Subthalamic nucleus and its connections
Anatomic substrate for the network effects of deep brain stimulation
Abstract
GLOSSARY: GP = globus pallidus; GPe = external segment of the globus pallidus; GPi = internal segment of the globus pallidus; PD = Parkinson disease; PPT = pedunculopontine tegmental nucleus; SNc = substantia nigra pars compacta; SNr = substantia nigra pars reticulata; STN = subthalamic nucleus.
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Published online: May 19, 2008
Published in issue: May 20, 2008
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Benarroch's review on the anatomical connections of the subthalamic nucleus (STN) and their clinical correspondences does not mention the interhemispheric relays between the STN with the contralateral STN or other basal ganglia. [1]
We reported bilateral ballism following unilateral STN infarction and interpreted our findings with respect to the bilateral interconnections of the STN. [2] We noted the tendency among contemporary reviews to omit discussing interhemispheric relays of the STN.
Our study provided several references for these interhemispheric connections and their basic neuroscience and clinical relevance, including deep-brain stimulation. I believe a clinico-anatomical discussion of the STN is incomplete without referring to its interhemispheric connections.
References
1. Benarroch EE. Subthalamic nucleus and its connections: Anatomic substrate for the network effects of deep brain stimulation [review]. Neurology 2008;70:1991-1995.
2. Mark VW, Oberheu AM, Henderson C, Woods AJ. Ballism following stroke responds to simple therapeutic interventions. Arch Phys Med Rehabil 2005;86:1226-1233. Disclosures: The author has no disclosures
I appreciate Dr. Mark's comments on my short review where I focused on subthalamic nucleus connections that have been best characterized in experimental animals using modern neuroanatomical techniques.
However, this does not exclude the presence and potential functional significance of commissural subthalamic nucleus connections, as reported by Mark et al. [2]
I appreciate Dr Mark's emphasizing the potential significance of these connections for the effects of deep brain stimulation and rehabilitation techniques.
Disclosures: The author has no disclosures