Brain, Vol. 117, No. 4, 877-897, 1994
© 1994 Guarantors of Brain
review-article |
The functions of the basal ganglia and the paradox of stereotaxic surgery in Parkinson's disease
1University Department of Clinical Neurology, Institute of Neurology, The National Hospital for Neurology and Neurosurgery London, UK 2Departamento de Neurologia, Clinica Universitaria, University of Navarra Pamplona Spain
Correspondence to:
0Correspondence to: Professor C. D. Marsden, University Department of Clinical Neurology, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
The basal ganglia play a role in controlling movement. The motor circuits within the striato-pallidal complex are thought to facilitate desired movement and inhibit unwanted movement through their influence via thalamus, mainly on precentral motor cortical regions. Lesions in the motor thalamus, or in the globus pallidus, therefore might be expected to impair voluntary movement. But stereotaxic lesions in patients with Parkinson's disease directed at the motor thalamus verified at autopsy, and lesions in the globus pallidus, which improve rigidity and tremor, apparently do not worsen parkinsonian hypokinesia and bradykinesia; nor do they regularly cause dyskinesias. Reasons for this discrepancy are reviewed. It is concluded that the motor circuits of the basal ganglia are part of a distributed motor system which can operate, albeit imperfectly, in the absence of striato-pallido-thalamo-cortical feedback. There may, however, be subtle defects in motor performance after thalamic and pallidal lesions which have escaped attention. Further consideration leads to two hypotheses concerning normal basal ganglia motor function. First, it seems most likely that it is a pause in firing of medial pallidal and substantia nigra reticulata neurons that, by disinhibition of thalamic targets, permits movements generated by cortical motor areas. An increase in firing of medial pallidal neurons, which so far has been the major focus of attention, may be more concerned with inhibition of unwanted movement. Secondly, we suggest that the basal ganglia play a particular role in motor control. A change in firing of medial pallidal neurons appears to occur too late to initiate a new movement. However, the motor circuit within the striato-pallidal system routinely receives a continuous delayed read-out of cortical motor activity and issues an output directed via thalamus mainly to premotor cortical regions. This may permit the routine automatic execution of sequences of movements generated in cortical motor areas. There is evidence that other regions of the striatum respond to significant external or internal cues as dictated by their cortical inputs, the significance being determined by memory, novelty, emotional and other contexts. We suggest that such events capture the attention of the non-motor striatum, which then interrupts the routine operation of the motor circuit, perhaps at the level of the medial pallidum and substantia nigra pars reticulata, to permit new cortical motor action.
basal ganglia function; stereotaxic surgery
Received February 15, 1993. Revised December 2, 1993. Accepted February 8, 1994.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. Galati, P. Stanzione, V. D'Angelo, E. Fedele, F. Marzetti, G. Sancesario, T. Procopio, and A. Stefani The pharmacological blockade of medial forebrain bundle induces an acute pathological synchronization of the cortico\#8211;subthalamic nucleus\#8211;globus pallidus pathway J. Physiol., September 15, 2009; 587(18): 4405 - 4423. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Kalbe, J. Voges, T. Weber, M. Haarer, S. Baudrexel, J. C. Klein, J. Kessler, V. Sturm, W. D. Heiss, and R. Hilker Frontal FDG-PET activity correlates with cognitive outcome after STN-DBS in Parkinson disease Neurology, January 6, 2009; 72(1): 42 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Steigerwald, M. Potter, J. Herzog, M. Pinsker, F. Kopper, H. Mehdorn, G. Deuschl, and J. Volkmann Neuronal Activity of the Human Subthalamic Nucleus in the Parkinsonian and Nonparkinsonian State J Neurophysiol, November 1, 2008; 100(5): 2515 - 2524. