共查询到20条相似文献,搜索用时 15 毫秒
1.
《Human brain mapping》2017,38(4):1952-1964
The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson's disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward‐ and loss‐related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence‐related information during action control, but the proportion of valence‐responsive neurons was greater in the STN compared to the GPi. In the STN, reward‐related stimuli mobilized a greater proportion of neurons than loss‐related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was greater than has been previously reported. These findings may help to explain alterations in limbic function that have been observed following deep brain stimulation therapy of the STN and GPi. Hum Brain Mapp 38:1952–1964, 2017 . © 2017 Wiley Periodicals, Inc. 相似文献
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Raquel C.R. Martinez PhD Clement Hamani MD PhD Milene Cristina de Carvalho PhD Amanda Ribeiro de Oliveira PhD Eduardo Alho MD PhD Jessie Navarro MD Maria Gabriela dos Santos Ghilardi PhD Edson Bor‐Seng‐Shu MD PhD Helmut Heinsen PhD José Pinhata Otoch MD PhD Marcus Lira Brandão MD PhD Egberto Reis Barbosa MD PhD Manoel Jacobsen Teixeira MD PhD Erich Talamoni Fonoff MD PhD 《Movement disorders》2013,28(14):2027-2032
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Bacci JJ Absi el H Manrique C Baunez C Salin P Kerkerian-Le Goff L 《The European journal of neuroscience》2004,20(12):3331-3341
This study examined the effects of prolonged (4 days) high frequency stimulation (HFS) of the subthalamic nucleus (STN), in comparison with those of STN lesion, on the dopamine denervation-mediated cellular changes in the basal ganglia in a Wistar rat model of Parkinson's disease. STN HFS counteracted the dopamine lesion-induced increase in GAD67 mRNA expression in the output structures of the basal ganglia, as shown previously after STN lesion, providing cellular support for the similar antiparkinsonian benefits produced by the two surgical procedures. The dopamine denervation-induced increase in GAD67 mRNA levels in the globus pallidus was partially antagonized after HFS and totally reversed after ibotenate-induced STN lesion. The overexpression of striatal enkephalin mRNA tended to be further increased by HFS but was antagonized by STN lesion. The decrease in striatal substance P mRNA levels was affected neither by STN HFS nor lesion. As STN HFS for two hours was previously found not to interfere with the effects of dopamine lesion in the globus pallidus and striatum, the present data provide strong evidence that the effects of STN surgery in these structures involve long-term adaptive processes and that the rearrangements mediated by HFS and lesion are, at least in part, different. 相似文献
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Noémie Ligot Pierre Krystkowiak Clémence Simonin Serge Goldman Philippe Peigneux John Van Naemen Michel Monclus Simon Frédéric Lacroix David Devos Kathy Dujardin Christine Delmaire Eric Bardinet Arnaud Delval Marie Delliaux Luc Defebvre Jerome Yelnik Serge Blond Alain Destée Xavier De Tiège 《Journal of cerebral blood flow and metabolism》2011,31(1):41-46
Positron emission tomography with O-15-labeled water was used to study at rest the neurophysiological effects of bilateral external globus pallidus (GPe) deep brain stimulation in patients with Huntington''s disease (HD). Five patients were compared with a control group in the on and off states of the stimulator. External globus pallidus stimulation decreased neuronal activity and modulated cerebral connectivity within the basal ganglia-thalamocortical circuitry, the sensorimotor, and the default-mode networks. These data indicate that GPe stimulation modulates functional integration in HD patients in accordance with the basal ganglia-thalamocortical circuit model. 相似文献
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Diana Apetauerova R Kevin Ryan Susie I Ro Jeffrey Arle Jay Shils Efstathios Papavassiliou Daniel Tarsy 《Movement disorders》2006,21(8):1277-1279
We report the therapeutic effects of deep brain stimulation (DBS) in 2 patients with Parkinson's disease (PD) with severe end of dose dyskinesia that was resistant to medical therapy. In both patients, severe, end of day ballistic dyskinesias occurred when the last levodopa dose of the day was wearing off. Globus pallidus (GPi) DBS in 1 case and subthalamic (STN) DBS in the second case produced full resolution of end of day dyskinesia. 相似文献
