Our general understanding of the function of neurons is that dendrites receive information that is relayed to the axon, where action potentials are initiated and propagated to eventually trigger neurotransmitter relea...Our general understanding of the function of neurons is that dendrites receive information that is relayed to the axon, where action potentials are initiated and propagated to eventually trigger neurotransmitter release at synaptic terminals. Although for a number of neuron types in the mammalian brain, many neuron types do not follow this classical polarity pattern. In fact, dendrites may be the site of action potentials initiation and propagation. It should be noted that convincing evidence has been obtained for the existence of dendritic action potentials in hippocampal and neocortical neurons. With regard to the dendrite potentials of thalamic neurons in general and specifically the reticular nucleus of the thalamus, it has not yet been reported. The results of this study demonstrate, for the first time, that generation of spike potentials of different amplitudes was observed in the activity of the thalamic reticular nucleus neurons. The generation of one action potential does not interfere with the generation of another, and a spike potential of smaller amplitude can occur at the ascending or descending phase of the spike potential of large amplitude. It can be argued that the spike potentials of lower amplitudes arising in the thalamic reticular nucleus neuron are of dendrite origin. Given both the strategic position and the functional purpose of the TRN, it can be assumed that the neurons of this structure must each time be discharged with spike potentials in order to carry out their modulating effect on other areas of the nervous system of the brain without leakage.展开更多
BACKGROUND The early diagnosis of basal ganglia and thalamus germinomas is often difficult due to the absence of elevated tumor markers,and atypical clinical symptoms and neuroimaging features.CASE SUMMARY Four male c...BACKGROUND The early diagnosis of basal ganglia and thalamus germinomas is often difficult due to the absence of elevated tumor markers,and atypical clinical symptoms and neuroimaging features.CASE SUMMARY Four male children aged 8 to 15 years were diagnosed with germinomas in the basal ganglia and thalamus by stereotactic biopsy from 2017 to 2019.All patients developed hemiplegia except patient 4 who also had cognitive decline,speech disturbance,nocturnal enuresis,polydipsia,polyuria,precocious puberty and abnormalities of thermoregulation.All four cases were alpha-fetoprotein and beta-human chorionic gonadotrophin(p-HCG)negative except patient 3 who had slightly elevated p-HCG in cerebrospinal fluid(CSF).No malignant cells were detected in the patients'CSF.Brain magnetic resonance imaging findings were diverse in these patients with the exception of the unique and common characteristics of ipsilateral hemisphere atrophy,especially in the cerebral peduncle.All patients were diagnosed with germinomas of the basal ganglia and thalamus by stereotactic brain biopsy.CONCLUSION Stereotactic brain biopsy is necessary to confirm the diagnosis of ectopic germinomas.Serial neuroimaging studies can not only differentiate disease but also determine the biopsy site.展开更多
Consciousness is controlled by complicated actions of various neural structures(Schiff,2010;Long et al.,2016).The thalamocortical connections between the central thalamus and cerebral cortex are considered an importan...Consciousness is controlled by complicated actions of various neural structures(Schiff,2010;Long et al.,2016).The thalamocortical connections between the central thalamus and cerebral cortex are considered an important neural structure for consciousness(Laureys et al.,2000;Schiff,2010;Jang and Lee,2015).Here,we report a patient who revealed increased thalamocortical connectivity from the affected thalamus to the unaffected hemisphere through interthalamic adhesion.展开更多
This paper introduces a two-layer network to investigate the effects of cortico-thalamic circuits on the cortex’s collective behavior.In the brain,different parts of the cortex collaborate to process information.One ...This paper introduces a two-layer network to investigate the effects of cortico-thalamic circuits on the cortex’s collective behavior.In the brain,different parts of the cortex collaborate to process information.One of the main parts,which is the path of different cortex contacts,is the thalamus whose circuit is referred to as the"vertical"cortico-thalamic connectivity.Thalamus subnuclei can participate in the processing of the information that passes through them.It has been shown that they play the functional role of logic gates(AND,OR and XOR).To study how these thalamus circuits affect the cortical neuron behavior,a two-layer network is proposed wherein the cortex layer is composed of Hindmarsh–Rose models and the thalamus layer is constructed with logic gates.Results show that considering these logic gates can lead the network towards different synchronization,asynchronization,chimera and solitary patterns.It is revealed that for AND-gate and OR-gate,increasing the number of gates or their outputs can increase and decrease the network’s coherency in excitatory and inhibitory cases,respectively.However,considering XOR-gates always results in the chimera state.展开更多
Objective To observe the distribution of acetylcholinesterase activity in the thalamus of the monkey.Methods Histochemical method was used to detect the acetylcholinesterase activity in the thalamus.Results Acetylchol...Objective To observe the distribution of acetylcholinesterase activity in the thalamus of the monkey.Methods Histochemical method was used to detect the acetylcholinesterase activity in the thalamus.Results Acetylcholinesterase was found to be inhomogeneous distribution in the primate thalamus and to reveal previously uncovered inhomogeneity within certain thalamic nuclei and their subdivisions. The medial, ventral and posterior nuclear groups displayed markedly uneven acetylcholinesterase reaction.In the mediodorsal nucleus,three distinct sbudivisions were revealed by acetylcholinesterase histochemistry, medial magnocellular part, ventral sector of central parvicellular part and dorsolateral sector of lateral pars multiformity showed weak, moderate and strong acetylcholinesterase activity, respectively. In the ventral nuclear group, acetylcholinesterase histochemistry was strong in the medial part of ventral posterior nucleus, moderate in the magnocellular part of ventral anterior, caudal, medial, oral and pars postrema parts of ventral lateral nucleus, as well as lateral part of ventral posterior nucleus, poor and weak in the inferior part of ventral posterior nucleus, par compacta of the medial part of ventral posterior nucleus and parvicellular part of ventral anterior nucleus. In the pulvinar nucleus, acetylcholinesterase reaction ranged from weak, moderate to strong in the parts of the oral, medial and lateral, as well as inferior of this nucleus, respectively. Regional variations of acetylcholinesterase activity within the thalamic nuclei and their subdivisions can help to identify them by acetylcholinesterase histochemistry. In addition, the dark patches of strong acetylcholinesterase activity contrasting with a lighter surrounding matrix were revealed within the parvicellular part and pars multiformis of mediodorsal nucleus, paracentral nucleus, central lateral nucleus, pars postrema part of ventral lateral nucleus and medial habenula nucleus, as well as medial part of pulvinar necleus, respectively.Conclusion Acetylcholinesterase histochemistry can serve as useful marker for delineating the thalamic nuclei and their sbudivisions. The different distribution of acetylcholinesterase histochemistry implies the activity of thalamic nuclei may be modulated by cholinergic systems.展开更多
