https://scholars.lib.ntu.edu.tw/handle/123456789/594602
標題: | An electrophysiological perspective on Parkinson’s disease: symptomatic pathogenesis and therapeutic approaches | 作者: | Lee L.-H.N. Huang C.-S. Chuang H.-H. Lai H.-J. Yang C.-K. Yang Y.-C. CHUNG-CHIN KUO |
關鍵字: | Basal ganglia circuitry; Brain rhythms; Brain stimulation; Burst discharges; Cortico-subcortical re-entrant loops; Hyperdirect pathway; Hyperkinesia; Hypokinesia; Motor control; Subthalamic nucleus | 公開日期: | 2021 | 出版社: | BioMed Central Ltd | 卷: | 28 | 期: | 1 | 起(迄)頁: | 85 | 來源出版物: | Journal of Biomedical Science | 摘要: | Parkinson’s disease (PD), or paralysis agitans, is a common neurodegenerative disease characterized by dopaminergic deprivation in the basal ganglia because of neuronal loss in the substantia nigra pars compacta. Clinically, PD apparently involves both hypokinetic (e.g. akinetic rigidity) and hyperkinetic (e.g. tremor/propulsion) symptoms. The symptomatic pathogenesis, however, has remained elusive. The recent success of deep brain stimulation (DBS) therapy applied to the subthalamic nucleus (STN) or the globus pallidus pars internus indicates that there are essential electrophysiological abnormalities in PD. Consistently, dopamine-deprived STN shows excessive burst discharges. This proves to be a central pathophysiological element causally linked to the locomotor deficits in PD, as maneuvers (such as DBS of different polarities) decreasing and increasing STN burst discharges would decrease and increase the locomotor deficits, respectively. STN bursts are not so autonomous but show a “relay” feature, requiring glutamatergic synaptic inputs from the motor cortex (MC) to develop. In PD,?there is an increase in overall MC activities and the corticosubthalamic input is?enhanced and contributory to excessive burst discharges in STN. The increase in MC activities may be relevant to the enhanced beta power in local field potentials (LFP) as well as the deranged motor programming at the cortical level in PD. Moreover, MC could not only drive erroneous STN bursts, but also be driven by STN discharges at specific LFP frequencies (~ 4 to 6?Hz) to produce coherent tremulous muscle contractions. In essence, PD may be viewed as a disorder with deranged rhythms in the cortico-subcortical re-entrant loops, manifestly including STN, the major component of the oscillating core, and MC, the origin of the final common descending motor pathways. The configurations of the deranged rhythms may play a determinant role in the symptomatic pathogenesis of PD, and provide insight into the mechanism underlying normal motor control. Therapeutic brain stimulation for PD and relevant disorders should be adaptively exercised with in-depth pathophysiological considerations for each individual patient, and aim at a final normalization of cortical discharge patterns for the best ameliorating effect on the locomotor and even non-motor symptoms. ? 2021, The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85120877879&doi=10.1186%2fs12929-021-00781-z&partnerID=40&md5=75c2496a98c84222ec83707d26fc378c https://scholars.lib.ntu.edu.tw/handle/123456789/594602 |
ISSN: | 1021-7770 | DOI: | 10.1186/s12929-021-00781-z | SDG/關鍵字: | dopamine; beta rhythm; brain depth stimulation; brain electrophysiology; cortical synchronization; globus pallidus; glutamatergic transmission; human; hyperkinesia; hypokinesia; ion current; local field potential; locomotion; motor control; motor cortex; muscle contraction; muscle rigidity; nonhuman; Parkinson disease; pathogenesis; Review; substantia nigra pars compacta; subthalamic nucleus; synapse; tremor; electrophysiology; nerve cell; Parkinson disease; pathophysiology; physiology; Electrophysiological Phenomena; Humans; Motor Cortex; Neurons; Parkinson Disease; Subthalamic Nucleus |
顯示於: | 生理學科所 |
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