Parkinson s Disease and Cortico-Basal Ganglia Circuits

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1 Continuing Medical Education 213 Parkinson s Disease and Cortico-Basal Ganglia Circuits Ming-Kai Pan, Chun-Hwei Tai, Chung-Chin Kuo Abstract- Cortico-basal ganglia circuit model has been studied extensively after it was first proposed by Alexander and Crutcher in This model accurately predicted the hyperactivity of indirect pathway and subthalamic nucleus(stn) in the dopamine deficiency state of Parkinson s disease (PD), prompting the experimental approaches of lesioning STN in parkinsonian primates. Application of these successful experiences with STN lesions in the reversal of parkinsonian symptoms to human PD patients facilitates the development of STN deep brain stimulation (DBS), which has become one of the most important therapies for PD in recent years. Although the classical model of the cortico-basal ganglia circuits by Alexander and Crutcher has provided many important insights into the basal ganglia function, the functional role of cortico-subthalamic hyperdirect pathway in the circuits has been relatively neglected. The first part of this article summarizes recent development concerning the cortico-basal ganglia circuits, especially emphasizing the importance of the hyperdirect pathway. In the second part of this article, we would describe the analyses of gross corticobasal ganglia circuit electrophysiological findings, especially emphasizing the coherence between two oscillating signals. We would also discuss the correlation between these parameters and the motor dysfunction, and its pathophysiological implications in PD. Key words: cortico-basal ganglia circuit, electrophysiology, Parkinson s diseasae, pathophysiology, spectrum analysis. From the Department of Physiology, National Taiwan University College of Medicine, and Department of Neurology, National Taiwan University Hospital,Taipei, Taiwan. Received March 12, Accepted March 15, Correspondence to: Chung-Chin Kuo, MD, PhD. Department of Neurology, College of Medicine and University Hospital, National Taiwan University, No. 7, Chong-Shan South Road, Taipei, Taiwan. chungchinkuo@ntu.edu.tw

2 Alexander Crutcher Alexander Crutcher - (coherence) Acta Neurol Taiwan 2010;19: basal ganglia striatum, globus pallidus, (subthalamic nucleus) substantia nigra, chungchinkuo@ntu.edu.tw

3 215 (cortical-basal ganglia circuits) (1) (2) (dopamine) (deep brain stimulation, DBS) (local field potential, LFP) beta synchronization 1990 Alexander Crutcher (3) 1A 1. Alexander Crutcher (A) (B) (C) (D)

4 216 (direct pathway) (indirect pathway) D1 D2 1B (4) (5) (6) (7) 1C (8) 1D ( ) 2002 Nambu (9) (hyperdirect pathway) (10) 2. (A) (hyperdirect) - (1) (2) (3) (B) Nambu

5 217 2A 2B 3. x(t) X( ) 3 1Hz 1Hz P( ) X( )

6 218 ( ) (spectrum analysis) (time domain signal) (frequency domain signal) ( 60Hz ) (cross-correlation) (Fourier transform) (magnitude) (phase) 3 (power spectrum density, PSD) 0 (coherence) (Coherence) C ( ) 2 (synchronization) (consistency of linear association through trials) (11) x y (Cross-spectrum correlation function) x y (auto-spectrum correlation function) x y ( x y ) 0 1 (real number) x y (normalization) 1 0 ( ) (Confidence limit) (12) CL (α) = 1 - (1 - α) 1/(L - 1) L type 1 error CL (α) 1960 (Ventral nucleus groups of thalamus) (13-15) (16-18) 1988 Lenz 4~6Hz (19) (20)

7 219 (21) (dorsal part) ( ) (22) (23) (24) ( ) 3~6Hz 3-6Hz (rigidity) (bradykinesia) (GPi) (25-30) (30-37) 10~30Hz beta synchronization beta beta synchronization (36-39) (40,41) (Levodopa) (dopaminergic agonist) beta synchronization (31,33,35,40,41) beta synchronization 10~30Hz 10~30Hz beta synchronization beta synchronization (39) beta synchronization beta synchronization - (bradykinesia) (dyskinesia) (oscillation)

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SYNCHRONIZATION OF PALLIDAL ACTIVITY IN THE MPTP PRIMATE MODEL OF PARKINSONISM IS NOT LIMITED TO OSCILLATORY ACTIVITY

SYNCHRONIZATION OF PALLIDAL ACTIVITY IN THE MPTP PRIMATE MODEL OF PARKINSONISM IS NOT LIMITED TO OSCILLATORY ACTIVITY Gali Heimer, Izhar Bar-Gad, Joshua A. Goldberg and Hagai Bergman * 1. INTRODUCTION