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Physiology of Basal Ganglia Disorders: An Overview

Published online by Cambridge University Press:  18 September 2015

Mark Hallett
Mark Hallett*
Affiliation:
Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
*
Clinical Director, NINDS, National Institutes of Health, Building 10, Room 5N226, Bethesda, Maryland 20892, USA
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Abstract:

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The pathophysiology of the movement disorders arising from basal ganglia disorders has been uncertain, in part because of a lack of a good theory of how the basal ganglia contribute to normal voluntary movement. An hypothesis for basal ganglia function is proposed here based on recent advances in anatomy and physiology. Briefly, the model proposes that the purpose of the basal ganglia circuits is to select and inhibit specific motor synergies to carry out a desired action. The direct pathway is to select and the indirect pathway is to inhibit these synergies. The clinical and physiological features of Parkinson's disease, L-DOPA dyskinesias, Huntington's disease, dystonia and tic are reviewed. An explanation of these features is put forward based upon the model.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 20 , Issue 3 , August 1993 , pp. 177 - 183
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

References

REFERENCES

1.Marsden, CD. The mysterious motor function of the basal ganglia. Neurology 1982; 32: 514–539.CrossRefGoogle ScholarPubMed
2.Hallett, M. Long-latency reflexes. In: Quinn, NP, Jenner, PG, eds. Disorders of Movement. London: Academic Press, 1989: 529–541.Google Scholar
3.Playford, ED, Jenkins, IH, Passingham, RE, Nutt, J, Frackowiak, RSJ, et al.Impaired mesial frontal and putamen activation in Parkinson's disease: a positron emission tomography study. Ann Neurol 1992; 32: 151–161.CrossRefGoogle ScholarPubMed
4.Jenkins, IH, Fernandez, W, Playford, ED, Lees, AJ, Frackowiak, RSJ, et al.Impaired activation of the supplementary motor area in Parkinson's disease is reversed when akinesia is treated with apomorphine. Ann Neurol 1992; 32: 749–757.CrossRefGoogle ScholarPubMed
5.Rossini, PM, Babiloni, F, Bernardi, G, Cecchi, L, Johnson, PB, et al.Abnormalities of short-latency somatosensory evoked potentials in parkinsonian patients. Electroencephalogr Clin Neurophysiol 1989; 74: 277–289.CrossRefGoogle ScholarPubMed
6.Rossini, P, Boccasena, P, Passarelli, F, Traversa, R, Pacifici, L, et al.Frontal SEP changes in Parkinsonian patients during apomorphine test. Abstracts of IX International Congress of Electromyography and Clinical Neurophysiology, Jerusalem, Israel, June 8-12, 1992: 359.Google Scholar
7.Hallett, M, Ravits, J. Involuntary movements. In: Asbury, AK, McKhann, GM, McDonald, WI, eds. Diseases of the Nervous System. Clinical Neurobiology. Philadelphia: W.B. Saunders, 1986: 452–460.Google Scholar
8.Thompson, PD, Berardelli, A, Rothwell, JC, Day, BL, Dick, JP, et al.The coexistence of bradykinesia and chorea in Huntington's disease and its implications for theories of basal ganglia control of movement. Brain 1988; 111: 223–244.CrossRefGoogle ScholarPubMed
9.Dubinsky, RM, Greenberg, M, DiChiro, G, Baker, M, Hallett, M. Hemiballismus: study of a case using positron emission tomography with 18fluoro-2-deoxyglucose. Mov Disord 1989; 4: 310–319.CrossRefGoogle ScholarPubMed
10.Tatton, WG, Bedingham, W, Verrier, MC, Blair, RD. Characteristic alterations in responses to imposed wrist displacements in parkinsonian rigidity and dystonia musculorum deformans. Can J Neurol Sci 1984; 11: 281–287.CrossRefGoogle ScholarPubMed
11.Rothwell, JC, Obeso, JA, Day, BL, Marsden, CD. Pathophysiology of dystonias. Adv Neurol 1983; 39: 851–863.Google ScholarPubMed
12.Herz, E. Dystonia. Historical review: analysis of dystonic symptoms and physiologic mechanisms involved. Arch Neurol Psychiatry 1944; 51: 305–318.CrossRefGoogle Scholar
13.Yanagisawa, N, Goto, A. Dystonia musculorum defonnans, analysis with electromyography. J Neurol Sci 1971; 13: 39–65.CrossRefGoogle ScholarPubMed
14.Hughes, M, McLellan, DL. Increased co-activation of the upper limb muscles in writer's cramp. J Neurol Neurosurg Psychiatry 1985; 48: 782–787.CrossRefGoogle ScholarPubMed
15.Cohen, G, Hallett, M. Hand cramps: clinical features and electromyographic patterns in a focal dystonia. Neurology 1988; 38: 1005–1012.CrossRefGoogle Scholar
16.Day, BL, Marsden, CD, Obeso, JA, Rothwell, JC. Reciprocal inhibition between the muscles of the human forearm. J Physiol (Lond) 1984; 349: 519–534.CrossRefGoogle ScholarPubMed
17.Berardelli, A, Day, BL, Marsden, CD, Rothwell, JC. Evidence favoring presynaptic inhibition between antagonist muscle afferents in the human forearm. J Physiol (Lond) 1987; 39: 71–83.CrossRefGoogle Scholar