Background Small subcortical infarcts account for up to 25%of ischaemic strokes.Thalamus is one of the subcortical structures that commonly manifest with lacunar infarcts on MRI of the brain.Studies have shown that th...Background Small subcortical infarcts account for up to 25%of ischaemic strokes.Thalamus is one of the subcortical structures that commonly manifest with lacunar infarcts on MRI of the brain.Studies have shown that thalamus infarction is associated with cognitive decline.However,due to the lack of proper animal models,little is known about the mechanism.We aimed to establish a focal thalamus infarction model,characterise the infarct lesion and assess functional effects.Methods Male C57BL/6J mice were anaesthetised,and Rose Bengal dye was injected through the tail vein.The right thalamus was illuminated with green laser light by stereotactic implantation of optic fibre.Characteristics of the infarct and lesion evolution were evaluated by histological analysis and 7T MRI at various times.The cognitive and neurological functions were assessed by behavioural tests.Retrograde tracing was performed to analyse neural connections.Results An ischaemic lesion with small vessel occlusion was observed in the thalamus.It became a small circumscribed infarct with reactive astrocytes accumulated in the infarct periphery on day 21.The mice with thalamic infarction demonstrated impaired learning and memory without significant neurological deficits.Retrogradely labelled neurons in the retrosplenial granular cortex were reduced.Conclusion This study established a mouse model of thalamic lacunar infarction that exhibits cognitive impairment.Neural connection dysfunctions may play a potential role in post-stroke cognitive impairment.This model helps to clarify the pathophysiology of post-stroke cognitive impairment and to develop potential therapies.展开更多
Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to ...Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is more prominent in basal ganglia than in thalamus suggesting that the activity likely results from dopaminergic depletion.While both basal ganglia and thalamus have tremor activity,the thalamus appears to play a more important role in tremor production,and basal ganglia β oscillatory activity might be the trigger.展开更多
The thalamus is the gate of the cerebral cortex, the ultimate target for the neural networks controlling behavioral states and cognitive functions. According to the reticular theory initially proposed by Moruzzi and M...The thalamus is the gate of the cerebral cortex, the ultimate target for the neural networks controlling behavioral states and cognitive functions. According to the reticular theory initially proposed by Moruzzi and Magoun, excitatory inputs from large reticular zones of the brainstem via widespread intra- and extra-thalamocortical systems finally activate the cerebral cortex to cause generalized cortical activation and wakefulness [1]. This theory proposes a central relay role to the thalamus for cortical activation as supported by early studies using neurodegeneration techniques and by the elegant work of Steriade’s group and other investigators illustrating the electrophysiological mechanisms of the thalamocortical system at the cellular level during wakefulness, rapid eye-movement sleep (REMs) and non-REM sleep (NREMs)[2].展开更多
Many research works through out the world show that the preoptic area(POA) is a region concerned with analgesia. Electric stimulation to this region could enhance markedly pain threshold and exert an analgesic effect....Many research works through out the world show that the preoptic area(POA) is a region concerned with analgesia. Electric stimulation to this region could enhance markedly pain threshold and exert an analgesic effect. Central 5-hydroxytryptamine (5-HT) plays an important role in pain mediation. Acupuncture could accelerate the synthe-展开更多
The paraventricular nucleus of the thalamus(PVT),which serves as a hub,receives dense projections from the medial prefrontal cortex(mPFC)and projects to the lateral division of central amygdala(CeL).The infralimbic(IL...The paraventricular nucleus of the thalamus(PVT),which serves as a hub,receives dense projections from the medial prefrontal cortex(mPFC)and projects to the lateral division of central amygdala(CeL).The infralimbic(IL)cortex plays a crucial role in encoding and recalling fear extinction memory.Here,we found that neurons in the PVT and IL were strongly activated during fear extinction retrieval.Silencing PVT neurons inhibited extinction retrieval at recent time point(24 h after extinction),while activating them promoted extinction retrieval at remote time point(7 d after extinction),suggesting a critical role of the PVT in extinction retrieval.In the mPFC-PVT circuit,projections from IL rather than prelimbic cortex to the PVT were dominant,and disrupting the IL-PVT projection suppressed extinction retrieval.Moreover,the axons of PVT neurons preferentially projected to the CeL.Silencing the PVT-CeL circuit also suppressed extinction retrieval.Together,our findings reveal a new neural circuit for fear extinction retrieval outside the classical IL-amygdala circuit.展开更多
