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The European Journal of Neuroscience May 2016The external globus pallidus (GPe) of the basal ganglia is in a unique and powerful position to influence processing of motor information by virtue of its widespread... (Review)
Review
The external globus pallidus (GPe) of the basal ganglia is in a unique and powerful position to influence processing of motor information by virtue of its widespread projections to all basal ganglia nuclei. Despite the clinical importance of the GPe in common motor disorders such as Parkinson's disease, there is only limited information about its cellular composition and organizational principles. In this review, recent advances in the understanding of the diversity in the molecular profile, anatomy, physiology and corresponding behaviour during movement of GPe neurons are described. Importantly, this study attempts to build consensus and highlight commonalities of the cellular classification based on existing but contentious literature. Additionally, an analysis of the literature concerning the intricate reciprocal loops formed between the GPe and major synaptic partners, including both the striatum and the subthalamic nucleus, is provided. In conclusion, the GPe has emerged as a crucial node in the basal ganglia macrocircuit. While subtleties in the cellular makeup and synaptic connection of the GPe create new challenges, modern research tools have shown promise in untangling such complexity, and will provide better understanding of the roles of the GPe in encoding movements and their associated pathologies.
Topics: Animals; Basal Ganglia; Brain Diseases; Globus Pallidus; Humans; Movement; Neural Pathways; Neurons; Subthalamic Nucleus
PubMed: 26841063
DOI: 10.1111/ejn.13196 -
The Journal of International Medical... Oct 2017Objective Deep brain stimulation (DBS) for treatment of advanced Parkinson's disease (PD) has two anatomical targets: the subthalamic nucleus (STN) and the globus... (Meta-Analysis)
Meta-Analysis Review
Objective Deep brain stimulation (DBS) for treatment of advanced Parkinson's disease (PD) has two anatomical targets: the subthalamic nucleus (STN) and the globus pallidus internus (GPI). The clinical effectiveness of these two stimulation targets was compared in the present study. Methods A systematic review and meta-analysis was performed to evaluated the postoperative changes in the United Parkinson's Disease Rating Scale (UPDRS) on- and off-phase, on-stimulation motor scores; activities of daily living score (ADLS); and levodopa equivalent dose (LED) after STN and GPI stimulation. Randomized and nonrandomized controlled trials of PD treated by STN and GPI stimulation were considered for inclusion. Results Eight published reports of eligible studies involving 599 patients met the inclusion criteria. No significant differences were observed between the STN and GPI groups in the on-medication, on-stimulation UPDRS motor score [mean difference, 2.15; 95% confidence interval (CI), -0.96-5.27] or ADLS (mean difference, 3.40; 95% CI, 0.95-7.76). Significant differences in favor of STN stimulation were noted in the off-medication, on-stimulation UPDRS motor score (mean difference, 1.67; 95% CI, 0.98-2.37) and LED (mean difference, 130.24; 95% CI, 28.82-231.65). Conclusion The STN may be the preferred target for DBS in consideration of medication reduction, economic efficiency, and motor function improvement in the off phase. However, treatment decisions should be made according to the individual patient's symptoms and expectations.
Topics: Activities of Daily Living; Aged; Deep Brain Stimulation; Dose-Response Relationship, Drug; Female; Globus Pallidus; Humans; Levodopa; Male; Middle Aged; Outcome Assessment, Health Care; Parkinson Disease; Publication Bias; Subthalamic Nucleus
PubMed: 28701061
DOI: 10.1177/0300060517708102 -
Trends in Neurosciences Aug 2021A recent article by Lilascharoen et al. identified two distinct pathways in the globus pallidus (GPe) that are associated with discrete behaviors. Dysfunctions in these...
A recent article by Lilascharoen et al. identified two distinct pathways in the globus pallidus (GPe) that are associated with discrete behaviors. Dysfunctions in these pathways were shown to underlie Parkinsonian motor and cognitive deficits in mice, and selective manipulation of these circuits rescued locomotor deficits and improved behavioral flexibility.