18.Panizza, M, Hallett, M, Nilsson, J. Reciprocal inhibition in patients with hand cramps. Neurology 1989; 39: 85–89.CrossRefGoogle ScholarPubMed
19.Panizza, M, Lelli, S, Nilsson, J, Hallett, M. H-reflex recovery curve and reciprocal inhibition of H-reflex in different kinds of dystonia. Neurology 1990; 40: 824–828.CrossRefGoogle ScholarPubMed
20.Nakashima, K, Rothwell, JC, Day, BL, Thompson, PD, Shannon, K, et al.Reciprocal inhibition in writer's and other occupational cramps and hemiparesis due to stroke. Brain 1989; 112: 681–697.CrossRefGoogle ScholarPubMed
21.Berardelli, A, Rothwell, JC, Day, BL, Marsden, CD. Pathophysiology of blepharospasm and oromandibular dystonia. Brain 1985; 108: 593–608.CrossRefGoogle ScholarPubMed
22.Cohen, LG, Ludlow, CL, Warden, M, Estegui, M, Agostino, R, et al.Blink reflex excitability recovery curves in patients with spasmodic dysphonia. Neurology 1989; 39: 572–577.CrossRefGoogle ScholarPubMed
23.Topka, H, Hallett, M. Perioral reflexes in orofacial dyskinesia and spasmodic dysphonia. Muscle Nerve 1992; 15: 1016–1022.CrossRefGoogle ScholarPubMed
24.Nakashima, K, Thompson, PD, Rothwell, JC, Day, BL, Stell, R, et al.An exteroceptive reflex in the sternocleidomastoid muscle produced by electrical stimulation of the supraorbital nerve in normal subjects and patients with spasmodic torticollis. Neurology 1989; 39: 1354–1358.CrossRefGoogle ScholarPubMed
25.Lelli, S, Panizza, M, Hallett, M. Spinal cord inhibitory mechanisms in Parkinson's disease. Neurology 1991; 41: 553–556.CrossRefGoogle ScholarPubMed
26.Reilly, JA, Hallett, M, Cohen, LG, Tarkka, IM, Dang, N. The N30 component of somatosensory evoked potentials in patients with dystonia. Electroencephalogr Clin Neurophysiol 1992; 84: 243–247.CrossRefGoogle ScholarPubMed
27.Playford, ED, Passingham, RE, Marsden, CD, Brooks, DJ. Abnormal activation of striatum and dorsolateral prefrontal cortex in dystonia [abstract]. Neurology 1992; 42 (Suppl 3): 377.Google Scholar
28.Lang, A. Patient perception of tics and other movement disorders. Neurology 1991; 41: 223–228.CrossRefGoogle ScholarPubMed
29.Obeso, JA, Rolhwell, JC, Marsden, CD. Simple tics in Gilles de la Tourette's syndrome are not prefaced by a normal premovement potential. J Neurol Neurosurg Psychiatry 1981; 44: 735–738.CrossRefGoogle ScholarPubMed
30.Glaze, DG, Frost, JD, Jankovic, J. Sleep in Gilles de la Tourette's syndrome: disorder of arousal. Neurology 1983; 33: 586–592.CrossRefGoogle ScholarPubMed
31.Shapiro, E, Shapiro, AK, Fulop, G, Hubbard, M, Mandeli, J, et al.Controlled study of haloperidol, pimozide and placebo for the treatment of Gilles de la Tourette's syndrome. Arch Gen Psychiatry 1989; 46: 722–730.CrossRefGoogle ScholarPubMed
32.Borcherding, BG, Keysor, CS, Rapoport, JL, Elia, J, Amass, J. Motor/vocal tics and compulsive behaviors on stimulant drugs: is there a common vulnerability? Psychiatry Res 1990; 33: 83–94.CrossRefGoogle Scholar
33.Singer, HS, Walkup, JT. Tourette syndrome and other tic disorders. Diagnosis, pathophysiology, and treatment. Medicine (Baltimore) 1991; 70: 15–32.CrossRefGoogle ScholarPubMed
34.Stone, LA, Jankovic, J. The coexistence of tics and dystonia. Arch Neurol 1991; 48: 862–865.CrossRefGoogle ScholarPubMed
35.Alexander, GE, Crutcher, MD. Functional achitecture of basal ganglia circuits: neural substrates of parallel processing. Trends Neurosci 1990; 13: 266–271.CrossRefGoogle Scholar
36.Chevalier, G, Deniau, JM. Disinhibition as a basic process in the expression of striatal function. Trends Neurosci 1990; 13: 277–280.CrossRefGoogle Scholar
37.Hallett, M, Khoshbin, S. A physiological mechanism of bradykinesia. Brain 1980; 103: 301–314.CrossRefGoogle ScholarPubMed
38.Kelland, MD, Asdourian, D. Pedunculopontine tegmental nucleus-induced inhibition of muscle activity in the rat. Behav Brain Res 1989; 34: 213–234.CrossRefGoogle ScholarPubMed
39.Penney, JB Jr, Young, AB. Speculations on the functional anatomy of basal ganglia disorders. Annu Rev Neurosci 1983; 6: 73–94.CrossRefGoogle ScholarPubMed
40.Miller, WC, DeLong, MR. Parkinsonian symptomatology. An anatomical and physiological analysis. Ann NY Acad Sci 1988; 515: 287–302.Google ScholarPubMed
41.DeLong, MR. Primate models of movement disorders of basal ganglia origin. Trends Neurosci 1990; 13: 281–285.CrossRefGoogle ScholarPubMed
42.Mitchell, IJ, Jackson, A, Sambrook, MA, Crossman, AR. The role of the subthalamic nucleus in experimental chorea. Brain 1989; 112: 1533–1548.CrossRefGoogle ScholarPubMed
43.Burton, K, Farrell, K, Li, D, Calne, DB. Lesions of the brain and dystonia: CT and magnetic resonance imaging. Neurology 1984; 34: 962–965.CrossRefGoogle ScholarPubMed