The deep cerebellar nuclei(DCN)integrate various inputs to the cerebellum and form the final cerebellar outputs critical for associative sensorimotor learning.However,the functional relevance of distinct neuronal subp...The deep cerebellar nuclei(DCN)integrate various inputs to the cerebellum and form the final cerebellar outputs critical for associative sensorimotor learning.However,the functional relevance of distinct neuronal subpopulations within the DCN remains poorly understood.Here,we examined a subpopulation of mouse DCN neurons whose axons specifically project to the ventromedial(Vm)thalamus(DCNVm neurons),and found that these neurons represent a specific subset of DCN units whose activity varies with trace eyeblink conditioning(tEBC),a classical associative sensorimotor learning task.Upon conditioning,the activity of DCNVm neurons signaled the performance of conditioned eyeblink responses(CRs).Optogenetic activation and inhibition of the DCNVm neurons in well-trained mice amplified and diminished the CRs,respectively.Chemogenetic manipulation of the DCNVm neurons had no effects on non-associative motor coordination.Furthermore,optogenetic activation of the DCNVm neurons caused rapid elevated firing activity in the cingulate cortex,a brain area critical for bridging the time gap between sensory stimuli and motor execution during tEBC.Together,our data highlights DCNVm neurons’function and delineates their kinematic parameters that modulate the strength of associative sensorimotor responses.展开更多
Background:Schizophrenia(SCZ)is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure.Hemispheric asymmetries are a fundamental organizational principle of the human ...Background:Schizophrenia(SCZ)is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure.Hemispheric asymmetries are a fundamental organizational principle of the human brain and relate to human psychological and behavioral characteristics.We aimed to explore the state of thalamic lateralization of SCZ.Methods:We used voxel-based morphometry(VBM)analysis,whole-brain analysis of low-frequency fluctuations(ALFF),fractional amplitude of low-frequency fluctuations(fALFF),and resting-state seed-based functional connectivity(FC)analysis to investigate brain structural and functional deficits in SCZ.Also,we applied Pearson’’s correlation analysis to validate the correlation between Positive and Negative Symptom Scale(PANSS)scores and them.Results:Compared with healthy controls,SCZ showed increased gray matter volume(GMV)of the left thalamus(t=2.214,p=0.029),which positively correlated with general psychosis(r=0.423,p=0.010).SCZ also showed increased ALFF in the putamen,the caudate nucleus,the thalamus,fALFF in the nucleus accumbens(NAc),and the caudate nucleus,and decreased fALFF in the precuneus.The left thalamus showed significantly weaker resting-state FC with the amygdala and insula in SCZ.PANSS negative symptom scores were negatively correlated with the resting-state FC between the thalamus and the insula(r=-0.414,p=0.025).Conclusions:Collectively,these results suggest the possibility of aberrant laterality in the left thalamus and its FC with other related brain regions involved in the limbic system.展开更多
The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures i...The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.展开更多
Understanding the mechanics of consciousness remains one of the most important challenges in modern cognitive science. One key step toward understanding consciousness is to associate unconscious physiological processe...Understanding the mechanics of consciousness remains one of the most important challenges in modern cognitive science. One key step toward understanding consciousness is to associate unconscious physiological processes with subjective experiences of sensory, motor, and emotional contents. This article explores the role of various cellular membrane potential differences and how they give rise to the dynamic infrastructure of conscious experience. This article explains that consciousness is a body-wide, biological process not limited to individual organs because the mind and body are unified as one entity;therefore, no single location of consciousness can be pinpointed. Consciousness exists throughout the entire body, and unified consciousness is experienced and maintained through dynamic repolarization during inhalation and expiration. Extant knowledge is reviewed to provide insight into how differences in cellular membrane potential play a vital role in the triggering of neural and non-neural oscillations. The role of dynamic cellular membrane potentials in the activity of the central nervous system, peripheral nervous system, cardiorespiratory system, and various other tissues (such as muscles and sensory organs) in the physiology of consciousness is also explored. Inspiration and expiration are accompanied by oscillating membrane potentials throughout all cells and play a vital role in subconscious human perception of feelings and states of mind. In addition, the role of the brainstem, hypothalamus, and complete nervous system (central, peripheral, and autonomic) within the mind-body space combine to allow consciousness to emerge and to come alive. This concept departs from the notion that the brain is the only organ that gives rise to consciousness.展开更多
Most common cause of thalamic bleed is hypertension;other causes are arteriovenous malformation,aneurysm,bleeding thathesis,drugs,amyloid angiopathy,tumor etc.We present a case of Plasmodium vivax(P.vivax) malaria wit...Most common cause of thalamic bleed is hypertension;other causes are arteriovenous malformation,aneurysm,bleeding thathesis,drugs,amyloid angiopathy,tumor etc.We present a case of Plasmodium vivax(P.vivax) malaria with unusual site of bleeding i.e.left thalamus of brain.To the best of our knowledge,this is the first reported case of thalamic bleed caused by vivax malaria in absence of severe thrombocytopenia/disseminated intravascular coagulation (DIC).展开更多
AIM To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with schizophrenia.METHODS A systematic, computerised literature search was conducted in t...AIM To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with schizophrenia.METHODS A systematic, computerised literature search was conducted in the PubM ed/Medline and PsychI nfo databases. The search was performed through February 2016 without any restrictions on language or publication date. The search was performed using the following search terms: [("cogniti*" and "remediation" or "training" or "enhancement") and("fMRI" or "MRI" or "PET" or "SPECT") and(schizophrenia or schiz*)]. The search was accompanied by a manual online search and a review of the references from each of the papers selected, and those papers fulfilling our inclusion criteria were also included.RESULTS A total of 101 studies were found, but only 18 of them fulfilled the inclusion criteria. These studies indicated that cognitive remediation improves brain activation in neuroimaging studies. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Those findings are in agreement with the hypofrontality hypothesis, which proposes that frontal hypoactivation is the underlying mechanism of cognitive impairments in schizophrenia. Nonetheless,great heterogeneity among the studies was found. They presented different hypotheses, different results and different findings. The results of more recent studies interpreted cognitive recovery within broader frameworks, namely, as amelioration of the efficiency of different networks. Furthermore, advances in neuroimaging methodologies, such as the use of wholebrain analysis, tractography, graph analysis, and other sophisticated methodologies of data processing, might be conditioning the interpretation of results and generating new theoretical frameworks. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Cognitive, functional and structural improvements tended to be positively correlated.CONCLUSION Neuroimaging studies of cognitive remediation in patients with schizophrenia suggest a positive effect on brain functioning in terms of the functional reorganisation of neural networks.展开更多
BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocorti...BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocortical pathway in schizophrenia.However,the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia(TRS).AIM To identify the neural mechanisms underlying TRS,we investigated FC of thalamic sub-regions with cortical networks and voxels,and the associations of this FC with clinical symptoms.We hypothesized that the FC of thalamic subregions with cortical networks and voxels would differ between TRS patients and HCs.METHODS In total,50 patients with TRS and 61 healthy controls(HCs)matched for age,sex,and education underwent resting-state functional magnetic resonance imaging(rs-fMRI)and clinical evaluation.Based on the rs-fMRI data,we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels,and within thalamic subregions and cortical functional networks,in the patients with TRS.A functional parcellation atlas was used to segment the thalamus into nine subregions.Correlations between altered FC and TRS symptoms were explored.RESULTS We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and HCs.In addition,increased FC was observed between thalamic subregions and the sensorimotor cortex,frontal medial cortex,and lingual gyrus.These abnormalities were associated with the pathophysiology of TRS.CONCLUSION Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks,and within the thalamocortical pathway,has potential as a marker for TRS.Our findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms.展开更多
In this article, the mechanisms of central pain syndrome (CPS) are examined for the purpose of gaining insight into how a unified conscious experience arises from brain and body interaction. We provide a novel etiolog...In this article, the mechanisms of central pain syndrome (CPS) are examined for the purpose of gaining insight into how a unified conscious experience arises from brain and body interaction. We provide a novel etiology for CPS via implementation of the previously proposed 3D Default Space (3DDS) consciousness model in which consciousness and body schema arise when afferent information is processed by corticothalamic feedback loops and integrated via the thalamus. Further, we propose the mechanisms by which CPS represents deficits in dynamic interactions between afferent and efferent signaling. Modern hypotheses of CPS suggest roles for maladaptive neuroplasticity, a deafferentated somatosensory cortex and/or thalamus, and reorganization along the sensory pathways of the spinothalamic tract in the pathogenesis of the painful sensations. We propose that CPS arises when painful sensory signals originating along the maladapted and/or dysfunctional spinothalamic tract become accentuated by the dominant top down mechanisms of the brain.展开更多
Deep brain stimulation of the bilateral subthalamic nucleus(STN)is a therapeutic option for patients with Parkinson’s disease(PD)in whom medical therapies have been ineffective.This retrospective cohort study analyze...Deep brain stimulation of the bilateral subthalamic nucleus(STN)is a therapeutic option for patients with Parkinson’s disease(PD)in whom medical therapies have been ineffective.This retrospective cohort study analyzed the motor function of 27 patients with advanced PD,from the First Affiliated Hospital of Guangzhou Medical University,China,who received deep brain stimulation of the bilateral subthalamic nucleus and evaluated its therapeutic effects.The 10-year follow-up data of patients was analyzed in Qingyuan People’s Hospital,Sixth Affiliated Hospital of Guangzhou Medical University,China.The follow-up data were divided into two categories based on patients during levodopa treatment(on-medication)and without levodopa treatment(off-medication).Compared with baseline,the motor function of onmedication PD patients improved after deep brain stimulation of the bilateral subthalamic nucleus.Even 2 years later,the motor function of off-medication PD patients had improved.On-medication PD patients exhibited better therapeutic effects over the 5 years than offmedication PD patients.On-medication patients’akinesia,speech,postural stability,gait,and cognitive function worsened only after 5 years.These results suggest that the motor function of patients with advanced PD benefitted from treatment with deep brain stimulation of the bilateral subthalamic nucleus over a period up to 5 years.The overall therapeutic effects were more pronounced when levodopa treatment was combined with deep brain stimulation of the bilateral subthalamic nucleus.This study was approved by Institutional Review Board of Qingyuan People’s Hospital,The Sixth Affiliated Hospital of Guangzhou Medical University,China(approval No.QPH-IRB-A0140)on January 11,2018.展开更多
文摘Our general understanding of the function of neurons is that dendrites receive information that is relayed to the axon, where action potentials are initiated and propagated to eventually trigger neurotransmitter release at synaptic terminals. Although for a number of neuron types in the mammalian brain, many neuron types do not follow this classical polarity pattern. In fact, dendrites may be the site of action potentials initiation and propagation. It should be noted that convincing evidence has been obtained for the existence of dendritic action potentials in hippocampal and neocortical neurons. With regard to the dendrite potentials of thalamic neurons in general and specifically the reticular nucleus of the thalamus, it has not yet been reported. The results of this study demonstrate, for the first time, that generation of spike potentials of different amplitudes was observed in the activity of the thalamic reticular nucleus neurons. The generation of one action potential does not interfere with the generation of another, and a spike potential of smaller amplitude can occur at the ascending or descending phase of the spike potential of large amplitude. It can be argued that the spike potentials of lower amplitudes arising in the thalamic reticular nucleus neuron are of dendrite origin. Given both the strategic position and the functional purpose of the TRN, it can be assumed that the neurons of this structure must each time be discharged with spike potentials in order to carry out their modulating effect on other areas of the nervous system of the brain without leakage.
