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PubMed1994

Neurons projecting from the entopeduncular nucleus to the thalamus receive convergent synaptic inputs from the subthalamic nucleus and the neostriatum in the rat.

The two major afferents of the entopeduncular nucleus are the subthalamic nucleus and the neostriatum, which have opposing physiological effects on entopeduncular neurons. Experiments were performed to test the hypothesis that individual entopeduncular neurons that project to the thalamus receive convergent synaptic input from both the subthalamic nucleus and the neostriatum in the rat. This was achieved using double anterograde tracing combined with retrograde tracing. In the electron microscope anterogradely labelled subthalamic (Subthalamic Type 1) and neostriatal terminals were observed to form asymmetrical and symmetrical synaptic contacts respectively, with all parts of entopeduncular neurons. Labelled subthalamic and neostriatal terminals were observed in convergent synaptic contact with entopeduncular neurons, some of which were retrogradely labelled from the thalamus. A second rarer type of terminal was labelled (Subthalamic Type 2) which formed symmetrical synaptic contacts with the proximal regions of unlabelled and retrogradely labelled entopeduncular neurons. These terminals are believed to be derived from the globus pallidus. It is concluded that the topographical and synaptic organization of the so-called direct (neostriatum to entopeduncular nucleus) and indirect pathways (involving the subthalamus and the globus pallidus) is capable of mediating the inhibition and excitation of output neurons in the entopeduncular nucleus that occur following neostriatal stimulation.

Animals↗

PubMedDate not supplied

[Neuronal activity in the subthalamic nucleus in Parkinson disease].

INTRODUCTION: The subthalamic nucleus has been demonstrated to be involved in Parkinson's disease. Electrical stimulation of this nucleus at high frequency was proved to revert most symptoms and is used as the most advanced alternative therapy. The technique requires the recording of single cell activity as an important step in locating spatially the limits of the nucleus together with magnetic resonance imaging and ventriculography. OBJECTIVES: To study the electrophysiological properties of single cells in the subthalamus. This information is important to recognize the nucleus in the operating room so as to implant the definitive stimulating electrode. PATIENTS AND METHODS: Twelve patients with Parkinson's disease were implanted with bilateral electrodes in the subthalamic nucleus. Several neurological tests were applied during one year to study the clinical results. RESULTS: Single cell activity was recorded in both hemispheres. Three types of cells were recognized based on the mode of discharge: tonic, phasic and rhythmic. The track chosen to implant the definitive electrode was based on the higher number of cells recorded and on the response to tremor and passive or voluntary movements. The neurological tests applied demonstrated a diminution of the symptoms. CONCLUSION: The subthalamic nucleus plays an important role in handling motor and sensory information. Stimulation of the nucleus at high frequency reveals an amelioration of Parkinson's symptoms during the one year period of study.

Adult↗

PubMed2002

Dyskinesias and grip control in Parkinson's disease are normalized by chronic stimulation of the subthalamic nucleus.

Deep-brain stimulation of the subthalamic nucleus appears to reduce levodopa-induced dyskinesias, but whether this effect is caused by the reduction of the total levodopa ingestion or represents a direct effect on the motor system is unknown. Precision grip force of grasping movements and levodopa-induced dyskinesias was analyzed in 10 parkinsonian patients before and after 3 months of deep-brain stimulation of the subthalamic nucleus. Peak grip force was abnormally increased before surgery in the off-drug state and, particularly, in the on-drug state (sensitization). This grip force upregulation normalized with chronic deep-brain stimulation in both conditions (desensitization). Peak-dose dyskinesias also improved, and off-dystonia was completely abolished. Mean dosage of dopaminergic drugs was reduced, but force overflow and dyskinesias were equally improved in 2 patients without a reduction. Despite the same single levodopa test dose, force excess and levodopa-induced dyskinesias were drastically reduced after 3 months of deep-brain stimulation of the subthalamic nucleus. This indicates that direct effects of deep-brain stimulation of the subthalamic nucleus on levodopa-induced dyskinesias are likely to occur. Grip force overflow is a promising parameter to study the desensitizing effect of chronic deep-brain stimulation on levodopa-induced dyskinesias.

Dose-Response Relationship, Drug↗

PubMed2005

Reward-related neuronal activity in the subthalamic nucleus of the monkey.