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Wataru Sako MD Masami Nishio MD PhD Tomoyuki Maruo MD Hideki Shimazu MD PhD Kazuhito Matsuzaki MD PhD Tetsuya Tamura MD Hideo Mure MD Yukitaka Ushio MD PhD Shinji Nagahiro MD PhD Ryuji Kaji MD PhD Satoshi Goto MD PhD 《Movement disorders》2009,24(7):1076-1079
Camptocormia becomes increasingly recognized as a disabling symptom associated with Parkinson's disease (PD). We here report six patients with advanced PD in whom continuous bilateral stimulation of the subthalamic nucleus produced substantial (mean 78% ± 9.1% of the thoracolumbar angle) improvement of camptocormia along with other motor symptoms. © 2009 Movement Disorder Society 相似文献
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Effects of high frequency stimulation of subthalamic nucleus on extracellular glutamate and GABA in substantia nigra and globus pallidus in the normal rat 总被引:10,自引:0,他引:10
Windels F Bruet N Poupard A Urbain N Chouvet G Feuerstein C Savasta M 《The European journal of neuroscience》2000,12(11):4141-4146
High frequency stimulation (130 Hz) of the subthalamic nucleus has dramatic beneficial motor effects in severe parkinsonian patients. However, the mechanisms underlying these clinical results remain obscure. The objective of the present work was to study the neurochemical changes induced in rats by high frequency stimulation of the subthalamic nucleus by using intracerebral microdialysis within its target structures. Our results show that high frequency stimulation of the subthalamic nucleus induces a significant increase of extracellular glutamate levels in the ipsilateral globus pallidus and substantia nigra while GABA was augmented only in the substantia nigra. These data suggest that functional effects induced by high frequency stimulation of the subthalamic nucleus might imply distal mechanisms involving the synaptic relationships with the subthalamic efferences. They question the current view that the direct inhibition of the subthalamic neurons is induced by high frequency stimulation. 相似文献
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The safety and efficacy of subthalamic nucleus (STN) deep brain stimulation (DBS) in patients who have had a previous unilateral pallidotomy is not clear. We identified 10 patients (9 male) at the Baylor College of Medicine Parkinson's Disease Center who underwent STN DBS after prior unilateral pallidotomy. Demographics, efficacy as determined by off Unified Parkinson's Disease Rating Scale (UPDRS) part III scores, and levodopa equivalent dosing were analyzed. We then compared these to an age- and sex-matched group of 25 DBS patients who had no prior pallidotomy. After their initial pallidotomy (mean age, 51.8 +/- 10.8 years), the mean UPDRS motor off medicine scores improved from 51.3 +/- 14.3 to 34.9 +/- 12.8, and the UPDRS dyskinesia score improved from 1.8 +/- 1.0 to 0.8 +/- 0.7. Their STN DBS off UPDRS motor scores (mean age, 56.0 +/- 10.2 years) improved by 16.0% from 53.1 +/- 9.7 (range, 42-68) to 44.6 +/- 11.1 (range, 25-67). In contrast, the UPDRS off motor scores in a control group of 25 DBS patients improved by 49.9%, from 49.7 +/- 11.1 to 25.7 +/- 18.9, (16.0% vs. 49.9%; P < 0.001). Changes in UPDRS dyskinesia scores were similar in both groups. AE thought to be related to the STN DBS following pallidotomy included worse dysarthria (three) and worse balance (two). STN DBS patients with prior pallidotomy had less improvement in UPDRS off motor score compared to other STN DBS patients, despite relatively good outcomes immediately after their pallidotomy. This may be partially due to a selection bias, but it may also indicate that prior pallidotomy is a negative predictor of outcome of STN DBS and should be considered in patient selection. 相似文献
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Galit Kleiner-Fisman David N Fisman Orit Zamir Jonathan O Dostrovsky Elspeth Sime Jean A Saint-Cyr Andres M Lozano Anthony E Lang 《Movement disorders》2004,19(10):1209-1214
Unilateral pallidotomy is an effective treatment for contralateral parkinsonism and dyskinesia, yet symptoms progress in many patients. Little is known about whether such patients obtain a useful response to subsequent bilateral subthalamic nucleus deep brain stimulation (STN DBS). Changes in Unified Parkinson's Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores, medication requirements, and dyskinesias were measured. Clinical outcomes were compared to patients with de novo STN DBS. Neuronal recordings were performed. STN DBS resulted in a significant reduction in UPDRS Motor scores (42.1%; 95% confidence interval [CI], 26.9-57.4; P = 0.03), comparable with de novo STN DBS surgery (41%; 95% CI, 26-46%; P < 0.001). There was also less change in dyskinesia duration and disability scores (P = 0.017, 0.005). There were no side-to-side differences clinically or in the STN neuronal firing rates and patterns. Bilateral STN DBS is safe and efficacious in improving motor symptoms in patients with prior pallidotomy. 相似文献
