This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Dostrovsky, J. O. Articles by Lozano, A. M. Search for Related Content PubMed PubMed Citation Articles by Dostrovsky, J. O. Articles by Lozano, A. M. Social Bookmarking                         What's this?

The Globus Pallidus, Deep Brain Stimulation, and Parkinson's Disease

Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;The Toronto Western Research Institute, The Toronto Western Hospital, Canada;Jonathan O. Dostrovsky, Dept. of Physiology, Rm. 3305 Medical Sciences Building, 1 King's College Circle, University of Toronto, Toronto, Ontario, Canada M5S 1A8; j.dostrovsky{at}utoronto.ca

William D. Hutchison

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, Canada

Andres M. Lozano

Department of Surgery, University of Toronto, Division of Neurosurgery, The Toronto Western Hospital, Canada;The Toronto Western Research Institute, The Toronto Western Hospital, Canada

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.

Key Words: Parkinson's disease • Functional stereotactic surgery • Basal ganglia • Movement disorders • Deep brain stimulation

The Neuroscientist, Vol. 8, No. 3, 284-290 (2002)
DOI: 10.1177/1073858402008003014


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?