基金The Third Affiliated Hospital of Sun Yat-Sen University,Clinical Research Program,No.YHJH201907.
文摘BACKGROUND The early diagnosis of basal ganglia and thalamus germinomas is often difficult due to the absence of elevated tumor markers,and atypical clinical symptoms and neuroimaging features.CASE SUMMARY Four male children aged 8 to 15 years were diagnosed with germinomas in the basal ganglia and thalamus by stereotactic biopsy from 2017 to 2019.All patients developed hemiplegia except patient 4 who also had cognitive decline,speech disturbance,nocturnal enuresis,polydipsia,polyuria,precocious puberty and abnormalities of thermoregulation.All four cases were alpha-fetoprotein and beta-human chorionic gonadotrophin(p-HCG)negative except patient 3 who had slightly elevated p-HCG in cerebrospinal fluid(CSF).No malignant cells were detected in the patients'CSF.Brain magnetic resonance imaging findings were diverse in these patients with the exception of the unique and common characteristics of ipsilateral hemisphere atrophy,especially in the cerebral peduncle.All patients were diagnosed with germinomas of the basal ganglia and thalamus by stereotactic brain biopsy.CONCLUSION Stereotactic brain biopsy is necessary to confirm the diagnosis of ectopic germinomas.Serial neuroimaging studies can not only differentiate disease but also determine the biopsy site.
文摘Consciousness is controlled by complicated actions of various neural structures(Schiff,2010;Long et al.,2016).The thalamocortical connections between the central thalamus and cerebral cortex are considered an important neural structure for consciousness(Laureys et al.,2000;Schiff,2010;Jang and Lee,2015).Here,we report a patient who revealed increased thalamocortical connectivity from the affected thalamus to the unaffected hemisphere through interthalamic adhesion.
基金the research groups program(Grant No.R.G.P.2/48/42)。
文摘This paper introduces a two-layer network to investigate the effects of cortico-thalamic circuits on the cortex’s collective behavior.In the brain,different parts of the cortex collaborate to process information.One of the main parts,which is the path of different cortex contacts,is the thalamus whose circuit is referred to as the"vertical"cortico-thalamic connectivity.Thalamus subnuclei can participate in the processing of the information that passes through them.It has been shown that they play the functional role of logic gates(AND,OR and XOR).To study how these thalamus circuits affect the cortical neuron behavior,a two-layer network is proposed wherein the cortex layer is composed of Hindmarsh–Rose models and the thalamus layer is constructed with logic gates.Results show that considering these logic gates can lead the network towards different synchronization,asynchronization,chimera and solitary patterns.It is revealed that for AND-gate and OR-gate,increasing the number of gates or their outputs can increase and decrease the network’s coherency in excitatory and inhibitory cases,respectively.However,considering XOR-gates always results in the chimera state.
文摘Objective To observe the distribution of acetylcholinesterase activity in the thalamus of the monkey.Methods Histochemical method was used to detect the acetylcholinesterase activity in the thalamus.Results Acetylcholinesterase was found to be inhomogeneous distribution in the primate thalamus and to reveal previously uncovered inhomogeneity within certain thalamic nuclei and their subdivisions. The medial, ventral and posterior nuclear groups displayed markedly uneven acetylcholinesterase reaction.In the mediodorsal nucleus,three distinct sbudivisions were revealed by acetylcholinesterase histochemistry, medial magnocellular part, ventral sector of central parvicellular part and dorsolateral sector of lateral pars multiformity showed weak, moderate and strong acetylcholinesterase activity, respectively. In the ventral nuclear group, acetylcholinesterase histochemistry was strong in the medial part of ventral posterior nucleus, moderate in the magnocellular part of ventral anterior, caudal, medial, oral and pars postrema parts of ventral lateral nucleus, as well as lateral part of ventral posterior nucleus, poor and weak in the inferior part of ventral posterior nucleus, par compacta of the medial part of ventral posterior nucleus and parvicellular part of ventral anterior nucleus. In the pulvinar nucleus, acetylcholinesterase reaction ranged from weak, moderate to strong in the parts of the oral, medial and lateral, as well as inferior of this nucleus, respectively. Regional variations of acetylcholinesterase activity within the thalamic nuclei and their subdivisions can help to identify them by acetylcholinesterase histochemistry. In addition, the dark patches of strong acetylcholinesterase activity contrasting with a lighter surrounding matrix were revealed within the parvicellular part and pars multiformis of mediodorsal nucleus, paracentral nucleus, central lateral nucleus, pars postrema part of ventral lateral nucleus and medial habenula nucleus, as well as medial part of pulvinar necleus, respectively.Conclusion Acetylcholinesterase histochemistry can serve as useful marker for delineating the thalamic nuclei and their sbudivisions. The different distribution of acetylcholinesterase histochemistry implies the activity of thalamic nuclei may be modulated by cholinergic systems.