Topics: Animals; Cognition; Globus Pallidus; Mice; Neurons
PubMed: 34144845
DOI: 10.1016/j.tins.2021.06.001 -
Neurosurgery Clinics of North America Oct 2017Current knowledge of the functional anatomy of the subthalamic nucleus and globus pallidus, discovered through microelectrode recording and postoperative imaging,... (Review)
Review
Current knowledge of the functional anatomy of the subthalamic nucleus and globus pallidus, discovered through microelectrode recording and postoperative imaging, justifies purely anatomic targeting for deep brain stimulation (DBS). Interventional MRI (iMRI)-DBS is more anatomically accurate than traditional awake procedures and has similar clinical outcomes without increased risk or increased operative times. iMRI lead implantation allows patients to receive DBS therapy who cannot tolerate or do not agree to undergo an awake procedure. This article describes considerations for iMRI-DBS implantation in the subthalamic nucleus and globus pallidus, including patient selection, technique of electrode placement, expected outcomes, and potential complications.
Topics: Deep Brain Stimulation; Electrodes, Implanted; Globus Pallidus; Humans; Magnetic Resonance Imaging, Interventional; Subthalamic Nucleus; Treatment Outcome
PubMed: 28917282
DOI: 10.1016/j.nec.2017.05.007 -
Brain Pathology (Zurich, Switzerland) Nov 2016Huntington's disease (HD) is characterized by pronounced pathology of the basal ganglia, with numerous studies documenting the pattern of striatal neurodegeneration in... (Review)
Review
Huntington's disease (HD) is characterized by pronounced pathology of the basal ganglia, with numerous studies documenting the pattern of striatal neurodegeneration in the human brain. However, a principle target of striatal outflow, the globus pallidus (GP), has received limited attention in comparison, despite being a core component of the basal ganglia. The external segment (GPe) is a major output of the dorsal striatum, connecting widely to other basal ganglia nuclei via the indirect motor pathway. The internal segment (GPi) is a final output station of both the direct and indirect motor pathways of the basal ganglia. The ventral pallidum (VP), in contrast, is a primary output of the limbic ventral striatum. Currently, there is a lack of consensus in the literature regarding the extent of GPe and GPi neurodegeneration in HD, with a conflict between pallidal neurons being preserved, and pallidal neurons being lost. In addition, no current evidence considers the fate of the VP in HD, despite it being a key structure involved in reward and motivation. Understanding the involvement of these structures in HD will help to determine their involvement in basal ganglia pathway dysfunction in the disease. A clear understanding of the impact of striatal projection loss on the main neurons that receive striatal input, the pallidal neurons, will aid in the understanding of disease pathogenesis. In addition, a clearer picture of pallidal involvement in HD may contribute to providing a morphological basis to the considerable variability in the types of motor, behavioral, and cognitive symptoms in HD. This review aims to highlight the importance of the globus pallidus, a critical component of the cortical-basal ganglia circuits, and its role in the pathogenesis of HD. This review also summarizes the current literature relating to human studies of the globus pallidus in HD.
Topics: Cerebral Cortex; Globus Pallidus; Humans; Huntington Disease; Neural Pathways
PubMed: 27529459
DOI: 10.1111/bpa.12429 -
BMJ Case Reports Feb 2021
Topics: Brain Mapping; Globus Pallidus; Humans
PubMed: 33547109
DOI: 10.1136/bcr-2020-241088 -
Neurobiology of Disease Sep 2020Levo-dihydroxyphenylalanine (L-DOPA) is the most effective treatment for Parkinson's disease; however, most patients develop uncontrollable abnormal involuntary...