The subthalamic nucleus is a key structure for motor information processing in the basal ganglia. Little is known about its involvement in other aspects of behavior such as motivation. We investigated neuronal activity in the subthalamic nucleus while a monkey performed arm-reaching movements to obtain a liquid reward. Most neurons were modulated both during the movement and reward phases of the task. The changes in activity occurring after or just before the delivery of reward consisted of either increases or decreases in firing and were not directly related to mouth movements. These findings indicate that STN neurons are involved in the detection and expectation of reward, consistent with a role for these neurons in the processing of motivational information.

Action Potentials↗

PubMed1996

Apomorphine and dopamine D(1) receptor agonists increase the firing rates of subthalamic nucleus neurons.

The present study investigated the regulation of spontaneous neuronal activity in the subthalamic nucleus by dopamine receptors using in vivo extracellular single unit recording techniques. Subthalamic nucleus neuronal firing rates were doubled by systemic administration of the nonselective dopamine receptor agonist apomorphine. The response to apomorphine was attenuated in animals anesthetized with chloral hydrate or ketamine. The dopamine D(2)/D(3) receptor agonist quinpirole did not alter subthalamic nucleus neuronal firing rates. Firing rates were increased by the D(1) receptor agonists SKF 38393 and SKF 82958 two- to three-fold; these increases were reversed by the D(1) receptor antagonist, SCH 23390. Autoradiographic studies using [(125)I]SCH 23982 indicated that D(1) family receptors were located along the ventral edge of the subthalamic nucleus and the dorsal aspect of the cerebral peduncle. Local administration of SKF 82958 into the subthalamic nucleus doubled neuronal firing rates; these increases were reversed by systemic administration of SCH 23390. Infusion of SCH 23390 into the subthalamic nucleus prevented systemic SKF 38393 from increasing the firing rates of subthalamic nucleus neurons. These results indicate that apomorphine and D(1) receptor agonists exert an excitatory influence on subthalamic nucleus neuronal activity. In addition, the excitation induced by D(1) receptor agonists appears to be mediated, at least in part, by D(1) receptors located in the vicinity of the subthalamic nucleus. The data suggest that basal ganglia output under conditions of increased dopamine receptor stimulation is influenced by the activation of excitatory subthalamic efferent pathways, as opposed to suppression of these pathways as predicted by current models of basal ganglia function.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

PubMed1995

Functional anatomy of the basal ganglia. II. The place of subthalamic nucleus and external pallidum in basal ganglia circuitry.

The subthalamic nucleus and the external pallidum (GPe) are classically viewed as part of the so-called indirect pathway, which acts in concert with the direct pathway. The direct and indirect pathways form the conceptual framework of the anatomical and functional organization of the basal ganglia. A review of recent data regarding the connections of the subthalamic nucleus and the GPe has revealed a lack of firm anatomical support for the existence of the indirect pathway. However, newly recognized projections of the subthalamic nucleus and the GPe place these structures on various novel routes that change the conceptual architecture of the basal ganglia circuitry. These new findings force us to modify our view of the functional identity of the subthalamic nucleus and the GPe. In this new perspective, the GPe stands as an additional integrative station, together with the striatum and the internal pallidum and substantia nigra pars reticulata (GPi/SNr), along the main steam of information processing within the basal ganglia circuitry. Because of its crucial position between the input and output stations of the basal ganglia, the GPe can markedly influence the neuronal computation that occurs at GPi/SNr levels. The subthalamic nucleus can still be regarded as a 'control structure' lying alongside the main stream of information processing. However, because of its widespread efferent projections, the subthalamic nucleus exerts its driving effect on most components of the basal ganglia. Its action is mediated not only by the indirect pathway, but by a multitude of mono- and polysynaptic projections that ultimately reach the basal ganglia output cells.

Afferent Pathways↗

PubMed2006

Sensory timing cues improve akinesia of grasping movements in Parkinson's disease: a comparison to the effects of subthalamic nucleus stimulation.