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Karimi, N. Golchin, S. D. Tabbal, T. Hershey, T. O. Videen, J. Wu, J. W. M. Usche, F. J. Revilla, J. M. Hartlein, A. R. Wernle, et al. Subthalamic nucleus stimulation-induced regional blood flow responses correlate with improvement of motor signs in Parkinson disease Brain, October 1, 2008; 131(10): 2710 - 2719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Desmurget and R. S. Turner Testing Basal Ganglia Motor Functions Through Reversible Inactivations in the Posterior Internal Globus Pallidus J Neurophysiol, March 1, 2008; 99(3): 1057 - 1076. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.D Humphries, K Gurney, and T.J Prescott Is there a brainstem substrate for action selection? Phil Trans R Soc B, September 29, 2007; 362(1485): 1627 - 1639. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Heimer, M. Rivlin-Etzion, I. Bar-Gad, J. A. Goldberg, S. N. Haber, and H. Bergman Dopamine Replacement Therapy Does Not Restore the Full Spectrum of Normal Pallidal Activity in the 1-Methyl-4-Phenyl-1,2,3,6-Tetra-Hydropyridine Primate Model of Parkinsonism J. Neurosci., August 2, 2006; 26(31): 8101 - 8114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A C Pereira and T. Z Aziz Surgical insights into Parkinson's disease. J R Soc Med, May 1, 2006; 99(5): 238 - 244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. T. Grafton, R. S. Turner, M. Desmurget, R. Bakay, M. Delong, J. Vitek, and M. Crutcher Normalizing motor-related brain activity: Subthalamic nucleus stimulation in Parkinson disease Neurology, April 25, 2006; 66(8): 1192 - 1199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Fogelson, D. Williams, M. Tijssen, G. van Bruggen, H. Speelman, and P. Brown Different Functional Loops between Cerebral Cortex and the Subthalmic Area in Parkinson's Disease Cereb Cortex, January 1, 2006; 16(1): 64 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Colosimo, P Pantano, V Calistri, P Totaro, G Fabbrini, and A Berardelli Diffusion tensor imaging in primary cervical dystonia J. Neurol. Neurosurg. Psychiatry, November 1, 2005; 76(11): 1591 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.-c. Liu and F. Nottebohm Variable rate of singing and variable song duration are associated with high immediate early gene expression in two anterior forebrain song nuclei PNAS, July 26, 2005; 102(30): 10724 - 10729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Garraux, C. McKinney, T. Wu, K. Kansaku, G. Nolte, and M. Hallett Shared Brain Areas But Not Functional Connections Controlling Movement Timing and Order J. Neurosci., June 1, 2005; 25(22): 5290 - 5297. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Silberstein, A. Pogosyan, A. A. Kuhn, G. Hotton, S. Tisch, A. Kupsch, P. Dowsey-Limousin, M. I. Hariz, and P. Brown Cortico-cortical coupling in Parkinson's disease and its modulation by therapy Brain, June 1, 2005; 128(6): 1277 - 1291. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Belforte and J. H. Pazo Striatal Inhibition of Nociceptive Responses Evoked in Trigeminal Sensory Neurons by Tooth Pulp Stimulation J Neurophysiol, March 1, 2005; 93(3): 1730 - 1741. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Alvarez, R. Macias, G. Lopez, E. Alvarez, N. Pavon, M. C. Rodriguez-Oroz, J. L. Juncos, C. Maragoto, J. Guridi, I. Litvan, et al. Bilateral subthalamotomy in Parkinson's disease: initial and long-term response Brain, March 1, 2005; 128(3): 570 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. G. Jenkins, R. Sanchez-Pernaute, A.-L. Brownell, Y.-C. I. Chen, and O. Isacson Mapping Dopamine Function in Primates Using Pharmacologic Magnetic Resonance Imaging J. Neurosci., October 27, 2004; 24(43): 9553 - 9560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Lei, Y. Jiao, N. Del Mar, and A. Reiner Evidence for Differential Cortical Input to Direct Pathway versus Indirect Pathway Striatal Projection Neurons in Rats J. Neurosci., September 22, 2004; 24(38): 8289 - 8299. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Paradiso, J. A. Saint-Cyr, A. M. Lozano, A. E. Lang, and R. Chen Involvement of the human subthalamic nucleus in movement preparation Neurology, December 9, 2003; 61(11): 1538 - 1545. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Silberstein, A. A. Kuhn, A. Kupsch, T. Trottenberg, J. K. Krauss, J. C. Wohrle, P. Mazzone, A. Insola, V. Di Lazzaro, A. Oliviero, et al. Patterning of globus pallidus local field potentials differs between Parkinson's disease and dystonia Brain, December 1, 2003; 126(12): 2597 - 2608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Maurer, T. Mergner, J. Xie, M. Faist, P. Pollak, and C. H. Lucking Effect of chronic bilateral subthalamic nucleus (STN) stimulation on postural control in Parkinson's disease Brain, May 1, 2003; 126(5): 1146 - 1163. