Spain</mods:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Movement Disorders and Basal Ganglia Unit, Department of Neurology and Neurosurgery, Neuroscience Program, Clinica Universitaria and Medical School, Universidad de Navarra, 31008 Pamplona</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><title level="j" type="abbrev">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2001-01">2001-01</date><biblScope unit="volume">124</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="5">5</biblScope><biblScope unit="page" to="19">19</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">0DA2656CC88F05470844FCFC28099C662D75FF34</idno><idno type="DOI">10.1093/brain/124.1.5</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>GPl = globus pallidus lateralis</term><term>GPm = globus pallidus medialis</term><term>HCB = hemichorea/ballism</term><term>Parkinson's disease</term><term>STN = subthalamic nucleus</term><term>VL = ventrolateralis nucleus</term><term>hemiballismus</term><term>history</term><term>stereotaxy</term><term>subthalamic nucleus</term><term>subthalamotomy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The subthalamic nucleus (STN) currently is considered to play a key role in the pathophysiological origin of the parkinsonian state and is therefore the main target for surgical treatment of Parkinson's disease. The authors review the incidence of hemichorea/ballism (HCB) as a complication of thalamotomy, pallidotomy or campotomy procedures before the introduction of levodopa therapy, including the few reported cases accompanied by a neuropathological study. The literature shows that only a small number of parkinsonian patients with HCB had a lesion of the STN. Preliminary data in Parkinson's disease patients submitted to a subthalamotomy with current functional stereotaxy also indicate that HCB is a very rare complication. To explain this observation, we suggest that the parkinsonian state is characterized by an increased threshold for the induction of dyskinesia following STN lesioning. This arises as a consequence of reduced activity in the `direct' GABA projection to the globus pallidus medialis (GPm) which accompanies dopamine depletion. Lesioning of the STN reduces excitation of the GPm, and theoretically this should induce dyskinesias. However, an STN lesion also, simultaneously, further reduces the hypoactivity in the globus pallidus lateralis (GPl) that is a feature of Parkinson's disease, and hence may compensate for GPm hypoactivity, thus self-stabilizing basal ganglia output activity and reducing the risk of HCB. We conclude that lesioning of the STN in Parkinson's disease is a feasible approach in some circumstances.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/JankovicV1/Data/Istex/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000C39 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Curation/biblio.hfd -nk 000C39 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= JankovicV1
|flux= Istex
|étape= Curation
|type= RBID
|clé= ISTEX:0DA2656CC88F05470844FCFC28099C662D75FF34
|texte= The subthalamic nucleus, hemiballismus and Parkinson's disease: reappraisal of a neurosurgical dogma
}}
| This area was generated with Dilib version V0.6.19. |  |