Five parkinsonian subjects with chronic bilateral stimulation of the subthalamic nucleus and five sex- and age-matched healthy controls grasped, lifted, and held an instrumented object. The grip-lift task was either performed at self-determined speed or in response to an auditory cuing signal. Parkinsonian subjects performed the task with subthalamic nucleus stimulation switched ON and OFF. In Parkinson's disease, stimulation of the subthalamic nucleus and the presentation of auditory timing cues improved akinesia of both the grasp and lift components of the task. The finding that auditory timing cues improve akinesia in the absence of subthalamic nucleus stimulation suggests that the basal ganglia are less involved in the control of movements made in response to environmental cues. However, subthalamic nucleus stimulation caused parkinsonian subjects to apply excessive grip forces, regardless of whether the movement was made under self-determined or externally guided speed conditions. This implies that subthalamic nucleus stimulation produces a generalized upregulation in the gain of all components of a movement without the subtlety of focused control that is required to normalize performance.

Acceleration↗

PubMed2006

Dopamine efflux in the rat striatum evoked by electrical stimulation of the subthalamic nucleus: potential mechanism of action in Parkinson's disease.

The precise mechanism whereby continuous high-frequency electrical stimulation of the subthalamic nucleus ameliorates motor symptoms of Parkinson's disease is unknown. We examined the effects of high-frequency stimulation of regions dorsal to and within the subthalamic nucleus on dopamine efflux in the striatum of urethane-anaesthetized rats using constant potential amperometry. Complementary extracellular electrophysiological studies determined the activity of subthalamic nucleus neurons in response to similar electrical stimulation of the subthalamic nucleus. High-frequency stimulation of the subthalamic nucleus increased action potential firing in the subthalamic nucleus only during the initial stimulation period and was followed by a cessation of firing over the remainder of stimulation. Electrical stimulation of the subthalamic nucleus with 15 pulses elicited stimulus-time-locked increases in striatal dopamine efflux with maximal peak effects occurring at 50 Hz frequency and 300 microA intensity. Extended subthalamic nucleus stimulation (1000 pulses at 50 Hz; 300 microA) elicited a similar peak increase in striatal dopamine efflux that was followed by a relatively lower steady-state elevation in extracellular dopamine over the course of stimulation. In contrast, extended stimulation immediately adjacent and dorsal to the subthalamic nucleus resulted in an 11-fold greater increase in dopamine efflux that remained elevated over the course of the stimulation. Immunohistochemical staining for tyrosine hydroxylase revealed catecholaminergic fibers running immediately dorsal to and through the subthalamic nucleus. Taken together, these results suggest that enhanced dopamine release within the basal ganglia may be an important mechanism whereby high-frequency stimulation of the subthalamic nucleus improves motor symptoms of Parkinson's disease.

Action Potentials↗

PubMed2005

Behavioral responses to injections of muscimol into the subthalamic nucleus: temporal changes after nigrostriatal lesions.

Changes in cellular activity in the subthalamic nucleus are a cardinal feature of Parkinson's disease and occur in rodents after lesions of the nigrostriatal pathway, a model of Parkinson's disease. GABA-ergic neurons from the globus pallidus provide a major input to the subthalamic nucleus. Previous electrophysiological studies revealed temporal changes in the activity of pallidal neurons after nigrostriatal lesions in rats. However, little is known about the impact of these changes on GABAergic transmission in the subthalamic nucleus. We have examined the behavioral responses to a local administration of the GABA A agonist muscimol into the subthalamic nucleus. Muscimol (0.01 and 0.1 microg) induced orofacial dyskinesia in normal rats; this response was blunted 2 weeks but enhanced 2 months after a unilateral lesion of the nigrostriatal pathway. The early decrease in the behavioral response occurred at a time when increased expression of mRNA for glutamic acid decarboxylase, the enzyme of GABA synthesis, and burst firing have been reported in the globus pallidus, suggesting an adaptive post-synaptic response to increased GABAergic transmission in the subthalamic nucleus. In contrast, we now show that glutamic acid decarboxylase mRNA is unchanged in the globus pallidus at the later time point, when electrophysiological changes also subside in this region. The increased behavioral response at this later time point may reflect a decreased activity in GABAergic inputs to the subthalamic nucleus. The results show time-dependent changes in behavioral responses to GABA A receptor stimulation in the subthalamic nucleus which may reflect adaptive changes in postsynaptic inhibitory responses after dopaminergic lesions.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

PubMed2005

The pallidosubthalamic projection: an anatomical substrate for nonmotor functions of the subthalamic nucleus in primates.

