Critical involvement of the motor cortex in the pathophysiology and treatment of Parkinson's disease

被引:110
作者
Lindenbach, David [1 ]
Bishop, Christopher [1 ]
机构
[1] SUNY Binghamton, Dept Psychol, Behav Neurosci Program, Binghamton, NY 13902 USA
基金
美国国家卫生研究院;
关键词
Parkinson's disease; Motor cortex; Supplementary motor area; Premotor cortex; Dopamine; Functional imaging; Transcranial magnetic stimulation; Deep brain stimulation; Plasticity; TRANSCRANIAL MAGNETIC STIMULATION; SUBTHALAMIC NUCLEUS STIMULATION; DEEP-BRAIN-STIMULATION; LEVODOPA-INDUCED DYSKINESIAS; DOPA-INDUCED DYSKINESIA; NEOCORTICAL MOVEMENT REPRESENTATIONS; GLOBUS-PALLIDUS STIMULATION; HIGH-FREQUENCY STIMULATION; PRIMATE CEREBRAL-CORTEX; BASAL GANGLIA;
D O I
10.1016/j.neubiorev.2013.09.008
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
This review examines the involvement of the motor cortex in Parkinson's disease (PD), a debilitating movement disorder typified by degeneration of dopamine cells of the substantia nigra. While much of PD research has focused on the caudate/putamen, many aspects of motor cortex function are abnormal in PD patients and in animal models of PD, implicating motor cortex involvement in disease symptoms and their treatment. Herein, we discuss several lines of evidence to support this hypothesis. Dopamine depletion alters regional metabolism in the motor cortex and also reduces interneuron activity, causing a breakdown in intracortical inhibition. This leads to functional reorganization of motor maps and excessive corticostriatal synchrony when movement is initiated. Recent work suggests that electrical stimulation of the motor cortex provides a clinical benefit for PD patients. Based on extant research, we identify a number of unanswered questions regarding the motor cortex in PD and argue that a better understanding of the contribution of the motor cortex to PD symptoms will facilitate the development of novel therapeutic approaches. (C) 2013 Elsevier Ltd. All rights reserved.
引用
收藏
页码:2737 / 2750
页数:14
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