Somatotopic organization in the internal segment of the globus pallidus in Parkinson's disease

• Type of Material: Article
• Authors: Kenneth B. Baker, Cleveland Clinic Foundation; John Y.K. Lee, University of Pennsylvania; Gaurav Mavinkurve, Cleveland Clinic Foundation; Gary S. Russo, Cleveland Clinic Foundation; Benjamin Walter, Case Western Reserve University; Mahlon DeLong, Emory University; Roy A.E. Bakay, Rush University; Jerrold L. Vitek, Cleveland Clinic Foundation
• Language: English
• Date: 2010-04-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.expneurol.2009.12.030
• Title of Journal or Parent Work: Experimental Neurology
• ISSN: 0014-4886
• Volume: 222
• Issue: 2
• Start Page: 219
• End Page: 225
• Keywords: Parkinson's disease; PRIMARY DYSTONIA; Somatotopic organization; PRIMATE SUBTHALAMIC NUCLEUS; MPTP-INDUCED PARKINSONISM; Basal ganglia; Science & Technology; Neurosciences; NEURONAL-ACTIVITY; Deep brain stimulation; PRIMARY MOTOR CORTEX; MOVEMENT-DISORDERS; Pallidotomy; Life Sciences & Biomedicine; Neurosciences & Neurology; Microelectrode; MICROELECTRODE-GUIDED PALLIDOTOMY; BASAL GANGLIA
• Research Categories: Biology, Neuroscience; Health Sciences, General; Health Sciences, Rehabilitation and Therapy

Abstract

Ablation or deep brain stimulation in the internal segment of the globus pallidus (GPi) is an effective therapy for the treatment of Parkinson's disease (PD). Yet many patients receive only partial benefit, including varying levels of improvement across different body regions, which may relate to a differential effect of GPi surgery on the different body regions. Unfortunately, our understanding of the somatotopic organization of human GPi is based on a small number of studies with limited sample sizes, including several based upon only a single recording track or plane. To fully address the three-dimensional somatotopic organization of GPi, we examined the receptive field properties of pallidal neurons in a large cohort of patients undergoing stereotactic surgery. The response of neurons to active and passive movements of the limbs and orofacial structures was determined, using a minimum of three tracks across at least two medial-lateral planes. Neurons (3183) were evaluated from 299 patients, of which 1972 (62%) were modulated by sensorimotor manipulation. Of these, 1767 responded to a single, contralateral body region, with the remaining 205 responding to multiple and/or ipsilateral body regions. Leg-related neurons were found dorsal, medial and anterior to arm-related neurons, while arm-related neurons were dorsal and lateral to orofacial-related neurons. This study provides a more detailed map of individual body regions as well as specific joints within each region and provides a potential explanation for the differential effect of lesions or DBS of the GPi on different body parts in patients undergoing surgical treatment of movement disorders.