China
Africa
Explore chapters and articles related to this topic
Hyperkinetic Movement Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Morales-Briceno Hugo, Victor S.C. Fung, Annu Aggarwal, Philip Thompson
Perinatal injury: Perinatal injury—cerebral palsy.Kernicterus (neonatal hyperbilirubinemia).Structural lesions involving basal ganglia, subthalamic nucleus.
The subthalamic nucleus: anatomy and neurophysiology
Published in Hans O Lüders, Deep Brain Stimulation and Epilepsy, 2020
The realization that abnormal activity in the subthalamic nucleus (STN) is an important feature in the pathogenesis of movement disorders, such as hemiballism and parkinsonism, has resulted in considerable interest in the anatomy and physiology of the STN. Knowledge gained from these studies has found widespread clinical application, particularly with the introduction of deep brain stimulation (DBS) as treatment for parkinsonism and other movement disorders. The objective of this review is to highlight some of the anatomic and physiologic properties of the STN that may be important for an understanding of the pathophysiology of clinical disorders.
Neurology
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
Improved understanding of the neural mechanism of Parkinson’s disease showed that the subthalamic nucleus is overactive. This led to the development of bilateral subthalamic stimulation surgery to switch off this nucleus.
The human functional connectome in neurodegenerative diseases: relationship to pathology and clinical progression
Published in Expert Review of Neurotherapeutics, 2023
Massimo Filippi, Edoardo Gioele Spinelli, Camilla Cividini, Alma Ghirelli, Silvia Basaia, Federica Agosta
Another well-established treatment option for PD patients with invalidating symptoms is the implant of a deep brain stimulation (DBS) device modulating aberrant motor pathways within the basal ganglia. DBS of the subthalamic nucleus was found to act by increasing coupling between motor thalamus and motor cortex, at the same time reducing striatal connectivity with pallidal, subthalamic and cerebellar structures, with an overall normalization effect compared with healthy controls [82]. A recent study suggested the use of functional connectomics to allow an early identification of PD patients who would soon be candidate to DBS implantation, as these patients were characterized by distinctive decreased connectivity in basal ganglia and sensorimotor brain regions as well as hyperconnectivity of parieto-occipital regions up to four years before satisfying criteria for surgery [83].
Optimal target localisation and eight-year outcome for subthalamic stimulation in patients with Parkinson’s disease
Published in British Journal of Neurosurgery, 2021
Song Guo, Jianyu Li, Yuqing Zhang, Yongjie Li, Ping Zhuang
Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a useful therapy for Parkinson’s disease (PD). Several researchers have reported the clinical outcomes in the short- and medium-term after STN-DBS, indicating significantly improved motor symptoms and quality of life, as well as reduced dependence on dopaminergic medications.1–5 However, information on the specific locations of the implanted lead contacts (electrodes) in the STN is lacking in these studies, making it hard to determine if a particular lead placement plays a beneficial role in patients who experience long-term benefits. The postoperative outcome varies radically with STN-DBS. Advanced patient age, a longer disease course, and suboptimal arrangement of the stimulating electrodes in the STN have all been reported as factors leading to a below-average outcome.2,6,7 Few studies have illustrated the clinical effects of STN-DBS when the locations of the inserted electrodes are examined and the patient is assessed during a stable phase after STN-DBS surgery. Our group previously provided data showing the efficacy of STN-DBS treatment in patients with PD and indicated that the location of active stimulating electrodes is associated with that of oscillatory STN neurons.8 In accord with our previous research experience,5,8–10 we report here on the 8-year postoperative outcomes in a cohort of 42 advanced PD patients who were treated with bilateral STN-DBS.
The effects of Alzheimer's disease related striatal pathologic changes on the fractional amplitude of low-frequency fluctuations
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
The basal ganglia, a subcortical nuclei, interconnected with the cerebral cortex, thalamus, and other brain areas, is associated with a variety of functions, such as control of voluntary motor movements, procedural learning, habit learning, eye movements, cognition and emotion. The main structures comprising the basal ganglia are the striatum, globus pallidus, substantia nigra, and subthalamic nucleus (STN). The striatum is the largest structure of the basal ganglia and mainly consists of Fast Spiking Interneurons (FSI) and Medium Spiny Neurons (MSN) including D1 and D2 type dopamine receptors (Bolam et al. 2000). The globus pallidus is divided into two functionally distinct parts, called the internal (GPi) and the external (GPe) segments. The substantia nigra is a midbrain gray matter portion of the basal ganglia that has two parts – the pars compacta (SNc) and the pars reticulata (SNr). GPi and SNr are often considered as a single structure due to their closely related inputs and outputs and similarities in cytology and function. SNr-GPi complex inhibits the thalamus (Plenz and Kitai 1998; Bolam et al. 2000; Samuelsson and Kotaleski 2007).