The subthalamic nucleus (STN) is the best target for correcting motor disability in parkinsonian patients with high-frequency stimulation. However, STN stimulation has also been reported to modify cognitive, emotional, and motivational functions. The aim of this study was to analyze the topographic organization of the STN according to its inputs coming from the sensorimotor, associative, and limbic territories of the external globus pallidus (GPe) in monkeys, with special reference to the limbic projection. Axonal tracers were injected into the different functional territories of the GPe. Injection performed in the limbic GPe resulted in labeling of cell bodies in the dorsal nucleus accumbens and in a dense labeling of axons in the anterior and medioventral portion of the STN. In comparison, injections in the associative and sensorimotor GPe led to labeling in the central and dorsolateral parts of the STN, respectively. Individual pallidosubthalamic axons ramified into numerous varicose branches, which were restricted to a given territory in the STN. These data provide a functional cartography of this structure in primates and suggest that behavioral disorders observed in stimulated parkinsonian patients could result from a dysfunction of the limbic part of the STN.

Animals↗

PubMed2000

Comparison of anatomic and neurophysiological methods for subthalamic nucleus targeting.

OBJECTIVE: The subthalamic nucleus (STN) has recently become the surgical target of choice for the treatment of medically refractory idiopathic Parkinson's disease. A number of anatomic and physiological targeting methods have been used to localize the STN. We retrospectively reviewed the various anatomic targeting methods and compared them with the final physiological target in 15 patients who underwent simultaneous bilateral STN implantation of deep brain stimulators. METHODS: The x, y, and z coordinates of our localizing techniques were analyzed for 30 STN targets. Our final targets, as determined by single-cell microelectrode recording, were compared with the following: 1) targets selected on coronal magnetic resonance inversion recovery and T2-weighted imaging sequences, 2) the center of the STN on a digitized scaled Schaltenbrand-Wahren stereotactic atlas, 3) targeting based on a point 13 mm lateral, 4 mm posterior, and 5 mm inferior to the midcommissural point, and 4) a composite target based on the above methods. RESULTS: All anatomic methods yielded targets that were statistically significantly different (P < 0.001) from the final physiological targets. The average distance error between the final physiological targets and the magnetic resonance imaging-derived targets was 2.6 +/- 1.3 mm (mean +/- standard deviation), 1.7 +/- 1.1 mm for the atlas-based method, 1.5 +/- 0.8 mm for the indirect midcommissural method, and 1.3 +/- 1.1 mm for the composite method. Once the final microelectrode-refined target was determined on the first side, the final target for the contralateral side was 1.3 +/- 1.2 mm away from its mirror image. CONCLUSION: Although all anatomic targeting methods provide accurate STN localization, a combination of the three methods offers the best correlation with the final physiological target. In our experience, direct magnetic resonance targeting was the least accurate method.

Aged↗

PubMed1999

Modifications of local cerebral metabolic rates for glucose and motor behavior in rats with unilateral lesion of the subthalamic nucleus.

Inactivation of the subthalamic nucleus (STN) has attracted interest as a therapeutic tool in Parkinson's disease. The functional consequences of the inactivation, however, are uncertain. In this study definition of the pattern of changes of cerebral functional activity associated with lesion of the STN and dopaminergic stimulation, by using the [14C]deoxyglucose method, was sought. Six or 7 days following unilateral lesion of the STN, the animals were divided into two groups: One group (n = 10) was administered apomorphine (1 mg/kg) subcutaneously; the second group (n = 10) received saline. The [14C]deoxyglucose procedure was initiated 10 minutes following the drug or saline injection. The results show that systemic administration of apomorphine to rats with unilateral lesion of the STN causes ipsiversive rotational behavior and asymmetries of glucose utilization of defined brain areas, including the substantia nigra reticulata, globus pallidus, and entopeduncular nucleus. These nuclei are the main targets of the subthalamic excitatory projections. Lesion of the nucleus per se (without challenge with apomorphine) has no significant consequences on glucose utilization. The findings indicate that the STN is involved in the activation of the basal ganglia output nuclei induced by systemic dopaminergic stimulation.

Animals↗

PubMed1987

Pharmacological study of the cortical-induced excitation of subthalamic nucleus neurons in the rat: evidence for amino acids as putative neurotransmitters.

