Neuronal activity in the basal ganglia in patients with generalized dystonia and hemiballismus

Jerrold L. Vitek, Vijay Chockkan, Jian Yu Zhang, Yoshiki Kaneoke, Marion Evatt, Mahlon R. DeLong, Shirley Triche, Klaus Mewes, Takao Hashimoto, Roy A.E. Bakay

Research output: Contribution to journalArticle

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Abstract

Microelectrode recording was performed in the basal ganglia of 3 patients with generalized dystonia and 1 patient with hemiballismus secondary to a brainstem hemorrhage. Neuronal activity was recorded from the internal and external segments of the globus pallidus and assessed for mean discharge rate and pattern of spontaneous activity. The responses of neurons in the internal segment of the globus pallidus to passive and active movements were also evaluated. Mean discharge rates of neurons in both segments of the pallidum in patients with dystonia and the patient with hemiballismus were considerably lower than those reported for patients with idiopathic Parkinson's disease. In addition, the pattern of spontaneous neuronal activity was highly irregular, occurring in intermittent grouped discharges separated by periods of pauses. Although receptive fields in the dystonia patients were widened and less specific than those reported in normal monkeys, neuronal responses to movement were uncommon in the hemiballismus patient. Before surgery, patients with dystonia experienced abnormal posturing and involuntary movements. Coactivation of agonist-antagonist muscle groups was observed both at rest and during the performance of simple movements. After pallidotomy there was a significant reduction in the involuntary movement associated with these disorders and a more normal pattern of electromyographic activity during rest and movement. Given the improvement in dystonic and hemiballistic movements in these patients after ablation of the sensorimotor portion of the internal segment of the globus pallidus, we suggest that pallidotomy can be an effective treatment for patients with dystonia and also for patients with medically intractable hemiballismus. Based on the finding of decreased neuronal discharge rates in pallidal neurons, we propose that physiologically dystonia most closely resembles a hyperkinetic movement disorder. A model for dystonia is proposed that incorporates the observed changes in the rate and pattern of neuronal activity in the pallidum with data from neuroimaging with positron emission tomography and 2-deoxyglucose studies.

Original languageEnglish (US)
Pages (from-to)22-35
Number of pages14
JournalAnnals of Neurology
Volume46
Issue number1
DOIs
StatePublished - Jul 17 1999

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Dystonia
Dyskinesias
Basal Ganglia
Globus Pallidus
Pallidotomy
Neurons
Hyperkinesis
Deoxyglucose
Movement Disorders
Microelectrodes
Neuroimaging
Positron-Emission Tomography
Brain Stem
Haplorhini
Parkinson Disease
Hemorrhage

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Neuronal activity in the basal ganglia in patients with generalized dystonia and hemiballismus. / Vitek, Jerrold L.; Chockkan, Vijay; Zhang, Jian Yu; Kaneoke, Yoshiki; Evatt, Marion; DeLong, Mahlon R.; Triche, Shirley; Mewes, Klaus; Hashimoto, Takao; Bakay, Roy A.E.

In: Annals of Neurology, Vol. 46, No. 1, 17.07.1999, p. 22-35.

Research output: Contribution to journalArticle

Vitek, JL, Chockkan, V, Zhang, JY, Kaneoke, Y, Evatt, M, DeLong, MR, Triche, S, Mewes, K, Hashimoto, T & Bakay, RAE 1999, 'Neuronal activity in the basal ganglia in patients with generalized dystonia and hemiballismus', Annals of Neurology, vol. 46, no. 1, pp. 22-35. https://doi.org/10.1002/1531-8249(199907)46:1<22::AID-ANA6>3.0.CO;2-Z
Vitek, Jerrold L. ; Chockkan, Vijay ; Zhang, Jian Yu ; Kaneoke, Yoshiki ; Evatt, Marion ; DeLong, Mahlon R. ; Triche, Shirley ; Mewes, Klaus ; Hashimoto, Takao ; Bakay, Roy A.E. / Neuronal activity in the basal ganglia in patients with generalized dystonia and hemiballismus. In: Annals of Neurology. 1999 ; Vol. 46, No. 1. pp. 22-35.
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