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Paradox of the Basal Ganglia Model: The Antidyskinetic Effect of Surgical Lesions in Movement Disorders

  • Jose A. Obeso
  • Fernando Alonso-Frech
  • Maria Cruz Rodriguez-Oroz
  • Lazaro Alvarez
  • Raul Macias
  • Gerardo Lopez
  • Jorge Guridi
Conference paper
Part of the Advances in Behavioral Biology book series (ABBI, volume 58)

Abstract

The revitalization of pallidotomy for Parkinson’s disease (PD) provided a new opportunity to examine the effects of focal lesion of the basal ganglia and the adequacy of current pathophysiological concepts. The accumulated data, both from early surgical experiences as well as contemporary pallidotomy, established a dual, antiparkinsonian and antidyskinetic effect of a similarly placed lesion of the globus pallidum medialis (GPm). Modern studies have shown that pallidotomy induces significant improvement of movement parameters, restores thalamocortical activity, and eliminates Levodopa-induced dyskinesias without causing any major deficit of movement control. In patients with hemichorea-ballism or dystonia, pallidotomy also induce marked amelioration of the dyskinesias. These observations pose two major paradoxes for the pathophysiological model of the basal ganglia (BG) (1) Pallidotomy improves parkinsonism and eliminates dyskinesias and (2) pallidotomy does not produce overt motor or behavioral deficits.

In this article, we review the data regarding the antidyskinetic effects of pallidotomy in PD and related movement disorders and discuss a possible solution to the first paradox of the classic basal ganglia model.

Keywords

Deep Brain Stimulation Local Field Potential Generalize Dystonia Neuronal Firing Rate Antidyskinetic Effect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Jose A. Obeso
    • 1
  • Fernando Alonso-Frech
    • 1
  • Maria Cruz Rodriguez-Oroz
    • 1
  • Lazaro Alvarez
    • 1
  • Raul Macias
    • 1
  • Gerardo Lopez
    • 1
  • Jorge Guridi
    • 1
  1. 1.Neurologia-Neurociencias, Clinica Universitaria, Universidad de NavarraPamplonaSpain

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