Levo-dihydroxyphenylalanine (L-DOPA) is the most effective treatment for Parkinson's disease; however, most patients develop uncontrollable abnormal involuntary movements known as L-DOPA-induced dyskinesia. L-DOPA-induced dyskinesia can be reduced by pallidotomy of the medial globus pallidus or pallidal deep brain stimulation, suggesting that the medial globus pallidus plays a significant role in the development of L-DOPA-induced dyskinesia. In the present study, the pathological changes of the medial globus pallidus in L-DOPA-induced dyskinesia were studied in rat models of Parkinson's disease (unilateral 6-hydroxydopamine lesioning) and L-DOPA-induced dyskinesia (L-DOPA injection in Parkinson's disease-model rats twice daily for 2 weeks, confirmed by display of dyskinesia-like abnormal involuntary movements). L-DOPA-induced dyskinesia-model rats displayed medial globus pallidus hypertrophy, enlarged axon terminals surrounding the dendrites of medial globus pallidus neurons, and increased density of synaptic vesicles in enlarged axon terminals on the lesioned side. Synaptic terminal enlargement reversed after discontinuation of L-DOPA. Histological studies revealed the enlarged synaptic terminals were those of GABAergic striatal (direct pathway) neurons. A single injection of L-DOPA enhanced GABA release in the medial globus pallidus on the lesioned side in L-DOPA-induced dyskinesia-model rats compared to Parkinson's disease-model rats. In addition, microinjection of muscimol, a GABA receptor agonist, into the medial globus pallidus on the lesioned side of Parkinson's disease-model rats induced dyskinesia-like abnormal involuntary movements. Microinjection of bicuculline, a GABA receptor antagonist, into the medial globus pallidus on the lesioned side alleviated L-DOPA-induced dyskinesia in Parkinson's disease-model rats that had received L-DOPA prior to the microinjection. These results indicate that priming for L-DOPA-induced dyskinesia comprises excessive GABA storage in axon terminals of the direct pathway and that expression of L-DOPA-induced dyskinesia is associated with enhanced GABA release into the medial globus pallidus after L-DOPA dosing and the resultant excessive stimulation of GABA receptors.
Topics: Animals; Antiparkinson Agents; Dyskinesia, Drug-Induced; Globus Pallidus; Levodopa; Male; Neuronal Plasticity; Neurons; Parkinsonian Disorders; Rats; Rats, Wistar; Synaptic Transmission; gamma-Aminobutyric Acid
PubMed: 32590036
DOI: 10.1016/j.nbd.2020.104979 -
International Journal of Environmental... Nov 2019: This study examined predictors of globus pallidus necrosis as there was a paucity of literature of globus pallidus necrosis resulted from carbon monoxide poisoning...
: This study examined predictors of globus pallidus necrosis as there was a paucity of literature of globus pallidus necrosis resulted from carbon monoxide poisoning after charcoal burning suicide. : A total of 67 patients who had attempted charcoal burning suicide were recruited and stratified into two subgroups based on either presence ( = 40) or absence ( = 27) of globus pallidus necrosis. Demographic, clinical, laboratory, and radiographic data were obtained for cross-sectional analysis. All patients were followed to investigate the risks for mortality. : The patients aged 36.8 ± 11.1 years (67.2%) were male. Patients with globus pallidus necrosis were younger ( = 0.044) and had less hypertension ( = 0.015) than patients without globus pallidus necrosis. Furthermore, patients with globus pallidus necrosis suffered from severer medical complications, i.e., fever ( = 0.008), acute myocardial injury ( = 0.022), acute rhabdomyolysis ( = 0.022), and neuropsychiatric symptoms ( < 0.001) than patients without globus pallidus necrosis. Moreover, patients with globus pallidus necrosis received less hyperbaric oxygen therapy than without necrosis ( = 0.024). Two patients (3.0%) died on arrival. In a multivariable regression model, it was revealed that acute myocardial injury (odds ratio 4.6, confidence interval 1.1-18.9, = 0.034) and neuropsychiatric symptoms (odds ratio 8.0, confidence interval 2.0-31.4, = 0.003), decreased blood bicarbonate level (odds ratio 0.8, confidence interval 0.7-1.0, = 0.032), and younger age (odds ratio 0.9, confidence interval 0.9-1.0, = 0.038) were significant predictors for globus pallidus necrosis. : Although patients who had attempted charcoal burning suicide had a low mortality rate (3.0%), globus pallidus necrosis was not uncommon (59.7%) in this population. Further studies are warranted.
Topics: Adult; Aged; Carbon Monoxide Poisoning; Charcoal; Cross-Sectional Studies; Female; Globus Pallidus; Humans; Incidence; Male; Middle Aged; Necrosis; Odds Ratio; Suicide, Attempted
PubMed: 31718107
DOI: 10.3390/ijerph16224426 -
Psychiatry and Clinical Neurosciences Nov 2022
Topics: Humans; Globus Pallidus; Schizophrenia; Putamen; Basal Ganglia
PubMed: 36000224
DOI: 10.1111/pcn.13465 -
Movement Disorders : Official Journal... Mar 2021
Topics: Dystonia; Dystonic Disorders; Globus Pallidus; Humans; Pallidotomy
PubMed: 33749921
DOI: 10.1002/mds.28409