Subthalamic Nucleus: Neuroanatomical Review

Discovered in 1865 by Jules Bernard Luys, the subthalamic nucleus is a set of small nuclei located in the diencephalon, inferior to the thalamus and superior to the substantia nigra, that can be visualized in a posterior coronal section. Histologically, it consists of neurons compactly distributed and filled with a large number of blood vessels and sparse myelinated fibers. This review presents an analysis of this anatomical region, considering what is most recent in the literature. Subthalamic neurons are excitatory and use glutamate as the neurotransmitter. In healthy individuals, these neurons are inhibited by nerve cells located in the side globus pallidus. However, if the fibers that make up the afferent circuit are damaged, the neurons become highly excitable, thus causing motor disturbances that can be classified as hyperkinetic, for example ballism and chorea, or hypokinetic, for example Parkinson disease (PD). The advent of deep brain stimulation has given the subthalamic nucleus great visibility. Studies reveal that the stimulation of this nucleus improves themotor symptoms of PD.

Functional Magnetic Resonance Imaging of Motor Cortex Activation in Schizophrenia

Previous fMRI studies of sensorimotor activation in schizophrenia have found in some cases hypoactivity, no difference, or hyperactivity when comparing patients with controls; similar disagreement exists in studies of motor laterality. In this multi-site fMRI study of a sensorimotor task in individuals with chronic schizophrenia and matched healthy controls, subjects responded with a right-handed finger press to an irregularly flashing visual checker board. The analysis includes eighty-five subjects with schizophrenia diagnosed according to the DSM-IV criteria and eighty-six healthy volunteer subjects. Voxel-wise statistical parametric maps were generated for each subject and analyzed for group differences; the percent Blood Oxygenation Level Dependent (BOLD) signal changes were also calculated over predefined anatomical regions of the primary sensory, motor, and visual cortex. Both healthy controls and subjects with schizophrenia showed strongly lateralized activation in the precentral gyrus, inferior frontal gyrus, and inferior parietal lobule, and strong activations in the visual cortex. There were no significant differences between subjects with schizophrenia and controls in this multi-site fMRI study. Furthermore, there was no significant difference in laterality found between healthy controls and schizophrenic subjects. This study can serve as a baseline measurement of schizophrenic dysfunction in other cognitive processes.

Diffusion Tensor Imaging: Exploring the Motor Networks and Clinical Applications

With the advances in diffusion magnetic resonance (MR) imaging techniques, diffusion tensor imaging (DTI) has been applied to a number of neurological conditions because DTI can demonstrate microstructures of the brain that are not assessable with conventional MR imaging. Tractography based on DTI offers gross visualization of the white matter fiber architecture in the human brain in vivo. Degradation of restrictive barriers and disruption of the cytoarchitecture result in changes in the diffusion of water molecules in various pathological conditions, and these conditions can also be assessed with DTI. Yet many factors may influence the ability to apply DTI clinically, so these techniques have to be used with a cautious hand.

Long lasting structural changes in primary motor cortex after motor skill learning: a behavioural and stereological study

Many motor skills, once acquired, are stored over a long time period, probably sustained by permanent neuronal changes. Thus, in this paper we have investigated with quantitative stereology the generation and persistence of neuronal density changes in primary motor cortex (MI) following motor skill learning (skilled reaching task). Rats were trained a lateralised reaching task during an "early" (22-31 days old) or "late" (362-371 days old) postnatal period. The trained and corresponding control rats were sacrificed at day 372, immediately after the behavioural testing. The "early" trained group preserved the learned skilled reaching task when tested at day 372, without requiring any additional training. The "late" trained group showed a similar capacity to that of the "early" trained group for learning the skilled reaching task. All trained animals ("early" and "late" trained groups) showed a significant inter hemispheric decrease of neuronal density in the corresponding motor forelimb representation area of MI (cortical layers II-III).

Imagens de ressonância magnética funcional em pacientes com doença de Parkinson submetidos à estimulação cerebral profunda / Functional Magnetic Resonance Imaging in patients with Parkinson’s disease with deep brain stimulation

A estimulação cerebral profunda (ECP) é usada para tratar a doença de Parkinson (DP) avançada. A estimulação do núcleo subtalâmico (NST) melhora o sintomas de parkinsonismo, mas seu mecanismo de ação permanece pouco compreendido. Dados comportamentais durante o exame e a evolução clínica foram analisados. RESULTADOS: Os pacientes não apresentaram complicações decorrentes dos exames de RMf. Com o estímulo elétrico ligado, nas sequências BL houve maior atividade em relação às RE, na área sensitivo-motora primária (SM1) esquerda. Durante o repouso, quando a estimulação elétrica foi ligada houve maior atividade das seguintes áreas: cerebelo direito, SM1 esquerda, Cgp, pM bilateral, mesencéfalo esquerdo e Cga. Houve melhora clínica dos pacientes e tanto a avaliação motora na primeira semana pós-operatória, na fase sem medicação, bem como a avaliação global em seis meses estiveram correlacionadas com os parâmetros motores aferidos durante os exames de RMf / Deep brain stimulation (DBS) is used to treat advanced Parkinson's disease (PD). Stimulation of the subthalamic nucleus (STN) is effective to improve the symptoms related to parkinsonism, but its mechanism of action remains poorly understood. Functional magnetic resonance imaging (fMRI) can be applied to study brain areas involved in motor activity, as a mean to better understand the effects of DBS. In this work we aimed to develop and test fMRI techniques to study DP patients treated with DBS. METHODS: We have initially performed tests to check the interference of the DBS in image quality and made adaptations that minimized the artifacts. After this initial phase PD patients were examined by fMRI in four different phases: during right hand movement (before surgery to implant DBS electrodes, after the surgery with the electrical stimulation turned off, and after the surgery with the electrical stimulation turned on the STN) and at rest with electrical stimulation turned on. In total, ten patients were examined, eight of them paired to matched normal volunteers...

Localization of sensorimotor cortex by using functional magnetic resonance imaging: comparison between finger tapping and palm scratching in normal volunteer.

The purpose of this study was to compare the location and intensity of activation of the sensorimotor cortex between finger tapping and palm scratching paradigms in normal volunteers and to consider using passive task instead of motor task in patients who are unable to perform motor task. Multishot echo-planar T2*-weighted imaging sequences at the level of the sensorimotor cortex were performed in axial plane during finger tapping and palm scratching paradigms in 13 normal volunteers. The authors found that the location of activation was slightly posterior only in bilateral passive task compared to bilateral motor task but there was no statistical significance. However, this observation was not seen in unilateral tasks. The intensity of activation of both motor and passive tasks was comparable. The authors conclude that in normal volunteers passive task (palm scratching) can be used instead of motor task (finger tapping) to localize the location of the sensorimotor cortex.

Functional magnetic resonance imaging of the primary motor cortex in humans: response to increased functional demands.

Functional magnetic resonance imaging (fMRI) studies have been performed on 20 right handed volunteers at 1.5 Tesla using echo planar imaging (EPI) protocol. Index finger tapping invoked localized activation in the primary motor area. Consistent and highly reproducible activation in the primary motor area was observed in six different sessions of a volunteer over a period of one month. Increased tapping rate resulted in increase in the blood oxygenation level dependent (BOLD) signal intensity as well as the volume/area of activation (pixels) in the contralateral primary motor area up to tapping rate of 120 taps/min (2 Hz), beyond which it saturates. Activation in supplementary motor area was also observed. The obtained results are correlated to increased functional demands.