基金the Beijing Municipal Science&Technology Commission(Grant No.D171100003017002)National Key R&D Program of China(Grant No.2018YFC1312903)+1 种基金Strategic Priority Research Program of the Chinese Academy of Sciences(XDB39000000)National Science and Technology Major Project(Grant No.2017ZX09304018).
文摘Background Small subcortical infarcts account for up to 25%of ischaemic strokes.Thalamus is one of the subcortical structures that commonly manifest with lacunar infarcts on MRI of the brain.Studies have shown that thalamus infarction is associated with cognitive decline.However,due to the lack of proper animal models,little is known about the mechanism.We aimed to establish a focal thalamus infarction model,characterise the infarct lesion and assess functional effects.Methods Male C57BL/6J mice were anaesthetised,and Rose Bengal dye was injected through the tail vein.The right thalamus was illuminated with green laser light by stereotactic implantation of optic fibre.Characteristics of the infarct and lesion evolution were evaluated by histological analysis and 7T MRI at various times.The cognitive and neurological functions were assessed by behavioural tests.Retrograde tracing was performed to analyse neural connections.Results An ischaemic lesion with small vessel occlusion was observed in the thalamus.It became a small circumscribed infarct with reactive astrocytes accumulated in the infarct periphery on day 21.The mice with thalamic infarction demonstrated impaired learning and memory without significant neurological deficits.Retrogradely labelled neurons in the retrosplenial granular cortex were reduced.Conclusion This study established a mouse model of thalamic lacunar infarction that exhibits cognitive impairment.Neural connection dysfunctions may play a potential role in post-stroke cognitive impairment.This model helps to clarify the pathophysiology of post-stroke cognitive impairment and to develop potential therapies.
基金This work was supported by the National Natural Science Foundation of China(NSFC)(No.81371256,81171061,81361128012)Ministry of Education of Republic of China(BIBD-PXM2013-014226-07-000084)Seed Grant of International Alliance of Translational Neuroscience(PXM2014-014226-000015).
文摘Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is more prominent in basal ganglia than in thalamus suggesting that the activity likely results from dopaminergic depletion.While both basal ganglia and thalamus have tremor activity,the thalamus appears to play a more important role in tremor production,and basal ganglia β oscillatory activity might be the trigger.
基金supported by grants from the National Natural Science Foundation of China (81471347, 81771426, and 31500853)the Talent-Introducing Project of State Administration of Foreign Experts Affairs of China (X2017008)
文摘The thalamus is the gate of the cerebral cortex, the ultimate target for the neural networks controlling behavioral states and cognitive functions. According to the reticular theory initially proposed by Moruzzi and Magoun, excitatory inputs from large reticular zones of the brainstem via widespread intra- and extra-thalamocortical systems finally activate the cerebral cortex to cause generalized cortical activation and wakefulness [1]. This theory proposes a central relay role to the thalamus for cortical activation as supported by early studies using neurodegeneration techniques and by the elegant work of Steriade’s group and other investigators illustrating the electrophysiological mechanisms of the thalamocortical system at the cellular level during wakefulness, rapid eye-movement sleep (REMs) and non-REM sleep (NREMs)[2].
文摘Many research works through out the world show that the preoptic area(POA) is a region concerned with analgesia. Electric stimulation to this region could enhance markedly pain threshold and exert an analgesic effect. Central 5-hydroxytryptamine (5-HT) plays an important role in pain mediation. Acupuncture could accelerate the synthe-
基金This work was supported by the National Natural Science Foundation of China(31530091 and 81870912)the National Key Research and Development Program of China(2016YFC1306703)+1 种基金the Science and Technology Program of Guangdong Province,China(2018B030334001)the Collaborative Innovation Center for Cardiovascular Disease Translational Medicine,China.
文摘The paraventricular nucleus of the thalamus(PVT),which serves as a hub,receives dense projections from the medial prefrontal cortex(mPFC)and projects to the lateral division of central amygdala(CeL).The infralimbic(IL)cortex plays a crucial role in encoding and recalling fear extinction memory.Here,we found that neurons in the PVT and IL were strongly activated during fear extinction retrieval.Silencing PVT neurons inhibited extinction retrieval at recent time point(24 h after extinction),while activating them promoted extinction retrieval at remote time point(7 d after extinction),suggesting a critical role of the PVT in extinction retrieval.In the mPFC-PVT circuit,projections from IL rather than prelimbic cortex to the PVT were dominant,and disrupting the IL-PVT projection suppressed extinction retrieval.Moreover,the axons of PVT neurons preferentially projected to the CeL.Silencing the PVT-CeL circuit also suppressed extinction retrieval.Together,our findings reveal a new neural circuit for fear extinction retrieval outside the classical IL-amygdala circuit.
基金This work was supported by grants from the National Natural Science Foundation of China(81871039)the Natural Science Foundation of Chongqing Municipality(cstc2019jcyj-msxmX0424)+1 种基金the Frontier Interdisciplinary Project of the College of Basic Sciences(2020JCZX02)the Special Training Program for Undergraduates of Army Medical University(2020XBK09 and 2021XBK45).