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Depressive symptoms may occur after Deep Brain Stimulation (DBS) in the subthalamic nucleus. This is often explained by reduced pharmacological treatment after surgery, and not as a direct effect of DBS. Pallidal DBS seems not to be associated with such side effects and have not, to our knowledge, previously been reported. We present a patient with acute depressive symptoms induced by pallidal DBS. We believe this case strengthen the hypothesis that the basal ganglia and structures involved in the functional connectome of these nucleuses play a role not only in regulation of movement but also in regulation of mood. 相似文献
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A. Stefani P. Stanzione A. Bassi P. Mazzone T. Vangelista G. Bernardi 《Journal of neural transmission (Vienna, Austria : 1996)》1997,104(8-9):895-904
Summary We analysed the firing activity of internal globus pallidus cells in two Parkinson's disease patients undergoing stereotaxic surgery. Both patients showed an advanced rigid-akinetic syndrome with disabling levodopa induced dyskinesias. Apomorphine, intraoperatively administered at doses (1–2 mg) inducing a short but clear clinical improvement without involuntary movements, reduced the pallidal discharge rate by >50% in both patients. An higher apomorphine dose (2.5 mg), tested in one hemisphere, blocked the firing activity with a time course independent from the occurrence of dyskinesias. These finding suggest that the reduction of internal pallidus excitability is one of the mechanisms underlying the efficacy of dopaminergic therapy, but also that changes in other basal ganglia stations are likely to be involved in dyskinesias. 相似文献
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Deep brain stimulation (DBS) can be remarkably effective in treating movement disorders such as Parkinson's disease, dystonia, and essential tremor. Yet these effects remain essentially unexplained, even paradoxical. Equally challenging is the fact that DBS of motor targets in the basal ganglia appears to reverse abnormalities of movement without any obvious deleterious effects on remaining aspects of movement. Here, we explore the extent to which the noisy signal hypothesis might help solve some of these apparent paradoxes. Essentially the hypothesis, first tentatively advanced by Marsden and Obeso (1994), suggests that disease leads to a pattern of basal ganglia activity that disrupts local and distant function and that surgery acts to suppress or override this noisy signal. Critical to the success this theory is that different disease phenotypes are associated with different patterns of noisy signal, and we survey the evidence to support this contention, with specific emphasis on different types of pathological synchronization. However, just as DBS may suppress or override noisy signals in the basal ganglia, it must equally antagonize any remaining physiological functioning in these key motor structures. We argue that the latter effect of DBS becomes manifest when baseline motor performance is relatively preserved, i.e., when pathological activity is limited. Under these circumstances, the deleterious effects of DBS are no longer obscured by its therapeutic actions in suppressing noisy signals. Whether true, oversimplified or simply incorrect, the noisy signal hypothesis has served to focus attention on the detailed character of basal ganglia discharge and its variation with disease and therapy. © 2007 Movement Disorder Society 相似文献
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Ni Z Bouali-Benazzouz R Gao D Benabid AL Benazzouz A 《The European journal of neuroscience》2000,12(12):4338-4344
