Related Experiment Videos
Neuronal activity in the globus pallidus in chorea caused by striatal lacunar infarction
T Hashimoto1, H Morita, T Tada
1Third Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan. takahhh@hsp.md.shinshu-u.ac.jp
Insights
Pallidotomy effectively treated hemichorea caused by striatal infarction. Lesions in the globus pallidus reduced limb chorea, suggesting a somatotopic organization for chorea pathways.
Area of Science:
- Neuroscience
- Neurosurgery
- Movement Disorders
Background:
- Hemichorea can result from striatal lesions, impacting motor control.
- Understanding the neural circuitry of chorea is crucial for effective treatment.
Observation:
- A patient with hemichorea underwent pallidotomy.
- Neurosurgical lesions in the medial and lateral globus pallidus reduced and eliminated, respectively, lower and upper limb chorea.
Findings:
- The globus pallidus showed low, irregular neuronal firing rates in this chorea patient, differing from Parkinson's patients.
- Chorea associated with striatal infarction appears driven by low-rate, phasic globus pallidus activity.
Implications:
- The globus pallidus exhibits functional somatotopic organization for chorea pathways.
- Pallidotomy offers a potential therapeutic strategy for specific types of chorea.
- This study provides insights into the pathophysiology of movement disorders originating in the basal ganglia.
Abstract:
Pallidotomy was performed in a patient with hemichorea caused by lacunar infarction in the striatum. Chorea in the lower limb was reduced after a neurosurgical lesion in the medial portion of the sensorimotor territory of the internal segment of the globus pallidus, and chorea in the upper limb disappeared after an additional lesion in the lateral portion of that same area. Intraoperative neuronal recording revealed that mean firing rates were low, and that firing was irregular in the globus pallidus compared with off-state parkinsonian patients. These results suggest that chorea with striatal infarction is driven by phasic neuronal activity with a low firing rate in the globus pallidus and that the neural pathway of chorea has a functional somatotopical organization in the globus pallidus.