文摘The deep cerebellar nuclei(DCN)integrate various inputs to the cerebellum and form the final cerebellar outputs critical for associative sensorimotor learning.However,the functional relevance of distinct neuronal subpopulations within the DCN remains poorly understood.Here,we examined a subpopulation of mouse DCN neurons whose axons specifically project to the ventromedial(Vm)thalamus(DCNVm neurons),and found that these neurons represent a specific subset of DCN units whose activity varies with trace eyeblink conditioning(tEBC),a classical associative sensorimotor learning task.Upon conditioning,the activity of DCNVm neurons signaled the performance of conditioned eyeblink responses(CRs).Optogenetic activation and inhibition of the DCNVm neurons in well-trained mice amplified and diminished the CRs,respectively.Chemogenetic manipulation of the DCNVm neurons had no effects on non-associative motor coordination.Furthermore,optogenetic activation of the DCNVm neurons caused rapid elevated firing activity in the cingulate cortex,a brain area critical for bridging the time gap between sensory stimuli and motor execution during tEBC.Together,our data highlights DCNVm neurons’function and delineates their kinematic parameters that modulate the strength of associative sensorimotor responses.
基金National Natural Science Foundation of China(Grant/Award Number:81701326)National Key Research and Development Program of China(Grant/Award Number:2016YFC1307004)+3 种基金Multidisciplinary Team for Cognitive Impairment of Shanxi Science and Technology Innovation Training Team(Grant/Award Number:201705D131027)Special Project of Scientific Research Plan Talents of Shanxi Provincial Health Commission(Grant/Award Number:2020081)Shanxi Provincial Science and Technology Achievements Transformation and Guidance Project(Grant/Award Numbers:201904D131020,81971601)Shanxi Province Overseas Students Science and Technology Activity Funding Project(Grant/Award Number:20200038)。
文摘Background:Schizophrenia(SCZ)is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure.Hemispheric asymmetries are a fundamental organizational principle of the human brain and relate to human psychological and behavioral characteristics.We aimed to explore the state of thalamic lateralization of SCZ.Methods:We used voxel-based morphometry(VBM)analysis,whole-brain analysis of low-frequency fluctuations(ALFF),fractional amplitude of low-frequency fluctuations(fALFF),and resting-state seed-based functional connectivity(FC)analysis to investigate brain structural and functional deficits in SCZ.Also,we applied Pearson’’s correlation analysis to validate the correlation between Positive and Negative Symptom Scale(PANSS)scores and them.Results:Compared with healthy controls,SCZ showed increased gray matter volume(GMV)of the left thalamus(t=2.214,p=0.029),which positively correlated with general psychosis(r=0.423,p=0.010).SCZ also showed increased ALFF in the putamen,the caudate nucleus,the thalamus,fALFF in the nucleus accumbens(NAc),and the caudate nucleus,and decreased fALFF in the precuneus.The left thalamus showed significantly weaker resting-state FC with the amygdala and insula in SCZ.PANSS negative symptom scores were negatively correlated with the resting-state FC between the thalamus and the insula(r=-0.414,p=0.025).Conclusions:Collectively,these results suggest the possibility of aberrant laterality in the left thalamus and its FC with other related brain regions involved in the limbic system.
基金supported by the Natural Science Foundation of Hainan Province of China,No.818MS153(to ZYC)the National Natural Science Foundation of China,No.81771200(to ZD)+2 种基金the National Key Research and Development Projects of Beijing Science and Technology Plan of China,No.Z161100002616013(to SYY)the Special Financial Grant from the China Postdoctoral Science Foundation,No.2014T70960(to ZYC)the Nursery Technology Innovation Fund of Chinese PLA General Hospital,No.12KMM39(to XYC)
文摘The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.
文摘Understanding the mechanics of consciousness remains one of the most important challenges in modern cognitive science. One key step toward understanding consciousness is to associate unconscious physiological processes with subjective experiences of sensory, motor, and emotional contents. This article explores the role of various cellular membrane potential differences and how they give rise to the dynamic infrastructure of conscious experience. This article explains that consciousness is a body-wide, biological process not limited to individual organs because the mind and body are unified as one entity;therefore, no single location of consciousness can be pinpointed. Consciousness exists throughout the entire body, and unified consciousness is experienced and maintained through dynamic repolarization during inhalation and expiration. Extant knowledge is reviewed to provide insight into how differences in cellular membrane potential play a vital role in the triggering of neural and non-neural oscillations. The role of dynamic cellular membrane potentials in the activity of the central nervous system, peripheral nervous system, cardiorespiratory system, and various other tissues (such as muscles and sensory organs) in the physiology of consciousness is also explored. Inspiration and expiration are accompanied by oscillating membrane potentials throughout all cells and play a vital role in subconscious human perception of feelings and states of mind. In addition, the role of the brainstem, hypothalamus, and complete nervous system (central, peripheral, and autonomic) within the mind-body space combine to allow consciousness to emerge and to come alive. This concept departs from the notion that the brain is the only organ that gives rise to consciousness.
文摘Most common cause of thalamic bleed is hypertension;other causes are arteriovenous malformation,aneurysm,bleeding thathesis,drugs,amyloid angiopathy,tumor etc.We present a case of Plasmodium vivax(P.vivax) malaria with unusual site of bleeding i.e.left thalamus of brain.To the best of our knowledge,this is the first reported case of thalamic bleed caused by vivax malaria in absence of severe thrombocytopenia/disseminated intravascular coagulation (DIC).