Changes in the neuronal activity of globus pallidus (GP) have been shown in animal models of parkinsonism. In order to study the implication of the subthalamic nucleus (STN) in these changes, the effects of STN lesions alone or in combination with 6-hydroxydopamine (6-OHDA) -induced damage to the substantia nigra compacta (SNc) were examined in rats using electrophysiological recordings of GP cells. In normal rats, the firing rate was 22.1+/-1.4 spikes/s. The pattern was regular in 45%, irregular in 49% and bursty in 6% of the cases. In rats with STN lesions, the firing rate of GP units (20.15+/-1.25 spikes/s) did not differ from that of normal rats and only regular (46%) and irregular (54%) cells were found; a bursty pattern was not observed. 6-OHDA lesions of the SNc induced no change in the firing rate of GP neurons (21.5+/-1.4 spikes/s, P>0.05) but a significant decrease in the percentage of regular cells (27%, P<0.001), a significant increase in burst cells (21%, P<0.001) with no change in the percentage of irregular units (52%) were observed. In rats with combined SNc and STN lesions, the firing pattern did not change from that of normal rats. The present results show that STN lesions induced the disappearance of bursts in normal rats and normalization of firing pattern in the GP units of rats with 6-OHDA lesions suggesting that the STN plays an important role in the modulation of the pattern of activity of GP neurons which may account for the therapeutic effect of STN lesions in Parkinson's disease. 相似文献
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Inken Tödt PhD Bassam Al-Fatly MD Oliver Granert Andrea A. Kühn MD PhD Paul Krack MD PhD Joern Rau Lars Timmermann MD PhD Alfons Schnitzler MD PhD Steffen Paschen MD Ann-Kristin Helmers MD Andreas Hartmann MD PhD Eric Bardinet MD PhD Michael Schuepbach MD Michael T. Barbe MD PhD Till A. Dembek MD Valerie Fraix MD PhD Dorothee Kübler MD Christine Brefel-Courbon MD PhD Alireza Gharabaghi MD PhD Lars Wojtecki MD PhD Marcus O. Pinsker MD PhD Stephane Thobois MD PhD Philippe Damier MD PhD Tatiana Witjas MD PhD Jean-Luc Houeto MD PhD Carmen Schade-Brittinger Marie Vidailhet MD PhD Andreas Horn MD PhD Günther Deuschl MD PhD 《Movement disorders》2022,37(2):291-301
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Alex A. MacDonald BSc Oury Monchi PhD Ken N. Seergobin MSc Hooman Ganjavi MD PhD Ruzbeh Tamjeedi BA Penny A. MacDonald MD PhD 《Movement disorders》2013,28(2):153-160
We investigated the hypothesis that variation in endogenous dopamine (DA) across brain regions explains dissimilar effects of dopaminergic therapy on aspects of cognition in early Parkinson's disease (PD). Extensive degeneration of DA‐producing cells in the substantia nigra cause dorsal striatum (DS) DA deficiency and movement abnormalities. Particularly in early PD, this contrasts with relative sparing of the dopaminergic cells of the ventral tegmental area (VTA). 1 The hypothesis predicts that DS‐mediated cognitive functions are deficient at baseline and improved by DA replacement, whereas functions depending upon VTA‐innervated brain regions are normal off medication and worsen with treatment. The latter pattern presumably owes to overdose of relatively DA‐replete VTA‐supplied brain regions with medication levels titrated to DS‐mediated motor symptoms. 2 , 3 As PD progresses, however, VTA degeneration increases. Impairment in cognitive operations performed by VTA‐innervated brain regions, such as the ventral striatum (VS), is expected. We compared the performance of early and late PD patients, on and off dopaminergic medication, relative to age‐matched controls, on reward learning, previously shown to implicate the VS. As expected, in early PD, stimulus‐reward learning was normal off medication, but worsened with DA replacement. At more advanced disease stages, PD patients learned stimulus‐reward contingencies more poorly than controls and early PD patients off medication. Furthermore, dopaminergic medication did not worsen reward learning in late PD patients, in line with the dopamine overdose hypothesis. Unlike its effect on DS‐mediated functions, however, DA‐replacement therapy did not improve reward learning in late PD patients. © 2012 Movement Disorder Society 相似文献
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Michael Schüpbach Ebba Lohmann Mathieu Anheim Suzanne Lesage Virginie Czernecki Sadek Yaici Yulia Worbe Perrine Charles Marie-Laure Welter Pierre Pollak Alexandra Dürr Yves Agid Alexis Brice 《Movement disorders》2007,22(1):119-122
Stimulation of the subthalamic nucleus (STN) improves motor signs in patients with levodopa-responsive Parkinson's disease (PD). Mutations in the leucine-rich repeat kinase-2 (LRRK2) gene cause Parkinsonism. We assessed 69 patients under STN stimulation and found heterozygous LRRK2 mutations in 9 (G2019S in 8 and T2031S in 1). The age at onset of PD, the clinical characteristics before or after neurosurgery, and the clinical response to STN stimulation were similar in both groups. Two patients with the G2019S LRRK2 mutation still benefited from STN stimulation, 9 and 10 years after surgery. Patients with LRRK2 mutations are, therefore, good candidates for STN stimulation. 相似文献