By Daniel Tarsy, Jerrold L. Vitek, Andres M. Lozano
A panel of hugely skilled neurosurgeons, neurophysiologists, neuropsychologists, and neuroanatomists subscribe to forces to create an built-in, state-of-the-art survey the entire methodologies worthwhile for winning surgery. at the surgical part they assessment a number of strategies for Parkinson's disorder, together with thalamotomy, pallidotomy and bilateral pallidotomy, subthalamotomy, pallidal and thalamic deep mind stimulation, and subthalmic deep mind stimulation. Surgical remedy for tremor and dystonia is usually lined. at the sufferer aspect, the authors systematically learn the major matters all in favour of any surgery: sufferer choice, sufferer overview prior to and after surgical procedure, mind objective localization, and postoperative programming of mind stimulators.
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Extra resources for Surgical Treatment of Parkinson's Disease and Other Movement Disorders (Current Clinical Neurology)
The Pallidotegmental Projection The pallidotegmental fibers terminate in the PPN, which is composed of two major subdivisions, the pars compacta and the pars diffusa (114,118). Studies in monkeys indicate that more than 80% of GPi neurons projecting to the PPN send axon collaterals to the ventral thalamus (112). The PPN gives rise to descending projections to the pons, medulla, and spinal cord as well as ascending projections to the thalamus and basal ganglia (115–117). Thus, the pallidotegmental projection may be a route by which cortical information can reach lower motor and autonomic centers.
2). Striatal interneurons immunoreactive for choline acetyltransferase, parvalbumin and somatostatin, but not those containing calretinin, also receive substantial inputs from CM in monkeys (44). In rats, cholinergic neurons are a major target of thalamic inputs from PF (23,24) whereas parvalbumin-containing neurons are much less innervated by thalamic afferents (45). Whether this represents a species difference between primates and nonprimates regarding thalamic innervation of parvalbumin-containing interneurons or a difference in the postsynaptic targets of CM and PF inputs to the striatum remains to be established.
Pallidal axons arising from the sensorimotor GPi terminate in CM where they form synapses with thalamostriatal neurons projecting back to the sensorimotor territory of the striatum (30,108) (Fig. 5). In contrast, associative inputs from the GPi terminate massively in the dorsolateral extension of PF (PFdl), which does not project back to the caudate nucleus but rather innervates preferentially the precommissural region of the putamen (Fig. 5). Finally, the limbic GPi innervates selectively the rostrodorsal part of PF, which in turn projects back to the nucleus accumbens (28,32).
Surgical Treatment of Parkinson's Disease and Other Movement Disorders (Current Clinical Neurology) by Daniel Tarsy, Jerrold L. Vitek, Andres M. Lozano