基金Supported by a grant from the Instituto de Salud Carlos Ⅲ of Fondo de Investigaciones Sanitarias FIS,No.PI 11/09158(to Penadés R)
文摘AIM To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with schizophrenia.METHODS A systematic, computerised literature search was conducted in the PubM ed/Medline and PsychI nfo databases. The search was performed through February 2016 without any restrictions on language or publication date. The search was performed using the following search terms: [("cogniti*" and "remediation" or "training" or "enhancement") and("fMRI" or "MRI" or "PET" or "SPECT") and(schizophrenia or schiz*)]. The search was accompanied by a manual online search and a review of the references from each of the papers selected, and those papers fulfilling our inclusion criteria were also included.RESULTS A total of 101 studies were found, but only 18 of them fulfilled the inclusion criteria. These studies indicated that cognitive remediation improves brain activation in neuroimaging studies. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Those findings are in agreement with the hypofrontality hypothesis, which proposes that frontal hypoactivation is the underlying mechanism of cognitive impairments in schizophrenia. Nonetheless,great heterogeneity among the studies was found. They presented different hypotheses, different results and different findings. The results of more recent studies interpreted cognitive recovery within broader frameworks, namely, as amelioration of the efficiency of different networks. Furthermore, advances in neuroimaging methodologies, such as the use of wholebrain analysis, tractography, graph analysis, and other sophisticated methodologies of data processing, might be conditioning the interpretation of results and generating new theoretical frameworks. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Cognitive, functional and structural improvements tended to be positively correlated.CONCLUSION Neuroimaging studies of cognitive remediation in patients with schizophrenia suggest a positive effect on brain functioning in terms of the functional reorganisation of neural networks.
基金Supported by the Korean Mental Health Technology R&D Project,Ministry of Health&Welfare,Republic of Korea,No.HL19C0015the Korea Health Technology R&D Project through the Korea Health Industry Development Institutefunded by the Ministry of Health&Welfare,Republic of Korea,No.HR18C0016.
文摘BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocortical pathway in schizophrenia.However,the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia(TRS).AIM To identify the neural mechanisms underlying TRS,we investigated FC of thalamic sub-regions with cortical networks and voxels,and the associations of this FC with clinical symptoms.We hypothesized that the FC of thalamic subregions with cortical networks and voxels would differ between TRS patients and HCs.METHODS In total,50 patients with TRS and 61 healthy controls(HCs)matched for age,sex,and education underwent resting-state functional magnetic resonance imaging(rs-fMRI)and clinical evaluation.Based on the rs-fMRI data,we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels,and within thalamic subregions and cortical functional networks,in the patients with TRS.A functional parcellation atlas was used to segment the thalamus into nine subregions.Correlations between altered FC and TRS symptoms were explored.RESULTS We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and HCs.In addition,increased FC was observed between thalamic subregions and the sensorimotor cortex,frontal medial cortex,and lingual gyrus.These abnormalities were associated with the pathophysiology of TRS.CONCLUSION Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks,and within the thalamocortical pathway,has potential as a marker for TRS.Our findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms.
文摘In this article, the mechanisms of central pain syndrome (CPS) are examined for the purpose of gaining insight into how a unified conscious experience arises from brain and body interaction. We provide a novel etiology for CPS via implementation of the previously proposed 3D Default Space (3DDS) consciousness model in which consciousness and body schema arise when afferent information is processed by corticothalamic feedback loops and integrated via the thalamus. Further, we propose the mechanisms by which CPS represents deficits in dynamic interactions between afferent and efferent signaling. Modern hypotheses of CPS suggest roles for maladaptive neuroplasticity, a deafferentated somatosensory cortex and/or thalamus, and reorganization along the sensory pathways of the spinothalamic tract in the pathogenesis of the painful sensations. We propose that CPS arises when painful sensory signals originating along the maladapted and/or dysfunctional spinothalamic tract become accentuated by the dominant top down mechanisms of the brain.
基金This study was supported in part by the Guangdong Medical Science Foundation of China,Nos.A2013252(to GXC),C2013024(to QMY)Guangdong Science and Technology Foundation of China,No.20120318018(to QMY).
文摘Deep brain stimulation of the bilateral subthalamic nucleus(STN)is a therapeutic option for patients with Parkinson’s disease(PD)in whom medical therapies have been ineffective.This retrospective cohort study analyzed the motor function of 27 patients with advanced PD,from the First Affiliated Hospital of Guangzhou Medical University,China,who received deep brain stimulation of the bilateral subthalamic nucleus and evaluated its therapeutic effects.The 10-year follow-up data of patients was analyzed in Qingyuan People’s Hospital,Sixth Affiliated Hospital of Guangzhou Medical University,China.The follow-up data were divided into two categories based on patients during levodopa treatment(on-medication)and without levodopa treatment(off-medication).Compared with baseline,the motor function of onmedication PD patients improved after deep brain stimulation of the bilateral subthalamic nucleus.Even 2 years later,the motor function of off-medication PD patients had improved.On-medication PD patients exhibited better therapeutic effects over the 5 years than offmedication PD patients.On-medication patients’akinesia,speech,postural stability,gait,and cognitive function worsened only after 5 years.These results suggest that the motor function of patients with advanced PD benefitted from treatment with deep brain stimulation of the bilateral subthalamic nucleus over a period up to 5 years.The overall therapeutic effects were more pronounced when levodopa treatment was combined with deep brain stimulation of the bilateral subthalamic nucleus.This study was approved by Institutional Review Board of Qingyuan People’s Hospital,The Sixth Affiliated Hospital of Guangzhou Medical University,China(approval No.QPH-IRB-A0140)on January 11,2018.