Extracellular records were made from subthalamic nucleus neurons during microiontophoretic application of drugs and stimulation of the corticosubthalamic nucleus pathway. In 87% of the subthalamic nucleus cells, cortical stimulation induced a powerful excitation, consisting of a burst of 1-7 spikes. This projection must arise from a large area of the cortex since stimulation of nearly all the ipsilateral cortex and the rostral two-thirds of the contralateral cortex was found to influence the activity of subthalamic nucleus neurons. Experiments were undertaken in order to determine the identity of the neurotransmitter involved in the corticosubthalamic nucleus pathway. Glutamic acid diethyl ester reversibly suppressed subthalamic nucleus excitations induced by ipsi- or contralateral cortical stimulation or microiontophoretically applied glutamate. On the same cells, this compound had no effect on acetylcholine-evoked excitation and gamma-aminobutyric acid-evoked inhibition and subthalamic excitation induced by stimulation of the tegmenti pedunculopontine nucleus. Atropine at doses which antagonized the acetylcholine response, flupenthixol at dose which antagonized the dopamine response, and bicuculline at doses which antagonized the gamma-aminobutyric acid response failed to block excitations evoked by cortical stimulation and by glutamate. These experiments excluded a role for acetylcholine, dopamine and gamma-aminobutyric acid in the cortically evoked excitation of subthalamic nucleus cells. Since an amino acid seemed to play a role as neurotransmitter of the corticosubthalamic nucleus pathway, further experiments were designed to confirm these data and to determine the contribution of each amino acid receptor type in the cortical-induced excitation of subthalamic cells. All the subthalamic cells recorded were also excited by microiontophoretically applied N-methyl-D-aspartic, quisqualic and kainic acids. The cortical-evoked activation of subthalamic nucleus neurons was reversibly suppressed by kynurenic acid and cis-2,3-piperidine dicarboxylic acid, two broad-spectrum antagonists of excitatory amino acids, microiontophoretically applied at doses which also blocked excitations induced by N-methyl-D-aspartic, quisqualic and kainic acids. Application of 2-amino-5-phosphonovaleric acid inhibited excitation induced by N-methyl-D-aspartic acid but not those elicited by quisqualic or kainic acid, while glutamate excitation was only slightly affected. This compound had no effect on the cortically evoked excitation of subthalamic nucleus neurons.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholine↗

PubMed2001

Striatal dopaminergic metabolism is increased by deep brain stimulation of the subthalamic nucleus in 6-hydroxydopamine lesioned rats.

Deep brain stimulation of the subthalamic nucleus is an established therapeutic strategy for patients with Parkinson's disease. Although the exact mechanisms of action remain unknown, it is noteworthy that dopaminergic medication can be markedly reduced after neurostimulation of the subthalamic nucleus. Previously, we have shown that deep brain stimulation of the subthalamic nucleus is followed by an increase of striatal extracellular dopamine metabolites in naive rats. In the present study we examined the effects of deep brain stimulation on striatal monoamine metabolism in the intrastriatal 6-hydroxydopamine rat model of Parkinson's disease. Deep brain stimulation of the subthalamic nucleus was followed by a delayed increase of extracellular 3,4-dihydroxyphenylacetic and homovanillic whereas dopamine levels were unchanged in stimulated rats and controls. Our results indicate that deep brain stimulation of the subthalamic nucleus affects significantly striatal dopaminergic metabolism in 6-hydroxydopamine lesioned rats.

3,4-Dihydroxyphenylacetic Acid↗

PubMed1996

Effects of subthalamic nucleus lesions in a putative model of tardive dyskinesia in the rat.

The effects of bilateral excitotoxic lesions of the subthalamic nucleus on vacuous chewing movements induced by chronic neuroleptic therapy were examined in the rat. Fluphenazine decanoate (25 mg/kg i.m.q 3 weeks x 24 weeks) induced vacuous chewing movements, as previously described. This response was suppressed to control levels in animals tested 1-3 weeks following bilateral infusion of quinolinic acid (100 nmol/1 microliter per side) into the subthalamic nucleus. Subthalamic nucleus lesions resulted in increased locomotion and sniffing in neuroleptic-naive animals, but these responses were suppressed by concomitant neuroleptic treatment. As vacuous chewing movements induced by chronic neuroleptics are considered to be analogous to tardive dyskinesia in humans, our findings lend further support to the importance of the subthalamic nucleus in the regulation of orofacial movements and suggest that tardive dyskinesia may, in part, be related to altered activity in this structure. This, in turn, suggests that current models of basal ganglia function are inadequate to account for certain pathological states and require re-examination.

