Movement Disorders and Motor Cortex Stimulation

Abstract

Since the initial reports in the early 1990s, stimulation of the primary motor cortex (MCS) has been used to treat chronic intractable pain conditions and movement disorders. Corticobasal ganglia dysfunction is widely present in patients with movement disorders, but can be improved by methods of cortical stimulation, such as transcranial magnetic stimulation and chronic stimulation with implanted electrodes. Repetitive transcranial magnetic stimulation can lead to transient improvements in motor performance when the primary motor cortex or the supplementary motor area is targeted; and chronic electrical stimulation can improve symptoms of a variety of movement disorders, including Parkinson’s disease, tremor and post-stroke dystonia. Immediate neuromodulation could be mediated by imposition of a specific pattern of activity and suppression of abnormal, disease-associated rhythmicity of oscillations in the corticobasal ganglia-cortical circuit. Additionally, delayed clinical benefit from MCS could come from synaptic plasticity, long-term potentiation, long-term depression, and expression of secondary messengers or polarization of brain tissue.

In this chapter, we will describe the advantages and shortcoming of MCS for the treatment of movement disorders, and discuss the mechanism of action of MCS in movement disorders.

Keywords

Motor cortex Transcranial magnetic stimulation Parkinson’s disease Pain Movement disorder Motor cortex stimulation Akinesia Central sulcus Electrode 

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© Springer Japan 2016

Authors and Affiliations

  1. 1.Graduate School of MedicineOsaka UniversitySuitaJapan

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