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Taniwaki, A. Okayama, T. Yoshiura, Y. Nakamura, Y. Goto, J.-i. Kira, and S. Tobimatsu Reappraisal of the Motor Role of Basal Ganglia: A Functional Magnetic Resonance Image Study J. Neurosci., April 15, 2003; 23(8): 3432 - 3438. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Siderowf and M. Stern Update on Parkinson Disease Ann Intern Med, April 15, 2003; 138(8): 651 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Schroeder, A. Kuehler, B. Haslinger, P. Erhard, W. Fogel, V. M. Tronnier, K. W. Lange, H. Boecker, and A. O. Ceballos-Baumann Subthalamic nucleus stimulation affects striato-anterior cingulate cortex circuit in a response conflict task: a PET study Brain, September 1, 2002; 125(9): 1995 - 2004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Mair, J. K. Koch, J. B. Newman, J. R. Howard, and J. A. Burk A Double Dissociation within Striatum between Serial Reaction Time and Radial Maze Delayed Nonmatching Performance in Rats J. Neurosci., August 1, 2002; 22(15): 6756 - 6765. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. MacAskill, T. J. Anderson, and R. D. Jones Adaptive modification of saccade amplitude in Parkinson's disease Brain, July 1, 2002; 125(7): 1570 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cassidy, P. Mazzone, A. Oliviero, A. Insola, P. Tonali, V. D. Lazzaro, and P. Brown Movement-related changes in synchronization in the human basal ganglia Brain, June 1, 2002; 125(6): 1235 - 1246. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Goldberg, T. Boraud, S. Maraton, S. N. Haber, E. Vaadia, and H. Bergman Enhanced Synchrony among Primary Motor Cortex Neurons in the 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine Primate Model of Parkinson's Disease J. Neurosci., June 1, 2002; 22(11): 4639 - 4653. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H-L Teulings, J L Contreras-Vidal, G E Stelmach, and C H Adler Adaptation of handwriting size under distorted visual feedback in patients with Parkinson's disease and elderly and young controls J. Neurol. Neurosurg. Psychiatry, March 1, 2002; 72(3): 315 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Sterio, A Rezai, A Mogilner, M Zonenshayn, J-M Gracies, K Kathirithamby, and A Beric Neurophysiological modulation of the subthalamic nucleus by pallidal stimulation in Parkinson's disease J. Neurol. Neurosurg. Psychiatry, March 1, 2002; 72(3): 325 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Berardelli, J. C. Rothwell, P. D. Thompson, and M. Hallett Pathophysiology of bradykinesia in Parkinson's disease Brain, November 1, 2001; 124(11): 2131 - 2146. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. O. Ceballos-Baumann, H. Boecker, W. Fogel, F. Alesch, P. Bartenstein, B. Conrad, N. Diederich, I. von Falkenhayn, J. R. Moringlane, M. Schwaiger, et al. Thalamic stimulation for essential tremor activates motor and deactivates vestibular cortex Neurology, May 22, 2001; 56(10): 1347 - 1354. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T B Babel, P C Warnke, and C B Ostertag Immediate and long term outcome after infrathalamic and thalamic lesioning for intractable Tourette's syndrome J. Neurol. Neurosurg. Psychiatry, May 1, 2001; 70(5): 666 - 671. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Frank, F. B. Horak, and J. Nutt Centrally Initiated Postural Adjustments in Parkinsonian Patients On and Off Levodopa J Neurophysiol, November 1, 2000; 84(5): 2440 - 2448. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Saint-Cyr, L. L. Trepanier, R. Kumar, A. M. Lozano, and A. E. Lang Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson's disease Brain, October 1, 2000; 123(10): 2091 - 2108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Pillon, C. Ardouin, P. Damier, P. Krack, J. L. Houeto, H. Klinger, A. M. Bonnet, P. Pollak, A. L. Benabid, and Y. Agid Neuropsychological changes between ""off"" and ""on"" STN or GPi stimulation in Parkinson's disease Neurology, August 8, 2000; 55(3): 411 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Jahanshahi, C. M. A. Ardouin, R. G. Brown, J. C. Rothwell, J. Obeso, A. Albanese, M. C. Rodriguez-Oroz, E. Moro, A. L. Benabid, P. Pollak, et al. The impact of deep brain stimulation on executive function in Parkinson's disease Brain, June 1, 2000; 123(6): 1142 - 1154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Lombardi, R. E. Gross, L. L. Trepanier, A. E. Lang, A. M. Lozano, and J. A. Saint-Cyr Relationship of lesion location to cognitive outcome following microelectrode-guided pallidotomy for Parkinson's disease: Support for the existence of cognitive circuits in the human pallidum Brain, April 1, 2000; 123(4): 746 - 758. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Volkow and J. S. Fowler Addiction, a Disease of Compulsion and Drive: Involvement of the Orbitofrontal Cortex Cereb Cortex, March 1, 2000; 10(3): 318 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. I. MacDonald Brain in the twentieth century Brain, January 1, 2000; 123(1): 3 - 8. [Full Text] [PDF]
|
|
|
|
|
|
K. K. Wenger, K. L. Musch, and J. W. Mink Impaired Reaching and Grasping After Focal Inactivation of Globus Pallidus Pars Interna in the Monkey J Neurophysiol, November 1, 1999; 82(5): 2049 - 2060. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Schrag, M Samuel, E Caputo, T Scaravilli, M Troyer, C D Marsden, D G T Thomas, A J Lees, D J Brooks, and N P Quinn Unilateral pallidotomy for Parkinson's disease: results after more than 1 year J. Neurol. Neurosurg. Psychiatry, October 1, 1999; 67(4): 511 - 517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. E. Kimber, C. S. Tsai, J. Semmler, B. P. Brophy, and P. D. Thompson Voluntary movement after pallidotomy in severe Parkinson's disease Brain, May 1, 1999; 122(5): 895 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Catalan, K. Ishii, M. Honda, A. Samii, and M. Hallett A PET study of sequential finger movements of varying length in patients with Parkinson's disease Brain, March 1, 1999; 122(3): 483 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Azulay, S. Mesure, B. Amblard, O. Blin, I. Sangla, and J. Pouget Visual control of locomotion in Parkinson's disease Brain, January 1, 1999; 122(1): 111 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Turner, S. T. Grafton, J. R. Votaw, M. R. Delong, and J. M. Hoffman Motor Subcircuits Mediating the Control of Movement Velocity: A PET Study J Neurophysiol, October 1, 1998; 80(4): 2162 - 2176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. L. Trepanier, J. A. Saint-Cyr, A. M. Lozano, and A. E. Lang Neuropsychological consequences of posteroventral pallidotomy for the treatment of Parkinson's disease Neurology, July 1, 1998; 51(1): 207 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hochstenbach, K. P. van Spaendonck, A. R Cools, M. W. Horstink, and T. Mulder Cognitive deficits following stroke in the basal ganglia Clinical Rehabilitation, June 1, 1998; 12(6): 514 - 520. [Abstract] [PDF]
|
|
|
|
|
|
H. Boecker, A. Dagher, A. O. Ceballos-Baumann, R. E. Passingham, M. Samuel, K. J. Friston, J.-B. Poline, C. Dettmers, B. Conrad, and D. J. Brooks Role of the Human Rostral Supplementary Motor Area and the Basal Ganglia in Motor Sequence Control: Investigations With H2 15O PET J Neurophysiol, February 1, 1998; 79(2): 1070 - 1080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Merello, A. Cammarota, O. Betti, M. I. Nouzeilles, D. Cerquetti, H. Garcia, R. Pikielny, and R. Leiguarda Involuntary movements during thermolesion predict a better outcome after microelectrode guided posteroventral pallidotomy J. Neurol. Neurosurg. Psychiatry, August 1, 1997; 63(2): 210 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Hommer, P. Andreasen, D. Rio, W. Williams, U. Ruttimann, R. Momenan, A. Zametkin, R. Rawlings, and M. Linnoila Effects of m-Chlorophenylpiperazine on Regional Brain Glucose Utilization: A Positron Emission Tomographic Comparison of Alcoholic and Control Subjects J. Neurosci., April 15, 1997; 17(8): 2796 - 2806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. F. De Salles Role of Stereotaxis in the Treatment of Cerebral Palsy J Child Neurol, November 1, 1996; 11(1_suppl): S43 - S50. [Abstract] [PDF]
|
|
|
|
|
|
M. R. Pranzatelli Topical Review: Antidyskinetic Drug Therapy for Pediatric Movement Disorders J Child Neurol, September 1, 1996; 11(5): 355 - 369. [Abstract] [PDF]
|
|
|
|
 |
|
 S. F. Bucher, K. C. Seelos, R. C. Dodel, W. Paulus, M. Reiser, and W. H. Oertel Pallidal Lesions: Structural and Functional Magnetic Resonance Imaging Arch Neurol, July 1, 1996; 53(7): 682 - 686. [Abstract] [PDF]
|
|