Animals↗

PubMed2000

Metabolic activity of excitatory parafascicular and pedunculopontine inputs to the subthalamic nucleus in a rat model of Parkinson's disease.

Using a combination of metabolic measurement and retrograde tracing, we show that the neurons in the pedunculopontine nucleus and parafascicular nucleus of the thalamus that project to the subthalamic nucleus are hyperactive after nigrostriatal dopaminergic denervation in rats. In Parkinson's disease, the loss of dopaminergic neurons induces a cascade of functional changes in the basal ganglia circuitry including a hyperactivity of the subthalamic nucleus. This hyperactivity is thought to be due to a diminution of the inhibitory pallidal influence. However, recent studies have suggested that other cerebral structures are involved in the subthalamic neuronal hyperactivity. This study was undertaken to identify these cerebral structures. Neurons projecting to the subthalamic nucleus were identified by retrograde transport of wheat germ agglutinin conjugated to horseradish peroxidase, injected into the subthalamic nucleus of rats with 6-hydroxydopamine unilateral lesion of the substantia nigra pars compacta and sham-lesioned animals. Metabolic activity was determined in the same neurons using in situ hybridization for the first subunit of cytochrome oxidase messenger RNA, a metabolic marker, and image analysis. Horseradish peroxidase-labeled neurons were found in the globus pallidus, parafascicular and pedunculopontine nucleus and sometimes in raphe nuclei and the substantia nigra pars compacta. Measurement of metabolic activity was performed for the globus pallidus, the pedunculopontine and parafascicular nuclei. The expression level of the first subunit of cytochrome oxidase messenger RNA in neurons projecting to the subthalamic nucleus was 62% higher in parafascicular neurons and 123% higher in pedunculopontine neurons in 6-hydroxydopamine-lesioned rats, compared to sham-lesioned animals. An increase was also observed in the globus pallidus, but did not reach significance. Our results suggest that hyperactivity of subthalamic neurons could be due, at least in part, to an increase of excitatory input arising from the pedunculopontine and parafascicular nuclei. These data also suggest that the latter structures may play an important role in the physiopathology of Parkinson's disease.

Animals↗

PubMed1995

Subthalamic nucleus lesions: widespread effects on changes in gene expression induced by nigrostriatal dopamine depletion in rats.

Lesions of the subthalamic nucleus block behavioral effects of nigrostriatal dopamine depletion in rats and primates, but the contribution of this region to the molecular effects of dopaminergic lesions is unknown. The effects of subthalamic nucleus lesions alone or in combination with a 6-hydroxydopamine-induced lesion of the substantia nigra were examined in adult rats. Unilateral subthalamic nucleus lesions caused ipsiversive rotation after peripheral administration of apomorphine and a small decrease in glutamic acid decarboxylase (GAD) mRNA in the ipsilateral globus pallidus (external pallidum). Confirming previous results, nigrostriatal dopaminergic lesions caused contraversive rotation after apomorphine injection, and increased enkephalin mRNA in the striatum, GAD mRNA in the globus pallidus, and somatostatin mRNA in the entopeduncular nucleus (internal pallidum) ipsilateral to the lesion. In addition, the lesion decreased substance P mRNA in the ipsilateral striatum compared to the contralateral side, and GAD mRNA in the contralateral entopeduncular nucleus. These effects were abolished in rats with lesions of the subthalamic nucleus and substantia nigra on the same side. Thus, the subthalamic lesions prevented changes in gene expression induced by dopamine depletion, not only in regions receiving a direct input from the subthalamic nucleus (ipsilateral pallidum), but also in regions which do not (striatum and contralateral pallidum). This suggests that polysynaptic pathways regulated by the subthalamic nucleus contribute to the effects of dopaminergic lesions in many regions of the basal ganglia. This pivotal role of the subthalamic nucleus may account for the beneficial effects of subthalamic nucleus lesions on motor symptoms resulting from dopamine depletion.

Animals↗

PubMed2002

Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson's disease.

Subthalamic nucleus stimulation is emerging as an effective surgical therapy for Parkinson's disease. It is considered to be a safe procedure with little morbidity, the most common complications being intracranial haemorrhage and hardware failure. We report on three cases of depression, one of whom attempted suicide after bilateral subthalamic nucleus stimulation.

Activities of Daily Living↗