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High-frequency stimulation in Parkinson's disease: more or less?

High-frequency stimulation in Parkinson's disease: more or less?
High-frequency stimulation in Parkinson's disease: more or less?
Deep-brain stimulation at high frequency is now considered the most effective neurosurgical therapy for movement disorders. An electrode is chronically implanted in a particular area of the brain and, when continuously stimulated, it significantly alleviates motor symptoms. In Parkinson's disease, common target nuclei of high-frequency stimulation (HFS) are ventral thalamic nuclei and basal ganglia nuclei, such as the internal segment of the pallidum and the subthalamic nucleus (STN), with a preference for the STN in recent years. Two fundamental mechanisms have been proposed to underlie the beneficial effects of HFS: silencing or excitation of STN neurons. Relying on recent experimental data, we suggest that both are instrumental: HFS switches off a pathological disrupted activity in the STN (a ‘less’ mechanism) and imposes a new type of discharge in the upper gamma-band frequency that is endowed with beneficial effects (a ‘more’ mechanism). The intrinsic capacity of basal ganglia and particular STN neurons to generate oscillations and shift rapidly from a physiological to a pathogenic pattern is pivotal in the operation of these circuits in health and disease.
209-216
Garcia, Liliana
c9c42bae-f632-44b5-ba0d-7ddc8399fc54
D'Alessandro, Giampaolo
bad097e1-9506-4b6e-aa56-3e67a526e83b
Bioulac, Bernard
a0fe511b-6de8-4cb6-9395-27bd81f2f904
Hammond, Constance
9e3ccab2-6aab-4200-89b3-77ec86e08c71
Garcia, Liliana
c9c42bae-f632-44b5-ba0d-7ddc8399fc54
D'Alessandro, Giampaolo
bad097e1-9506-4b6e-aa56-3e67a526e83b
Bioulac, Bernard
a0fe511b-6de8-4cb6-9395-27bd81f2f904
Hammond, Constance
9e3ccab2-6aab-4200-89b3-77ec86e08c71

Garcia, Liliana, D'Alessandro, Giampaolo, Bioulac, Bernard and Hammond, Constance (2005) High-frequency stimulation in Parkinson's disease: more or less? Trends in Neurosciences, 28 (4), 209-216. (doi:10.1016/j.tins.2005.02.005).

Record type: Article

Abstract

Deep-brain stimulation at high frequency is now considered the most effective neurosurgical therapy for movement disorders. An electrode is chronically implanted in a particular area of the brain and, when continuously stimulated, it significantly alleviates motor symptoms. In Parkinson's disease, common target nuclei of high-frequency stimulation (HFS) are ventral thalamic nuclei and basal ganglia nuclei, such as the internal segment of the pallidum and the subthalamic nucleus (STN), with a preference for the STN in recent years. Two fundamental mechanisms have been proposed to underlie the beneficial effects of HFS: silencing or excitation of STN neurons. Relying on recent experimental data, we suggest that both are instrumental: HFS switches off a pathological disrupted activity in the STN (a ‘less’ mechanism) and imposes a new type of discharge in the upper gamma-band frequency that is endowed with beneficial effects (a ‘more’ mechanism). The intrinsic capacity of basal ganglia and particular STN neurons to generate oscillations and shift rapidly from a physiological to a pathogenic pattern is pivotal in the operation of these circuits in health and disease.

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Published date: 2005

Identifiers

Local EPrints ID: 29311
URI: http://eprints.soton.ac.uk/id/eprint/29311
PURE UUID: c9090e57-05a7-4c69-a421-ba985ac75740
ORCID for Giampaolo D'Alessandro: ORCID iD orcid.org/0000-0001-9166-9356

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Date deposited: 11 May 2006
Last modified: 08 Jan 2022 02:41

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Contributors

Author: Liliana Garcia
Author: Bernard Bioulac
Author: Constance Hammond

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